Table 3.
Reports from Japan of Neisseria gonorrhoeae isolates with elevated MICs to third-generation cephalosporins.
| Author, publication year | Location | Year of Specimen Collection | Criteria and Number of isolates assessed | Cephalosporin MICs mg/L (range) | Comment |
|---|---|---|---|---|---|
| Japan | |||||
| Yamaguchi 1998105 | Several Areas of Japan | 1991 and 1996 | All isolates: 27 |
Cefpodoxime MIC90=4 Cefditoren MIC90=4 |
In vitro study of investigational antimicrobial. |
| Akasaka 2001104 | Kitakyushu | 1999 | Cefdinir Treatment Failure: 2 |
Cefpodoxime MIC = 4 Cefdinir MIC = 1 Ceftriaxone MIC=0.125 |
Case report. |
| Muratani 2001106 | Kitakyushu | 1999 | Cefozopran ≥ 8: 17 of 54 |
For 17 isolates: Ceftriaxone MIC90=0.125 (0.03–0.25) Cefpodoxime MIC90=4 (0.5–4) Cefixime MIC90=0.5 (0.125–0.5) |
|
| Ito 2004107 | Central Japan | 1999–2000 2001 2002 |
Cefixime ≥0.5: 0 of 91 39 of 150 67 of 221 |
1999: Cefixime MIC90 = 0.06 (≤0.004–0.125) Ceftriaxone MIC90 = 0.03 (≤0.004–0.06) 2002: Cefixime MIC90 = 0.5 (≤0.004–2) Ceftriaxone MIC90 = 0.06 (≤0.004–0.5) |
Emerging cefixime resistance. |
| Ameyama 2002108 | Tokyo | 2000 2001 |
Cefixime ≥ 0.25: 9 of 53 4 of 24 |
2000 and 2001: Cefixime MIC90 = 0.25 Ceftriaxone MIC90 = 0.06 |
Report also described a mosaic penA gene among isolates with cefixime MIC ≥0.25. |
| Tanaka 2002103 | Fukuoka City | 1995 2000 |
Cefixime ≥ 0.5 0 of 55 5 of 100 |
1995: Cefixime MIC90 = 0.015 (0.002–0.06) Ceftriaxone MIC90 = 0.015 (0.001–0.03) 2000: Cefixime MIC90 = 0.25 (0.002–0.5) Ceftriaxone MIC90 = 0.06 (0.002–0.5) |
Emerging cefixime resistance. |
| Tanaka 2006109 | Fukuoka City | 2000–2001 | Ceftriaxone = 0.5: 1 of 398 |
Cefixime MIC = 0.5 | Analysis of 1 ceftriaxone resistant isolate with mosaic penA and mtrR, ponA, penB mutations. |
| Yokoi 2007110 | Toyota | 2002–2003 | Cefixime Treatment Failure: 4 |
Cefixime (0.5–1) Ceftriaxone (0.125–0.5) |
Case report. |
| Osaka 2006111 | Tokyo | 2006 | Cefixime ≥0.125: 17 of 47 |
Cefixime MIC90 = 0.125 (0.004–0.25) Ceftriaxone MIC90 = 0.06 (0.002–0.125) |
MIC values compared to those of Ameyama in 2001. |
| Takahata 2006112 | Tokyo | 2006 | Cefixime ≥ 0.125 28 of 58 |
For 28 isolates with mosaic penA gene: Cefixime MIC90 = 0.5 (0.12–0.5) Ceftriaxone MIC90 = 0.12 (0.016–0.12) |
Cefixime MICs correlated with presence of mosaic penA. |
| Europe | |||||
| Olsen 2008125 | Sweden | 2002–2005 | Cefixime MIC >0.06–≤0.5: 6 of 679 |
All had ceftriaxone MIC < 0.125 | |
| Hoffmann 2005126 | Denmark | 2004 | Ceftriaxone MIC >0.023 <0.094 81 of 434 |
No PenA sequencing performed. Serotype, NG-MAST sequence type were related within group of ceftriaxone MIC >0.023 and <0.094 | |
| Martin 200651 | Europe (ESSTI) | 2004 | Ceftriaxone > 0.125: 3 of 965 |
Ceftriaxone MIC = 0.25 | Surveillance report. Resistant isolates included 2 from Italy and 1 from Sweden. |
| Vazquez 2007127 | Spain | 2004–2005 | 204 isolates | Ceftriaxone MIC90=0.007 (≤0.007–0.12) Cefditoren MIC90=0.12 (≤0.007–0.25) |
