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. 1993 Jan;6(1):22–33. doi: 10.1128/cmr.6.1.22

Antimicrobial susceptibility testing of Neisseria gonorrhoeae and implications for epidemiology and therapy.

T Fekete 1
PMCID: PMC358264  PMID: 8457978

Abstract

Antimicrobial susceptibility testing (AST) of Neisseria gonorrhoeae has been under development since the early days of antimicrobial agents. However, it is rarely applied to clinical isolates today. The history of the various in vitro tests to determine the susceptibility of N. gonorrhoeae to antibiotics is rich with evidence that these results predict response to therapy for almost all agents tested. Further, AST is a useful and important aspect of strain characterization and disease epidemiology in conjunction with the more specific but laborious techniques of auxotyping, serotyping, and plasmid analysis. Current technology has overcome many of the objections to AST for N. gonorrhoeae with standardization of test media and the development of an accurate disk diffusion AST method that is suited to most clinical laboratories regardless of volume or level of technical expertise. Ironically, the very low level of resistance to the current primary treatment strategy in the United States, ceftriaxone or another potent cephalosporin, makes the use of AST somewhat superfluous.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barry A. L., Cohen M. A., Sesnie J. C., Fuchs P. C., Washington J. A., Murray P. R., Baker C. Interpretive criteria and quality control limits for testing susceptibility of Neisseria gonorrhoeae to enoxacin. J Clin Microbiol. 1992 Apr;30(4):813–816. doi: 10.1128/jcm.30.4.813-816.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bauer A. W., Kirby W. M., Sherris J. C., Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol. 1966 Apr;45(4):493–496. [PubMed] [Google Scholar]
  3. Berg S. W., Kilpatrick M. E., Harrison W. O., McCutchan J. A. Cefoxitin as a single-dose treatment for urethritis caused by penicillinase-producing Neisseria gonorrhoeae. N Engl J Med. 1979 Sep 6;301(10):509–511. doi: 10.1056/NEJM197909063011001. [DOI] [PubMed] [Google Scholar]
  4. Boakes A. J., Loo P. S., Ridgway G. L., Tovey S., Oriel J. D. Treatment of uncomplicated gonorrhoea in women with a combination of rifampicin and erythromycin. Br J Vener Dis. 1984 Oct;60(5):309–311. doi: 10.1136/sti.60.5.309. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bohnhoff M., Morello J. A., Lerner S. A. Auxotypes, penicillin susceptibility, and serogroups of Neisseria gonorrhoeae from disseminated and uncomplicated infections. J Infect Dis. 1986 Aug;154(2):225–230. doi: 10.1093/infdis/154.2.225. [DOI] [PubMed] [Google Scholar]
  6. Boslego J. W., Tramont E. C., Takafuji E. T., Diniega B. M., Mitchell B. S., Small J. W., Khan W. N., Stein D. C. Effect of spectinomycin use on the prevalence of spectinomycin-resistant and of penicillinase-producing Neisseria gonorrhoeae. N Engl J Med. 1987 Jul 30;317(5):272–278. doi: 10.1056/NEJM198707303170504. [DOI] [PubMed] [Google Scholar]
  7. Brown S. T., Pedersen H. B., Holmes K. K. Comparison of erythromycin base and estolate in gonococcal urethritis. JAMA. 1977 Sep 26;238(13):1371–1373. [PubMed] [Google Scholar]
  8. Brunham R. C., Plummer F., Slaney L., Rand F., DeWitt W. Correlation of auxotype and protein I type with expression of disease due to Neisseria gonorrhoeae. J Infect Dis. 1985 Aug;152(2):339–343. doi: 10.1093/infdis/152.2.339. [DOI] [PubMed] [Google Scholar]
