1/14. neisseria gonorrhoeae resistant to ciprofloxacin: first report in cuba.BACKGROUND AND OBJECTIVES: The Cuban Ministry of public health plans to implement the syndromic approach to sexually transmitted diseases in persons with urethral or vaginal syndrome in cuba using 500 mg ciprofloxacin as therapy. Although the emergence of clinical isolates of neisseria gonorrhoeae with decreased susceptibility to ciprofloxacin have been sporadically detected in cuba, there has been no report of isolates that exhibited significant resistance to this drug. This is the first report of the isolation of a N gonorrhoeae strain resistant to ciprofloxacin in cuba. STUDY DESIGN: Case report. CONCLUSIONS: This case emphasizes the need for awareness regarding the potential emergence of a clinically significant resistance of N gonorrhoeae in cuba. There is a need for continued antimicrobial susceptibility surveillance of Cuban isolates to ciprofloxacin and other fluoroquinolones.- - - - - - - - - - ranking = 1keywords = gonorrhoeae (Clic here for more details about this article) |
2/14. Emergence of cephem- and aztreonam-high-resistant neisseria gonorrhoeae that does not produce beta-lactamase.Regarding neisseria gonorrhoeae, the National Committee for Clinical Laboratory Standards (NCCLS) has not defined the breakpoint minimum inhibitory concentration (MIC) for expanded spectrum cephems such as cefpodoxime and ceftizoxime, because of the absence of resistant strains to these antibiotics. To date, in gonococcal urethritis, after treatment with third generation cephems and aztreonam, clinical failures caused by resistant N. gonorrhoeae strains have not been reported. However, we experienced two clinical failures in patients with gonococcal urethritis treated with cefdinir and aztreonam. N. gonorrhoeae isolates from these two patients showed high-level MICs to these agents. The MIC of cefdinir was 1 microg/ml for both strains and that of aztreonam was 8 microg/ml for both strains, while the MICs of other beta-lactams were also higher than the NCCLS value, except for ceftriaxone, for which the MIC was 0.125 microg/ml for both strains. Moreover, the MICs of fluoroquinolones, tetracyclines, and erythromycin against these two isolates were higher than the NCCLS susceptibility value. These isolates were susceptible to spectinomycin. In N. gonorrhoeae, the emergence of these beta-lactam-resistant isolates is of serious concern. However, a more serious problem is that these isolates were already resistant to non-beta-lactam antimicrobials. In japan, ceftriaxone has not been permitted for clinical use against gonococcal infections. Therefore, in japan, patients with gonococcal urethritis caused by these resistant N. gonorrhoeae strains should be treated with cefodizime or spectinomycin.- - - - - - - - - - ranking = 1.2857142857143keywords = gonorrhoeae (Clic here for more details about this article) |
3/14. Simultaneous scabies and gonococcal infection.A case is presented of an unusual complication arising in a man with scabies and gonococcal urethritis: the secondary infection of excoriated genital lesions by neisseria gonorrhoeae. This occurred after he had occluded his genitals with a plastic wrap.- - - - - - - - - - ranking = 0.14285714285714keywords = gonorrhoeae (Clic here for more details about this article) |
4/14. Acute urethritis and arthritis-dermatitis syndrome due to neisseria meningitidis.Acute urethritis and arthritis-dermatitis syndrome after sexual contact are often assumed to be caused by neisseria gonorrhoeae. We report a case of arthritis-dermatitis syndrome in a 32-year-old man who presented with generalized maculopapular and petechial skin lesions and polyarthritis. Acute urethritis developed 1 week after oro-genital sexual contact with a sex worker about 3 weeks before admission. No pathogen was found on smear of urethral discharge and skin lesions, but Gram-negative diplococci were noted in joint fluid, and blood culture yielded N. meningitidis. His condition improved gradually after repeated arthrocentesis and antibiotic therapy with ceftriaxone followed by ciprofloxacin. Oro-genital contact is a transmission route for N. meningitidis infection manifesting as acute urethritis and arthritis-dermatitis syndrome.- - - - - - - - - - ranking = 0.14285714285714keywords = gonorrhoeae (Clic here for more details about this article) |