|
| Tzelepi 2008128 | Greece | Dec 2006–Jan 2008 | Cefotaxime MIC 0.25–1: 17 of 195 |
Ceftriaxone MIC90= 0.125 (0.064–0.125) Cefixime MIC90=0.25 (0.125–0.25) |
Isolates were part of a cluster with related serotypes and PFGE patterns in Northern Greece. Isolates were multidrug resistant including penicillin, tetracycline, and fluoroquinolones. |
| Gonococcal Resistance to Antimicrobials Surveillance Programme 200828 | United Kingdom | 2007 | Cefixime MIC = 0.25: 2 of 1113 |
Ceftriaxone MIC = 0.015 | Surveillance Report. |
| Australia | |||||
| Tapsall 2008113 | Australia | 1997–2006 | Ceftriaxone MIC 0.06–0.5: 134 of ~15,000 |
Isolates with elevated ceftriaxone MIC mostly from travelers or contacts. | |
| Australian Gonococcal Surveillance Program 2008114 | Australia | 2007 | Ceftriaxone MIC 0.06–0.25: 25 of 3,042 |
Surveillance report. | |
| Elsewhere in Asia | |||||
| Ray 2005123 | Chennai, India Hyderabad, India Nagpur, India Pune, India Kolkata, India Bangladesh |
2001 2001 2001 2001 2001 1999–2000 |
Ceftriaxone LS (disk diffusion): 4 of 80 9 of 46 10 of 74 4 of 37 4 of 58 2 of 110 |
Resistant isolates not confirmed at regional reference laboratory. | |
| Bala 2007124 | New Delhi, India | 2002–2006 | Ceftriaxone MIC≥0.06: 9 of 382 |
Ceftriaxone MIC 0.064–0.094 | No treatment failures reported. |
| Ye 2002116 | China (various) | 1993–1998 | Ceftriaxone R (not defined): 16 of 2801 |
Results not confirmed at national reference laboratory. | |
| Guoming 2000117 | Zhanjiang, China | 1998–1999 | Ceftriaxone MIC ≥1: 15 of 98 Ceftriaxone MIC ≥0.06: 34 of 98 |
Ceftriaxone MIC90=2 (0.016–2) | |
| Wong 2008118 | Taipei, Taiwan | Apr 2006–Aug 2007 | Cefixime R (disk diffusion): 24 of 146 Cefpodoxime R (disk diffusion): 31 of 146 |
All sensitive to ceftriaxone by disk diffusion. | NGMAST ST 835 and 2180 associated with cephalosporin resistance. |
| Lo 200884 | Hong Kong | Oct 2006–Aug 2007 | Ceftibuten Treatment Failure: 42 of 1228 |
Ceftibuten MIC90=1 (0.06–8) Ceftriaxone MIC90=0.06 (<0.016–0.125) Cefixime MIC90=0.125 (<0.016–0.25) |
NG MAST ST 835 and 2469 associated with cephalosporin resistance. |
| Clendennen 1992120 | Philippines | September 1989 | Ceftriaxone ≥0.5: 8 of 134 Cefpodoxime ≥4: 4 of 134 |
||
| Clendennen 1992121 | Thailand | May 1990 | Ceftriaxone ≥0.5: 3 of 333 Cefixime ≥4: 1 of 328 Cefpodoxime ≥4: 2 of 331 |
||
| Cao 2008119 | Ho Chi Minh Ville, Vietnam |
Mar 2004–Jun 2006 | Ceftriaxone MIC=0.5: 1 of 121 |
No other cephalosporins were evaluated. | |
| United States | |||||
| Wang 2003130 | Hawaii | 2001 | Multidrug resistance: 4 isolates |
Cefixime MIC 0.25–0.5 Ceftriaxone MIC 0.125 |
Case report. All 3 patients with links to Asia. |
| Gonococcal Isolate Surveillance Project 200883 | 2006 | 1992–2006 1988–2006 |
Cefixime MIC 0.5–2: 48 isolates Ceftriaxone MIC=0.5 4 isolates |
Surveillance Report. | |
R= Resistant; LS= Less Sensitive; NG MAST= Neisseria gonorrhoeae multiple antigen sequence typing