A CLINICAL ISOLATE OF NEISSERIA-GONORRHOEAE WITH IN-VITRO RESISTANCE TO ERYTHROMYCIN AND DECREASED SUSCEPTIBILITY TO AZITHROMYCIN

Background and Objectives: Erythromycin is a recommended treatment for penicillin-allergic pregnant women with gonorrhea, and azithromycin h as been suggested as therapy for coexisting gonococcal and chlamydial infections, Although gonococcal resistance to erythromycin is not unco mmon, decreased resistance to azithromycin is rare. A clinical isolate of Neisseria gonorrhoeae with in vitro resistance to erythromycin and decreased susceptibility to azithromycin is reported, Study Design: T his is a case report. Results: Antimicrobial susceptibility testing of a clinical isolate of N. gonorrhoeae revealed a minimal inhibitory co ncentration (MIC) of 2 mu g/ml to azitthromycin and 32 mu g/ml to eryt hromycin. Five hundred other urethral isolates were tested, resulting in an MIC for erythromycin ranging from 0.015 to 2 mu g/ml. The range for azithromycin was 0.015 to 0.5 mu g/ml. There was a strong correlat ion between erythromycin and azithromycin MICs (r = 0.73; P < 0.0001). Conclusions: Continued national monitoring is needed to detect the app earance and early dissemination of new types of gonococcal resistance.