CONTINUING EVOLUTION OF THE PATTERN OF QUINOLONE RESISTANCE IN NEISSERIA-GONORRHOEAE ISOLATED IN SYDNEY, AUSTRALIA

Background and Objectives: Multiple phenotypes of quinolone-resistant Neisseria gonorrhoeae isolated in Sydney since 1984 originated in Asia and increased in number and level of resistance in 1995. Goal: To stu dy the origins, characteristics, and infection pattern of quinolone-re sistant Neisseria gonorrhoeae in Sydney from 1995 to 1997 and to compa re these results with prior findings. Study Design: Quinolone minimal inhibatory concentrations, phenotype, and geographic source of quinolo ne-resistant Neisseria gonorrhoeae isolated in Sydney from 1995 to 199 7 were analyzed, Results: Two hundred nineteen episodes of infection w ith quinolone-resistant Neisseria gonorrhoeae from 2,236 gonococcal is olates occurred during 1995 through 1997, The rate of isolation of qui nolone-resistant Neisseria gonorrhoeae increased significantly at the end of 1996 and was maintained through 1997, The increase resulted fro m sustained domestic transmission of a limited number of phenotypes in heterosexual patients, Conclusion: The pattern of isolation of quinol one-resistant Neisseria gonorrhoeae in Sydney changed from the sporadi c isolation of multiple phenotypes of imported quinolone-resistant Nei sseria gonorrhoeae to a higher rate of endemic disease caused by a few subtypes, Alterations in antibiotic treatment regimens in the affecte d patient group were required.