ANTIMICROBIAL SUSCEPTIBILITY AND TYPES OF NEISSERIA-GONORRHOEAE IN GREECE - DATA FOR THE PERIOD 1990 TO 1993

Background: Surveillance of the rapidly changing patterns of antimicro bial resistance of Neisseria gonorrhoeae is imperative for monitoring gonococcal infection. Goal: To describe the types and the antimicrobia l susceptibility profile of a representative sample of gonococci isola ted in Greece between 1990 and 1993. Study Design: The antimicrobial s usceptibilities, serovar/auxotypes classes, and plasmid contents of 26 3 consecutive isolates of N. gonorrhoeae, recovered from cases of male gonococcal urethritis, were determined. Results: Penicillinase-produc ing N. gonorrhoeae (PPNG) were isolated at a rate 6.1% and were mostly from imported cases of infection, Six (2.3%) of the isolates (one PPN G and five non-PPNG) were highly resistant to tetracycline, and one PP NG strain was resistant to norfloxacin and ciprofloxacin. Strains with chromosomal resistance to penicillin, tetracycline, erythromycin, and chloramphenicol accounted for 18.5%, 12.5%, 19%, and 16% of the isola tes, respectively; much higher proportions of strains were intermediat ely susceptible to these antibiotics, Spectinomycin and cefotaxime wer e active against all gonococci studied, A shift to IB serovars and to sporadic types of strains was noted from previous years among the non- PPNG isolates. This is compatible with the marked increase in the rate of imported cases of infection caused by non-PPNG strains,Conclusions : The emergence of high-level resistance to tetracycline and resistanc e to fluoroquinolones was ascertained, At the present, however, the ma in problem with gonococcal resistance in Greece seems to ensue from th e increasing rates of chromosomally resistant strains, Moreover, the i ncreasing frequency of imported gonococci underlines the necessity for continuous epidemiologic surveillance.