Abstract
We review all cases of gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae (PPNG) seen between 1976 and 1983 at the sexually transmitted disease (STD) clinic of this hospital, which accounted for 11% of all such cases reported in that period in the United Kingdom. While the overall incidence of gonorrhoea remained relatively stable in this clinic, that of PPNG rose to 4.4% of all such cases by 1982. Until last year, 75% of these cases were imported, mainly from Nigeria and Ghana, but a marked change was seen in the second half of 1982, when 71% of cases were indigenous in origin. Casual partners and prostitutes in London were mentioned as the source of infection by 34% of patients, a much higher percentage than that seen previously. Such sources are notoriously difficult to trace and these figures show a very disturbing trend. Although rectal infection tends to be asymptomatic, PPNG was isolated in rectal cultures from two of five homosexuals and 19 of 26 women. There is therefore a risk that PPNG could spread rapidly through the homosexual population. We suggest that spectinomycin should no longer be the first drug of choice in the treatment of gonorrhoea caused by PPNG but should be replaced by the newer cephalosporins.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Arya O. P., Rees E., Percival A., Alergant C. D., Annels E. H., Turner G. C. Epidemiology and treatment of gonorrhoea caused by penicillinase-producing strains in Liverpool. Br J Vener Dis. 1978 Feb;54(1):28–35. doi: 10.1136/sti.54.1.28. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ashford W. A., Golash R. G., Hemming V. G. Penicillinase-producing Neisseria gonorrhoeae. Lancet. 1976 Sep 25;2(7987):657–658. doi: 10.1016/s0140-6736(76)92467-3. [DOI] [PubMed] [Google Scholar]
- Easmon C. S., Ison C. A., Bellinger C. M., Harris J. W. Emergence of resistance after spectinomycin treatment for gonorrhoea due to beta-lactamase producing strain of Neisseria gonorrhoeae. Br Med J (Clin Res Ed) 1982 May 29;284(6329):1604–1605. doi: 10.1136/bmj.284.6329.1604. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ellis C. J., Eykyn S. J., Watkins P., Bell M., Geddes A. M. Malaria in Birmingham and a London teaching hospital. Br Med J. 1979 Feb 10;1(6160):385–388. doi: 10.1136/bmj.1.6160.385. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Evans A. J. Relapse of gonorrhoea after treatment with penicillin or streptomycin. Br J Vener Dis. 1966 Dec;42(4):251–262. doi: 10.1136/sti.42.4.251. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McCutchan J. A., Adler M. W., Berrie J. R. Penicillinase-producing Neisseria gonorrhoeae in Great Britain, 1977-81: alarming increase in incidence and recent development of endemic transmission. Br Med J (Clin Res Ed) 1982 Jul 31;285(6338):337–340. doi: 10.1136/bmj.285.6338.337. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McManus T. J., Harris J. R., Ison C. A., Easmon C. S. Penicillinase-producing Neisseria gonorrhoeae. N Engl J Med. 1982 Dec 30;307(27):1706–1706. doi: 10.1056/NEJM198212303072712. [DOI] [PubMed] [Google Scholar]
- Morrison G. D., Evans A. J., Haskins H. W., Lewis N. M., Seale G. H., Mayall E., Mullinger B. M. Cefuroxime compared with penicillin for the treatment of gonorrhea. Sex Transm Dis. 1980 Oct-Dec;7(4):188–190. doi: 10.1097/00007435-198010000-00009. [DOI] [PubMed] [Google Scholar]
- Phillips I. Beta-lactamase-producing, penicillin-resistant gonococcus. Lancet. 1976 Sep 25;2(7987):656–657. doi: 10.1016/s0140-6736(76)92466-1. [DOI] [PubMed] [Google Scholar]
- Phillips I., Humphrey D., Middleton A., Nicol C. S. Diagnosis of gonorrhoea by culture on a selective medium containing vancomycin, colistin, nystatin and trimethoprim (VCNT). A comparison with Gram-staining and immunofluorescence. Br J Vener Dis. 1972 Aug;48(4):287–292. doi: 10.1136/sti.48.4.287. [DOI] [PMC free article] [PubMed] [Google Scholar]