  9. Bryan J. P., Hira S. K., Brady W., Luo N., Mwale C., Mpoko G., Krieg R., Siwiwaliondo E., Reichart C., Waters C. Oral ciprofloxacin versus ceftriaxone for the treatment of urethritis from resistant Neisseria gonorrhoeae in Zambia. Antimicrob Agents Chemother. 1990 May;34(5):819–822. doi: 10.1128/aac.34.5.819. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Bush L. M., Boscia J. A. Disseminated multiple antibiotic-resistant gonococcal infection: needed changes in antimicrobial therapy. Ann Intern Med. 1987 Nov;107(5):692–693. doi: 10.7326/0003-4819-107-5-692. [DOI] [PubMed] [Google Scholar]
  11. Catlin B. W. Nutritional profiles of Neisseria gonorrhoeae, Neisseria meningitidis, and Neisseria lactamica in chemically defined media and the use of growth requirements for gonococcal typing. J Infect Dis. 1973 Aug;128(2):178–194. doi: 10.1093/infdis/128.2.178. [DOI] [PubMed] [Google Scholar]
  12. Catlin B. W., Pace P. J. Nutritional requirements and penicillin susceptibilities of gonococci from pharyngeal and anogenital sites. Br J Vener Dis. 1977 Oct;53(5):299–303. doi: 10.1136/sti.53.5.299. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Catlin B. W., Reyn A. Neisseria gonorrhoeae isolated from disseminated and localised infections in pre-penicillin era. Auxotypes and antibacterial drug resistances. Br J Vener Dis. 1982 Jun;58(3):158–165. doi: 10.1136/sti.58.3.158. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Coovadia Y. M., Van den Ende J., Hoosen A. A., Kharsany A. Susceptibility of penicillinase-producing and non-penicillinase-producing strains of Neisseria gonorrhoeae isolated in Durban, South Africa, to 15 beta-lactam antibiotics. Sex Transm Dis. 1988 Jan-Mar;15(1):30–34. doi: 10.1097/00007435-198801000-00007. [DOI] [PubMed] [Google Scholar]
  15. Crider S. R., Colby S. D., Miller L. K., Harrison W. O., Kerbs S. B., Berg S. W. Treatment of penicillin-resistant Neisseria gonorrhoeae with oral norfloxacin. N Engl J Med. 1984 Jul 19;311(3):137–140. doi: 10.1056/NEJM198407193110301. [DOI] [PubMed] [Google Scholar]
  16. Dillon J. A., Tostowaryk W., Pauzé M. Effects of different media and methods of inoculum preparation on results of antimicrobial susceptibility testing of Neisseria gonorrhoeae by agar dilution. Antimicrob Agents Chemother. 1987 Nov;31(11):1744–1749. doi: 10.1128/aac.31.11.1744. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Dillon J. R., Bygdeman S. M., Sandström E. G. Serological ecology of Neisseria gonorrhoeae (PPNG and non-PPNG) strains: Canadian perspective. Genitourin Med. 1987 Jun;63(3):160–168. doi: 10.1136/sti.63.3.160. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Doern G. V., Jones R. N. Antimicrobial susceptibility testing of Haemophilus influenzae, Branhamella catarrhalis, and Neisseria gonorrhoeae. Antimicrob Agents Chemother. 1988 Dec;32(12):1747–1753. doi: 10.1128/aac.32.12.1747. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Easmon C. S. Gonococcal resistance to antibiotics. J Antimicrob Chemother. 1985 Oct;16(4):409–412. doi: 10.1093/jac/16.4.409. [DOI] [PubMed] [Google Scholar]
  20. Erwin M. E., Jones R. N. Interpretive criteria for susceptibility testing of CI-960 (PD127391, AM-1091), fleroxacin, lomefloxacin, and temafloxacin against Neisseria gonorrhoeae, including drug stability in GC agar medium. J Clin Microbiol. 1992 May;30(5):1170–1173. doi: 10.1128/jcm.30.5.1170-1173.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Erwin M. E., Jones R. N., Koontz F. P., Gerlach E. H., Murray P. R., Washington J. A. MIC and disk diffusion quality control guidelines for Neisseria gonorrhoeae susceptibility tests of cefdinir, cefetamet, CI-960, fleroxacin, lomefloxacin, and temafloxacin. J Clin Microbiol. 