THE EPIDEMIOLOGY OF NEISSERIA-GONORRHOEAE ISOLATES IN GREENLAND 1979-1990 - THE EMERGENCE, SPREAD AND DISAPPEARANCE OF NON-PPNG STRAINS CARRYING THE CONJUGATIVE 38.9 KB PLASMID
K. Reimann et al., THE EPIDEMIOLOGY OF NEISSERIA-GONORRHOEAE ISOLATES IN GREENLAND 1979-1990 - THE EMERGENCE, SPREAD AND DISAPPEARANCE OF NON-PPNG STRAINS CARRYING THE CONJUGATIVE 38.9 KB PLASMID, Sexually transmitted diseases, 20(6), 1993, pp. 338-343
Background: In 1990, Greenland was one of the few areas in the world i
n which endemic occurrence of PPNG had not been reported. However, bet
ween 1982 and 1988 an increase in the prevalence of strains with chrom
osomally mediated resistance to penicillin had been noticed. The stand
ard treatment regimen was changed early in 1983. Objective: To determi
ne the prevalence of the 38.9 kb plasmid in gonococcal strains isolate
d in Greenland 1979-1990. Design: Retrospective (1979-1984) and prospe
ctive (1985-1990) studies of antimicrobial susceptibility and plasmid
profile of consecutive N. gonorrhoeae isolates from patients attending
the STD clinic in Nuuk, Greenland; selected strains from 1982-1984 we
re subjected to serotyping and auxotyping. Results: Before 1982, N. go
norrhoeae strains harboring the 38.9 kb conjugative plasmid were rare;
in 1982, a sudden increase in the prevalence of these strains was str
ongly associated with the emergence of streptomycin-resistant strains
with high-level chromosomally mediated resistance to penicillin, 70% o
f which carried the 38.9 kb plasmid. Determination of antimicrobial su
sceptibility pattern, auxotype and serovar supported the assumption of
an epidemic spread of a single clone. The predominance of this clone
was transient, but the 38.9 kb plasmid spread to penicillin-susceptibl
e as well as to other clones of penicillin-resistant strains. Conclusi
on: The emergence of the 38.9 kb plasmid in 1982 was linked to a singl
e clone of strains, but the subsequent spread of the plasmid was indep
endent of the presence of other plasmids, and its disappearance was no
t associated with a change in standard treatment regimen.