Escalation in the relative prevalence of ciprofloxacin-resistant gonorrhoea among men with urethral discharge in two South African cities: Association with HIV seropositive

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dc.contributor.authorLewis D.A.
dc.contributor.authorScott L.
dc.contributor.authorSlabbert M.
dc.contributor.authorMhlongo S.
dc.contributor.authorVan Zijl A.
dc.contributor.authorSello M.
dc.contributor.authorDu Plessis N.
dc.contributor.authorRadebe F.
dc.contributor.authorWasserman E.
dc.date.accessioned2011-05-15T16:17:55Z
dc.date.available2011-05-15T16:17:55Z
dc.date.issued2008
dc.description.abstractObjectives: The objectives of this study were to assess the prevalence of ciprofloxacin-resistant gonorrhoea in two South African cities and to investigate the association between the isolation of ciprofloxacin-resistant Neisseria gonorrhoeae and the HIV serostatus of patients. Methods: Gonococci were cultured from endourethral swabs taken from consecutive men with urethritis attending clinics in Johannesburg and Cape Town. Minimum inhibitory concentrations (MIC) for ciprofloxacin and ceftriaxone were determined with E-tests. Isolates with a ciprofloxacin MIC of 1 mg/l or greater were defined as resistant and isolates with a ceftriaxone MIC of 0.25 mg/l or less were defined as susceptible. Rapid tests were used to screen and confirm the presence of HIV . antibodies. Survey data from 2004 were used as a baseline to assess trends in gonococcal resistance to ciprofloxacin. Results: In 2004, the prevalence of ciprofloxacin resistance was 7% in Cape Town and 11% in Johannesburg. In 2007, 37/139 (27%) Cape Town isolates and 47/149 (32%) Johannesburg isolates were resistant to ciprofloxacin; in comparison with 2004 data, this represents 2.9-fold and 1.9-fold increases, respectively. All isolates were fully susceptible to ceftriaxone. There was a significant association between HIV seropositivity and the presence of ciprofloxacin-resistant gonorrhoea among patients (p = 0.034). Conclusions: Johannesburg and Cape Town have witnessed significant rises in the prevalence of ciprofloxacin-resistant gonorrhoea among men with urethritis. The resistant phenotype is linked to HIV seropositivity. There is now an urgent need to change national first-line therapy for presumptive gonococcal infections within South Africa.
dc.description.versionArticle
dc.identifier.citationSexually Transmitted Infections
dc.identifier.citation84
dc.identifier.citation5
dc.identifier.issn13684973
dc.identifier.other10.1136/sti.2007.029611
dc.identifier.urihttp://hdl.handle.net/10019.1/14428
dc.subjectceftriaxone
dc.subjectciprofloxacin
dc.subjectdoxycycline
dc.subjectHuman immunodeficiency virus antibody
dc.subjectantibiotic sensitivity
dc.subjectarticle
dc.subjectbacterium culture
dc.subjectbacterium isolate
dc.subjectbacterium isolation
dc.subjectepsilometer test
dc.subjectgonorrhea
dc.subjecthuman
dc.subjectHuman immunodeficiency virus infection
dc.subjectimmunoassay
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectminimum inhibitory concentration
dc.subjectNeisseria gonorrhoeae
dc.subjectphenotype
dc.subjectprevalence
dc.subjectpriority journal
dc.subjectsingle drug dose
dc.subjectSouth Africa
dc.subjecturethra disease
dc.subjecturethral discharge
dc.subjecturethritis
dc.subjectAnti-Bacterial Agents
dc.subjectAnti-Infective Agents
dc.subjectCeftriaxone
dc.subjectCiprofloxacin
dc.subjectDrug Resistance, Bacterial
dc.subjectGonorrhea
dc.subjectHIV Seropositivity
dc.subjectHumans
dc.subjectMale
dc.subjectMicrobial Sensitivity Tests
dc.subjectNeisseria gonorrhoeae
dc.subjectPrevalence
dc.subjectSouth Africa
dc.subjectUrethritis
dc.titleEscalation in the relative prevalence of ciprofloxacin-resistant gonorrhoea among men with urethral discharge in two South African cities: Association with HIV seropositive
dc.typeArticle
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