1992 May;30(5):1317–1319. doi: 10.1128/jcm.30.5.1317-1319.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Falk E. S., Bygdeman S. M., Birkeland N. K., Bjorvatn B., Kallings I., Sandström E. G. Genotypes and phenotypes of beta lactamase producing strains of Neisseria gonorrhoeae from African countries. Genitourin Med. 1988 Aug;64(4):226–232. doi: 10.1136/sti.64.4.226. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Faruki H., Kohmescher R. N., McKinney W. P., Sparling P. F. A community-based outbreak of infection with penicillin-resistant Neisseria gonorrhoeae not producing penicillinase (chromosomally mediated resistance). N Engl J Med. 1985 Sep 5;313(10):607–611. doi: 10.1056/NEJM198509053131004. [DOI] [PubMed] [Google Scholar]
  24. Fekete T., Serfass D. A., Lafredo S. C., Cundy K. R. Susceptibility to cephalosporins of penicillin-susceptible and penicillin-resistant strains of Neisseria gonorrhoeae from Philadelphia. Antimicrob Agents Chemother. 1989 Feb;33(2):164–166. doi: 10.1128/aac.33.2.164. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Fekete T., Woodwell J., Cundy K. R. Susceptibility of Neisseria gonorrhoeae to cefpodoxime: determination of MICs and disk diffusion zone diameters. Antimicrob Agents Chemother. 1991 Mar;35(3):497–499. doi: 10.1128/aac.35.3.497. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Fuchs P. C., Barry A. L., Baker C., Murray P. R., Washington J. A., 2nd Proposed interpretive criteria and quality control parameters for testing in vitro susceptibility of Neisseria gonorrhoeae to ciprofloxacin. J Clin Microbiol. 1991 Oct;29(10):2111–2114. doi: 10.1128/jcm.29.10.2111-2114.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Fuchs P. C., Barry A. L., Baker C., Murray P. R., Washington J. A. Proposed interpretive criteria and quality control parameters for ofloxacin susceptibility testing of Neisseria gonorrhoeae. J Clin Microbiol. 1992 Apr;30(4):1024–1026. doi: 10.1128/jcm.30.4.1024-1026.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Geers T. A., Donabedian A. M. Comparison of broth microdilution and agar dilution for susceptibility testing of Neisseria gonorrhoeae. Antimicrob Agents Chemother. 1989 Feb;33(2):233–234. doi: 10.1128/aac.33.2.233. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Givan K. F., Jaeger R. Auxotypes of Neisseria gonorrhoeae isolated from heterosexual men, homosexual men, and heterosexual women. Sex Transm Dis. 1986 Jan-Mar;13(1):19–23. doi: 10.1097/00007435-198601000-00005. [DOI] [PubMed] [Google Scholar]
  30. Gransden W. R., Warren C., Phillips I. 4-Quinolone-resistant Neisseria gonorrhoeae in the United Kingdom. J Med Microbiol. 1991 Jan;34(1):23–27. doi: 10.1099/00222615-34-1-23. [DOI] [PubMed] [Google Scholar]
  31. Greenwood D. In vitro veritas? Antimicrobial susceptibility tests and their clinical relevance. J Infect Dis. 1981 Oct;144(4):380–385. doi: 10.1093/infdis/144.4.380. [DOI] [PubMed] [Google Scholar]
  32. Handsfield H. H., McCormack W. M., Hook E. W., 3rd, Douglas J. M., Jr, Covino J. M., Verdon M. S., Reichart C. A., Ehret J. M. A comparison of single-dose cefixime with ceftriaxone as treatment for uncomplicated gonorrhea. The Gonorrhea Treatment Study Group. N Engl J Med. 1991 Nov 7;325(19):1337–1341. doi: 10.1056/NEJM199111073251903. [DOI] [PubMed] [Google Scholar]
  33. Handsfield H. H., Sandström E. G., Knapp J. S., Perine P. L., Whittington W. L., Sayers D. E., Holmes K. K. Epidemiology of penicillinase-producing Neisseria gonorrhoeae infections: analysis by auxotyping and serogrouping. N Engl J Med. 1982 Apr 22;306(16):950–954. doi: 10.1056/NEJM198204223061602. [DOI] [PubMed] [Google Scholar]
