Abstract
Background and Objectives: There has been a remarkable increase in antimicrobial resistance among Neisseria gonorrhoeae strains in many developing countries in recent years. Most dramatic was appearance of β-lactamase producing isolates that bearing high M.Wt. plasmids, which created problem in treatment of infections caused by this organism. Little information is available regarding antibiotic resistance, β-lactamases production and plasmid content of the strains of N.gonorrhoeae in Iran. Aim of this study was to study the antimicrobial resistance, β-Lactamases production and plasmid profiles of the N.gonorroeae isolates among urethritis and cervicitis patients in Kerman, Iran.
Materials and Methods: 205 patients with signs and symptoms of urethritis and cervicitis were referred to 4 gynecology and urology clinics in city of Kerman from October 2004 to May 2006. 37 were infected with N.gonorrhoeae. For identification of the isolates, bacterial samples were collected from secretions and subjected to gram staining and inoculated into MTM medium with 2%hemoglobin. Oxidase, catalase and sugar utilization tests were also carried out for all isolates. Antibiotic sensitivity test was done by disk agar diffusion and MIC test by agar dilution in MHA medium. Similarly, β-lactamases and plasmid content of all isolates were investigated from the cell lysates.
Results: 83% of the isolates were highly resistant to penicillin. 72.9% were also resistant to tetracycline (TRNG). However, 78% of the isolates were sensitive to ciprofloxacin, 67.5% sensitive to ceftriaxone and 62% were sensitive to ceftazidime, respectively. 54% of the isolates that exhibited resistance to penicillin also produced β-lactamases (PPNG). Plasmid isolation and agarose gel electrophoresis revealed three types of high M.Wt. plasmid in both PPNG and TRNG isolates. However, plasmid band was absent in the majority of isolates.
Conclusion: It can be concluded that, the antibiotic resistant strains of N.gonorrhoeae are widely distributed among patients with urethritis and cervicitis in Kerman. The majority of penicillin resistant isolates were capable of producing a periplasmic β-lactamases (PPNG). However, majority of the isolates were sensitive to fluoroquinolones and the third generation cephalosporins.