Gonorrhoea in men: diagnostic aspects and changing antibiotic susceptibility pattern
sandeep nanda, sonia sandeep barve, chandralekha bhanujan, sachin p lohra, rupal patel, govind l ninama, kalpesh mistry.
BACKGROUND: Gonorrhea since the ancient times is causing significant morbidity. Though a number of methods are available for diagnosis in men, culture still remains the gold standard. Gonococci are delicate and fastidious bacteria but its remarkable ability to develop resistance to a variety of antibiotics makes it a major threat to public health.
OBJECTIVES: - To detect the incidence in symptomatic men and in vitro antimicrobial susceptibility pattern of the gonococcal isolates.
MATERIALS & METHODS: - 100 urethral swabs from men with urethritis were screened for presence of gonococci by gram stain and culture on Chocolate Agar and Modified Thayer-Martin medium. The isolated gonococci were screened for Penicillinase production and susceptibility to antibiotics was subsequently carried out by standard disc diffusion method.
RESULTS: - Gonorrhoea was detected in 56 of the urethral swabs giving a incidence of 56%. The difference of detection in gram stain and culture was insignificant (P>0.05). Of all the isolated gonococci considerable resistance was seen to ciprofloxacin(46.4%), tetracycline(23.2%) and Penicillin(17%) with Incidence of PPNG being 12.5%. All strains were uniformly sensitive to Spectinomycin and Cephalosporins.
INTERPRETATION & CONCLUSIONS: - Neisseria gonorrhoeae is main etiological agent in urethritis in sexually active men and culture though time consuming, costly and demands expertise is still better method for diagnosis as gives high isolation rate and observe changing patterns in antibiotic susceptibility to commonly used antimicrobials.
Key words: Gonococci, Neisseria gonorrhoeae, Penicillinase producing Neisseria gonorrhoeae (PPNG).