  34. Harrison W. O., Hooper R. R., Wiesner P. J., Campbell A. F., Karney W. W., Reynolds G. H., Jones O. G., Holmes K. K. A trial of minocycline given after exposure to prevent gonorrhea. N Engl J Med. 1979 May 10;300(19):1074–1078. doi: 10.1056/NEJM197905103001903. [DOI] [PubMed] [Google Scholar]
  35. Holmes K. K., Karney W. W., Harnisch J. P., Wiesner P. J., Turck M., Pedersen A. H. Single-dose aqueous procaine penicillin G therapy for gonorrhea: use of probenecid and cause of treatment failure. J Infect Dis. 1973 Apr;127(4):455–460. doi: 10.1093/infdis/127.4.455. [DOI] [PubMed] [Google Scholar]
  36. Hook E. W., 3rd, Brady W. E., Reichart C. A., Upchurch D. M., Sherman L. A., Wasserheit J. N. Determinants of emergence of antibiotic-resistant Neisseria gonorrhoeae. J Infect Dis. 1989 May;159(5):900–907. doi: 10.1093/infdis/159.5.900. [DOI] [PubMed] [Google Scholar]
  37. Ikeda F. Intrinsic penicillin resistance in penicillinase-producing Neisseria gonorrhoeae strains. Microbiol Immunol. 1990;34(1):1–9. doi: 10.1111/j.1348-0421.1990.tb00986.x. [DOI] [PubMed] [Google Scholar]
  38. Ison C. A., Bindayna K. M., Woodford N., Gill M. J., Easmon C. S. Penicillin and cephalosporin resistance in gonococci. Genitourin Med. 1990 Oct;66(5):351–356. doi: 10.1136/sti.66.5.351. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. JACKSON G. G., FINLAND M. Comparison of methods for determining sensitivity of bacteria to antibiotics in vitro. AMA Arch Intern Med. 1951 Oct;88(4):446–460. doi: 10.1001/archinte.1951.03810100030003. [DOI] [PubMed] [Google Scholar]
  40. Johnson S. R., Morse S. A. Antibiotic resistance in Neisseria gonorrhoeae: genetics and mechanisms of resistance. Sex Transm Dis. 1988 Oct-Dec;15(4):217–224. doi: 10.1097/00007435-198810000-00008. [DOI] [PubMed] [Google Scholar]
  41. Jones R. N., Edson D. C. The identification and antimicrobial susceptibility testing of Neisseria gonorrhoeae, 1980-1987. Results from the College of American Pathologists Microbiology Surveys Program. Arch Pathol Lab Med. 1988 May;112(5):485–488. [PubMed] [Google Scholar]
  42. Jones R. N., Fuchs P. C., Washington J. A., 2nd, Gavan T. L., Murray P. R., Gerlach E. H., Thornsberry C. Interpretive criteria, quality control guidelines, and drug stability studies for susceptibility testing of cefotaxime, cefoxitin, ceftazidime, and cefuroxime against Neisseria gonorrhoeae. Diagn Microbiol Infect Dis. 1990 Nov-Dec;13(6):499–507. doi: 10.1016/0732-8893(90)90082-7. [DOI] [PubMed] [Google Scholar]
  43. Jones R. N., Gavan T. L., Thornsberry C., Fuchs P. C., Gerlach E. H., Knapp J. S., Murray P., Washington J. A., 2nd Standardization of disk diffusion and agar dilution susceptibility tests for Neisseria gonorrhoeae: interpretive criteria and quality control guidelines for ceftriaxone, penicillin, spectinomycin, and tetracycline. J Clin Microbiol. 1989 Dec;27(12):2758–2766. doi: 10.1128/jcm.27.12.2758-2766.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Jones R. N., Gerlach E. H., Koontz F. P., Murray P. R., Pfaller M. A., Washington J. A., Erwin M. E., Knapp C. C. Development of Neisseria gonorrhoeae in vitro susceptibility test methods for cefixime including quality control guidelines. Diagn Microbiol Infect Dis. 1991 Sep-Oct;14(5):383–388. doi: 10.1016/0732-8893(91)90065-n. [DOI] [PubMed] [Google Scholar]