5/14. neisseria meningitidis in specimens from urogenital sites. Is increased awareness necessary?neisseria meningitidis serogroups B type 2 and Y were isolated from urogenital specimens from three heterosexual patients. The first patient was a young man with the clinical signs and microscopic findings of a typical gonococcal urethritis. The second was a middle-aged woman with cervicitis, in whom neither neisseria gonorrhoeae nor chlamydia trachomatis were demonstrated by culture. In the third patient, a young woman, N. meningitidis was associated with cervicitis, acute salpingitis, and peritonitis. The patients' clinical symptoms responded quickly to antibiotic treatment. Meningococci of the same serogroup/serotype as the index cases were demonstrated in two of the sexual consorts in pharyngeal specimens but not in genitourinary specimens. Orogenital sexual practice seemed to be the most likely route of transmission. During the period of this study (August 1989-March 1990), the three meningococcal strains observed at the authors' laboratory represented 20% of the total number of urogenital isolates of pathogenic Neisseria. A greater awareness of this problem from medical, diagnostic, epidemiologic, and legal viewpoints is therefore needed.- - - - - - - - - - ranking = 0.14285714285714keywords = gonorrhoeae (Clic here for more details about this article) |
6/14. urethritis caused by neisseria meningitidis: a case report.Isolation of N. meningitidis from the male urethra has become more common in recent years and this has been attributed to sexual activities and changes in social attitudes. We describe a further case of acute urethritis caused by transmission of N. meningitidis occurring after a single sexual contact (fellatio) in a heterosexual man. The urethritis was initially diagnosed as being caused by N. gonorrhoeae on a presumptive basis, then attributed to N. meningitidis serogroup Y. This case shows the need of accurate diagnostic procedures in all cases resembling gonococcal urethritis.- - - - - - - - - - ranking = 0.25726142085331keywords = gonorrhoeae, neisseria (Clic here for more details about this article) |
7/14. Gonococcal urethritis with bilateral tysonitis.A case of gonococcal urethritis with bilateral tysonitis is presented. Results of gram's stain and positive culture for neisseria gonorrhoeae confirmed the diagnosis. The patient was treated successfully with aqueous procaine penicillin with probenecid followed by oral ampicillin for ten days.- - - - - - - - - - ranking = 0.14285714285714keywords = gonorrhoeae (Clic here for more details about this article) |
8/14. Evaluation of plasmids in tetracycline resistant strains of neisseria gonorrhoeae and ureaplasma urealyticum in a case of severe urethritis.A young man who acquired gonococcal urethritis in the far east was not cured by repeated i.v. treatment with a broad-spectrum penicillin. Cultures of pre- and post-treatment urethral specimens grew tetracycline-resistant penicillinase-producing neisseria gonorrhoeae (PPNG) and tetracycline-resistant ureaplasma urealyticum. The patient was successfully treated with erythromycin, to which both isolates were sensitive. The strain of N. gonorrhoeae carried a novel plasmid of 10.5 Md molecular mass in addition to plasmids previously observed in this organism. The strain of U. urealyticum carried two distinct plasmids, one with mass 4.9 Md and the other one with mass 8.1 Md. This report demonstrates that ureaplasmas can contain plasmids and raises the question if tetracycline resistance is controlled by plasmids or by the chromosome.- - - - - - - - - - ranking = 0.85714285714286keywords = gonorrhoeae (Clic here for more details about this article) |
9/14. Colonisation of the urethra with streptococcus pneumoniae: a case report.A 25 year old man developed mild urethritis and urethral colonisation with streptococcus pneumoniae five days after a single orogenital sexual contact. The diagnosis was suspected because of the appearance of Gram positive diplococci in the urethral exudate. The incidence of urethral infection with S pneumoniae is not known. Pneumococci are unlikely to grow on the routine selective media used to identify neisseria gonorrhoeae.- - - - - - - - - - ranking = 0.14285714285714keywords = gonorrhoeae (Clic here for more details about this article) |
10/14. cefuroxime treatment of urethritis caused by a beta-lactamase-producing strain of neisseria gonorrhoeae.A patient who contracted urethritis from a beta-lactamase-producing strain of neisseria gonorrhoeae was successfully treated with the cephalosporin derivative cefuroxime. As expected, neither cefuroxime nor cefamandole was hydrolysed by plasmid-coded gonococcal beta-lactamase. cefuroxime ought to be a valuable and efficacious substitute for penicillins in the treatment of gonhorrhoea due to beta-lactamase-producing gonococcal strains.- - - - - - - - - - ranking = 0.71428571428571keywords = gonorrhoeae (Clic here for more details about this article) |
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