ANTIMICROBIAL RESISTANCE IN NEISSERIA-GONORRHOEAE IN THE UNITED-STATES, 1988-1994 - THE EMERGENCE OF DECREASED SUSCEPTIBILITY TO THE FLUOROQUINOLONES

Antimicrobial susceptibilities of Neisseria gonorrhoeae have been pros pectively determined in the Gonococcal Isolate Surveillance Project of the Centers for Disease Control and Prevention. From 1988 through 199 4, susceptibilities were determined for 35,263 isolates from 27 clinic s, Patients were demographically similar to those in nationally report ed gonorrhea cases, In 1994, 30.5% of isolates had chromosomally or pl asmid-mediated resistance to penicillin or tetracycline. Penicillin re sistance increased from 1988 (8.4%) to 1991 (19.5%) and then decreased in 1994 (15.6%), Tetracycline resistance decreased from 1988 (23.4%) to 1989 (17.3%) and then increased in 1994 (21.7%). Most isolates (99. 9%) were highly susceptible to broad-spectrum cephalosporins. Isolates with decreased susceptibility to ciprofloxacin increased from 1991 (0 .4%) to 1994 (1.3%); 4 isolates were ciprofloxacin-resistant. Ciproflo xacin-resistant strains may not respond to therapy with recommended do ses of fluoroquinolones, and the clinical importance of strains with d ecreased susceptibility is unknown. The emergence of fluoroquiuolone r esistance in N. gonorrhoeae in the United States threatens the future utility of this class of antimicrobials for gonorrhea therapy.