  45. Jones R. N., Gerlach E. H., Koontz F. P., Murray P. R., Pfaller M. A., Washington J. A., Erwin M. E., Knapp C. C. Interpretive criteria and quality control guidelines for Neisseria gonorrhoeae susceptibility test standardization for cefotetan. J Clin Microbiol. 1991 Feb;29(2):363–366. doi: 10.1128/jcm.29.2.363-366.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Judson F. N., Allaman J., Dans P. E. Treatment of gonorrhea. Comparison of penicillin G procaine, doxycycline, spectinomycin, and ampicillin. JAMA. 1974 Nov 4;230(5):705–708. doi: 10.1001/jama.230.5.705. [DOI] [PubMed] [Google Scholar]
  47. Judson F. N. Management of antibiotic-resistant Neisseria gonorrhoeae. Ann Intern Med. 1989 Jan 1;110(1):5–7. doi: 10.7326/0003-4819-110-1-5. [DOI] [PubMed] [Google Scholar]
  48. KJELLANDER J. O., FINLAND M. PENICILLIN TREATMENT OF GONORRHEAL URETHRITIS. EFFECTS OF PENICILLIN SUSCEPTIBILITY OF CAUSATIVE ORGANISM AND CONCOMITANT PRESENCE OF PENICILLINASE- PRODUCING BACTERIA ON RESULTS. N Engl J Med. 1963 Oct 17;269:834–836. doi: 10.1056/NEJM196310172691603. [DOI] [PubMed] [Google Scholar]
  49. Knapp J. S., Holmes K. K. Disseminated gonococcal infections caused by Neisseria gonorrhoeae with unique nutritional requirements. J Infect Dis. 1975 Aug;132(2):204–208. doi: 10.1093/infdis/132.2.204. [DOI] [PubMed] [Google Scholar]
  50. Knapp J. S. Laboratory methods for the detection and phenotypic characterization of Neisseria gonorrhoeae strains resistant to antimicrobial agents. Sex Transm Dis. 1988 Oct-Dec;15(4):225–233. doi: 10.1097/00007435-198810000-00009. [DOI] [PubMed] [Google Scholar]
  51. Knapp J. S., Tam M. R., Nowinski R. C., Holmes K. K., Sandström E. G. Serological classification of Neisseria gonorrhoeae with use of monoclonal antibodies to gonococcal outer membrane protein I. J Infect Dis. 1984 Jul;150(1):44–48. doi: 10.1093/infdis/150.1.44. [DOI] [PubMed] [Google Scholar]
  52. Knapp J. S., Zenilman J. M., Biddle J. W., Perkins G. H., DeWitt W. E., Thomas M. L., Johnson S. R., Morse S. A. Frequency and distribution in the United States of strains of Neisseria gonorrhoeae with plasmid-mediated, high-level resistance to tetracycline. J Infect Dis. 1987 Apr;155(4):819–822. doi: 10.1093/infdis/155.4.819. [DOI] [PubMed] [Google Scholar]
  53. Knapps J. S., Lind I., Reyn A., Holmes K. K. Unique strains of Neisseria gonorrhoeae causing epidemic gonorrhea during the penicillin era: a study of isolates from Denmark. J Infect Dis. 1986 Aug;154(2):363–366. doi: 10.1093/infdis/154.2.363. [DOI] [PubMed] [Google Scholar]
  54. Kuhlwein A., Nies B. A. Efficacy and safety of a single 400 mg oral dose of cefixime in the treatment of uncomplicated gonorrhea. Eur J Clin Microbiol Infect Dis. 1989 Mar;8(3):261–262. doi: 10.1007/BF01965274. [DOI] [PubMed] [Google Scholar]
  55. LOVE B. D., Jr, FINLAND M. Susceptibility of Neisseria gonorrhoeae to eleven antibiotics and sulfadiazine; comparison of susceptibility of recently isolated strains with results obtained in previous years in the same laboratory. AMA Arch Intern Med. 1955 Jan;95(1):66–73. doi: 10.1001/archinte.1955.00250070082010. [DOI] [PubMed] [Google Scholar]
  56. Lally R. T., Woolfrey B. F., Gresser-Burns M. E., Henry K. Antimicrobial agent resistance in Neisseria gonorrhoeae in St. Paul Minnesota. Diagn Microbiol Infect Dis. 1988 May;10(1):49–55. doi: 10.1016/0732-8893(88)90126-5. [DOI] [PubMed] [Google Scholar]
  57. Leigh D. A., Le Franc J., Turnbull A. R. Sensitivity to penicillin of Neisseria gonorrhoeae. Relationship to the results of treatment. Br J Vener Dis. 1969 Jun;45(2):151–153. doi: 10.1136/sti.45.2.151. [DOI] [PMC free article] [PubMed] [Google Scholar]
  58. Ley H. L., Jr, Mueller J. H. On the Isolation from Agar of an Inhibitor for Neisseria gonorrhoeae. J Bacteriol. 1946 Oct;52(4):453–460. doi: 10.1128/jb.52.4.453-460.1946. [DOI] [PMC free article] [PubMed] [Google Scholar]
