PERSISTENCE OF NEISSERIA-GONORRHOEAE STRAINS WITH DECREASED SUSCEPTIBILITIES TO CIPROFLOXACIN AND OFLOXACIN IN CLEVELAND, OHIO, FROM 1992 THROUGH 1993

Twenty-five isolates of beta-lactamase-negative strains of Neisseria g onorrhoeae exhibiting decreased susceptibilities to ciprofloxacin (MIC , greater than or equal to 0.125 mu g/ml) were isolated from men with uncomplicated gonococcal urethritis in Cleveland, Ohio, from January 1 992 through June 1993. The strains belonged to three auxotype-serovar classes: Pro-IB-1 (2 isolates), Pro-IB-2 (21 isolates), and Pro-IB-3 ( 2 isolates). MICs for strains were in the intermediate or resistant ca tegories for penicillin, the intermediate or susceptible categories fo r tetracycline (with the exception of one Strain that had acquired the 25.2-MDa TetM-containing plasmid) and cefoxitin, and the susceptible categories for ceftriaxone and cefixime (MICs, less than or equal to 0 .25 mu g/ml) and spectinomycin (MIC, less than or equal to 256 mu g/ml ). MICs for strains were also in the susceptible category for ofloxaci n (MIC, 0.25 mu g/ml) and in categories higher than susceptible for ci profloxacin (MICs, 0.125 to 0.25 mu g/ml) and ofloxacin (MIC, 0.5 mu g /ml). The diameters of zones of inhibition for these strains ranged fr om 31 to 39 mm for ciprofloxacin to 28 to 35 mm for ofloxacin. The per sistence of these strains over an 18-month period supports the need fo r routine sentinel surveillance and monitoring of gonococcal isolates, particularly posttreatment isolates, for resistance to quinolones whe n these agents are used for the primary therapy of uncomplicated gonor rhea.