SURVEILLANCE OF ANTIBIOTIC SUSCEPTIBILITY OF NEISSERIA-GONORRHOEAE INTHE WHO WESTERN PACIFIC REGION 1992-4

Objective: To describe the establishment and outcomes of a regional pr ogramme of continuing long term surveillance of antibiotic susceptibil ity of Neisseria gonorrhoeae over the period 1992-4. Methods: Laborato ries in 17 countries in the WHO Western Pacific Region participated in a continuing programme of surveillance of the susceptibility of gonoc occi to an agreed group of antibiotics over 3 years. Established techn iques were used and these included quality control and proficiency tes ting systems. Results: About 20 000 gonococci were examined over a 3 y ear period. Resistance to the penicillins through beta lactamase produ ction or chromosomal mechanisms was widespread, with further changes e vident over the 3 years. Spectinomycin resistance was infrequently enc ountered but high level tetracycline resistance was present in most pa rticipating centres, with some having high proportions of tetracycline resistant organisms. Quinolone resistance increased and became widesp read throughout the region in the 3 years, ultimately involving all bu t one centre. Both the number and minimum inhibitory concentrations of quinolone resistant isolates increased markedly. Conclusions: Pattern s of gonococcal resistance to antibiotics continue to evolve, at times rapidly, and have the potential for wide and rapid dissemination. Reg ional surveillance programmes can be developed by using and expanding existing resources. Data thus derived were applied to the development of appropriate treatment regimens in the region, and emphasised furthe r the need for a global expansion of the programme of integrated surve illance of gonococcal resistance.