  59. Liebowitz L. D., Ballard R. C., Koornhof H. J. In vitro susceptibility and cross-resistance of South African isolates of Neisseria gonorrhoeae to 14 antimicrobial agents. Antimicrob Agents Chemother. 1982 Oct;22(4):598–603. doi: 10.1128/aac.22.4.598. [DOI] [PMC free article] [PubMed] [Google Scholar]
  60. Maier T. W., Beilstein H. R., Zubrzycki L. Antibiotic disk susceptibility tests with Neisseria gonorrhoeae. Antimicrob Agents Chemother. 1974 Mar;5(3):210–216. doi: 10.1128/aac.5.3.210. [DOI] [PMC free article] [PubMed] [Google Scholar]
  61. Maness M. J., Sparling P. F. Multiple antibiotic resistance due to a single mutation in Neisseria gonorrhoeae. J Infect Dis. 1973 Sep;128(3):321–330. doi: 10.1093/infdis/128.3.321. [DOI] [PubMed] [Google Scholar]
  62. Martin J. E., Jr, Lester A., Price E. V., Schmale J. D. Comparative study of gonococcal susceptibility to penicillin in the United States, 1955-1969. J Infect Dis. 1970 Nov;122(5):459–461. doi: 10.1093/infdis/122.5.459. [DOI] [PubMed] [Google Scholar]
  63. Mason P. R., Gwanzura L., Latif A. S., Marowa E. Antimicrobial susceptibility of Neisseria gonorrhoeae in Harare, Zimbabwe. Relationship to serogroup. Sex Transm Dis. 1990 Apr-Jun;17(2):63–66. doi: 10.1097/00007435-199004000-00003. [DOI] [PubMed] [Google Scholar]
  64. McChesney D. G., Boslego J. W., Khan W. N. Spectinomycin disk zone diameter as a predictor of outcome in clinical treatment of gonorrhea. Antimicrob Agents Chemother. 1988 May;32(5):775–776. doi: 10.1128/aac.32.5.775. [DOI] [PMC free article] [PubMed] [Google Scholar]
  65. Megran D. W., Lefebvre K., Willetts V., Bowie W. R. Single-dose oral cefixime versus amoxicillin plus probenecid for the treatment of uncomplicated gonorrhea in men. Antimicrob Agents Chemother. 1990 Feb;34(2):355–357. doi: 10.1128/aac.34.2.355. [DOI] [PMC free article] [PubMed] [Google Scholar]
  66. Olsen G. A. Consumption of antibiotics in Greenland, 1964-70. IV. Changes in the sensitivity of N. gonorrhoeae to antibiotics. Br J Vener Dis. 1973 Feb;49(1):33–41. doi: 10.1136/sti.49.1.33. [DOI] [PMC free article] [PubMed] [Google Scholar]
  67. Plummer F. A., Brunham R. C. Gonococcal recidivism, diversity, and ecology. Rev Infect Dis. 1987 Jul-Aug;9(4):846–850. doi: 10.1093/clinids/9.4.846. [DOI] [PubMed] [Google Scholar]
  68. Putnam S. D., Lavin B. S., Stone J. R., Oldfield E. C., 3rd, Hooper D. G. Evaluation of the standardized disk diffusion and agar dilution antibiotic susceptibility test methods by using strains of Neisseria gonorrhoeae from the United States and Southeast Asia. J Clin Microbiol. 1992 Apr;30(4):974–980. doi: 10.1128/jcm.30.4.974-980.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  69. Reyn A., Schmidt H., Trier M., Bentzon M. W. Spectinomycin hydrochloride (Trobicin) in the treatment of gonorrhoea. Observation of resistant strains of Neisseria gonorrhoeae. Br J Vener Dis. 1973 Feb;49(1):54–59. doi: 10.1136/sti.49.1.54. [DOI] [PMC free article] [PubMed] [Google Scholar]
  70. Rice R. J., Thompson S. E. Treatment of uncomplicated infections due to Neisseria gonorrhoeae. A review of clinical efficacy and in vitro susceptibility studies from 1982 through 1985. JAMA. 1986 Apr 4;255(13):1739–1746. [PubMed] [Google Scholar]
  71. Schaadt R. D., Yagi B. H., Zurenko G. E. In vitro activity of cefpodoxime proxetil (U-76,252; CS-807) against Neisseria gonorrhoeae. Antimicrob Agents Chemother. 1990 Feb;34(2):371–372. doi: 10.1128/aac.34.2.371. [DOI] [PMC free article] [PubMed] [Google Scholar]
