A brief Neisseria gonorrhoeae update from our registrar Ian Marr at our regular bug of the week teaching round. We still culture it regularly from our samples – susceptibility testing is done at a reference laboratory. PCR diagnosis from early pass urine is the mainstay for most patients (main test method for C. trachomatis as well.
Please seek out this reference – here is the full text link. Abstract below. Good for a journal club. I’ve not found anything more recent. Perhaps someone can check with PNGIMR and with Dr Valleley.
P N G Med J. 2010 Mar-Jun;53(1-2):15-20. Neisseria gonorrhoeae isolates from four centres in Papua New Guinea remain susceptible to amoxycillin-clavulanate therapy. Toliman PJ1, Lupiwa T, Law GJ, Reeder JC, Siba PM.
Antibiotic-resistant strains of Neisseria gonorrhoeae have the potential to undermine treatment and control of gonorrhoea, which remains a highly prevalent sexually transmitted infection (STI) in Papua New Guinea (PNG). The standard treatment regimen for gonorrhoea in PNG based on amoxycillin and clavulanic acid (amoxycillin-clavulanate) was introduced about 15 years ago and there is some concern that over time circulating strains may have developed resistance to this therapy. To investigate this, N. gonorrhoeae isolates (n = 52) were collected from STI clinics in geographically representative centres in PNG and tested for their in vitro susceptibility to a range of antibiotics. All 52 isolates tested were found susceptible to amoxycillin-clavulanate, despite 40% (n = 21) being penicillinase producers and thus resistant to penicillin. These findings indicate that amoxycillin-clavulanate therapy remains an effective treatment for gonococcal infections in PNG, and support the maintenance of the present standard treatment for gonorrhoea in PNG.
- WHO STD Laboratory Reference Manual – this is a good reference to go to for advice on key techniques – it is essential that we get a reliable culture system working again in PMGH for instance and this is a good starting point.