  72. Schwarcz S. K., Zenilman J. M., Schnell D., Knapp J. S., Hook E. W., 3rd, Thompson S., Judson F. N., Holmes K. K. National surveillance of antimicrobial resistance in Neisseria gonorrhoeae. The Gonococcal Isolate Surveillance Project. JAMA. 1990 Sep 19;264(11):1413–1417. [PubMed] [Google Scholar]
  73. Shapiro M. A., Heifetz C. L., Sesnie J. C. Comparison of microdilution and agar dilution procedures for testing antibiotic susceptibility of Neisseria gonorrhoeae. J Clin Microbiol. 1984 Oct;20(4):828–830. doi: 10.1128/jcm.20.4.828-830.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  74. Snell J. J., Brown D. F. Antimicrobial susceptibility testing of Neisseria gonorrhoeae: a trial organised as part of the United Kingdom national external quality assessment scheme for microbiology. J Clin Pathol. 1988 Jan;41(1):97–102. doi: 10.1136/jcp.41.1.97. [DOI] [PMC free article] [PubMed] [Google Scholar]
  75. Strader K. W., Wise C. M., Wasilauskas B. L., Salzer W. L. Disseminated gonococcal infection caused by chromosomally mediated penicillin-resistant organisms. Ann Intern Med. 1986 Mar;104(3):365–366. doi: 10.7326/0003-4819-104-3-365. [DOI] [PubMed] [Google Scholar]
  76. Stratton C. W. Susceptibility testing revisited. Prog Clin Pathol. 1984;9:65–100. [PubMed] [Google Scholar]
  77. Whittington W. L., Knapp J. S. Trends in resistance of Neisseria gonorrhoeae to antimicrobial agents in the United States. Sex Transm Dis. 1988 Oct-Dec;15(4):202–210. doi: 10.1097/00007435-198810000-00006. [DOI] [PubMed] [Google Scholar]
  78. Wiesner P. J., Handsfield H. H., Holmes K. K. Low antibiotic resistance of gonococci causing disseminated infection. N Engl J Med. 1973 Jun 7;288(23):1221–1222. doi: 10.1056/NEJM197306072882308. [DOI] [PubMed] [Google Scholar]
  79. Wiesner P. J., Holmes K. K., Sparling P. F., Maness M. J., Bear D. M., Gutman L. T., Karney W. W. Single doses of methacycline and doxycycline for gonorrhea: a cooperative study of the frequency and cause of treatment failure. J Infect Dis. 1973 Apr;127(4):461–466. doi: 10.1093/infdis/127.4.461. [DOI] [PubMed] [Google Scholar]
  80. Woodford N., Bindayna K. M., Easmon C. S., Ison C. A. Associations between serotype and susceptibility to antibiotics of Neisseria gonorrhoeae. Genitourin Med. 1989 Apr;65(2):86–91. doi: 10.1136/sti.65.2.86. [DOI] [PMC free article] [PubMed] [Google Scholar]
  81. Yeung K. H., Dillon J. R., Pauzé M., Wallace E. A novel 4.9-kilobase plasmid associated with an outbreak of penicillinase-producing Neisseria gonorrhoeae. J Infect Dis. 1986 Jun;153(6):1162–1165. doi: 10.1093/infdis/153.6.1162. [DOI] [PubMed] [Google Scholar]
  82. Zenilman J. M., Nims L. J., Menegus M. A., Nolte F., Knapp J. S. Spectinomycin-resistant gonococcal infections in the United States, 1985-1986. J Infect Dis. 1987 Dec;156(6):1002–1004. doi: 10.1093/infdis/156.6.1002. [DOI] [PubMed] [Google Scholar]
  83. Zenilman J. M., Whittington W. L., Frazier D., Rice R. J., Knapp J. S. Penicillinase-producing Neisseria gonorrhoeae in Dade County, Florida: phenotypic characterization of isolates from 1983, 1984, and 1986. Sex Transm Dis. 1988 Jul-Sep;15(3):158–163. doi: 10.1097/00007435-198807000-00010. [DOI] [PubMed] [Google Scholar]
  84. van Klingeren B., Ansink-Schipper M. C., Dessens-Kroon M., Verheuvel M. Relationship between auxotype, plasmid pattern and susceptibility to antibiotics in penicillinase-producing Neisseria gonorrhoeae. J Antimicrob Chemother. 1985 Aug;16(2):143–147. doi: 10.1093/jac/16.2.143. [DOI] [PubMed] [Google Scholar]

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