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N. gonorrhoeae with reduced susceptibility to azithromycin detected in MSM
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CDC officials identified five Neisseria gonorrhoeae isolates with high minimal inhibitory concentrations to azithromycin in men who have sex with men residing in San Diego County, according to a recent Morbidity and Mortality Weekly Report.
Five MSM were diagnosed with gonorrhea during 2009. Three cases with 8 mcg/mL minimal inhibitory concentrations and two with 16 mcg/mL MICS were treated with ceftriaxone for uncomplicated gonorrhea and 1g of azithromycin for presumptive treatment of chlamydia.
Officials determined that four of the five isolates included a combination of mutations of the 23S rRNA gene and the coding region of the mtrR gene associated with N. gonorrhoeae azithromycin resistance, according to the report.
“Treatment of gonorrhea with monotherapy is not recommended because of concern over the emergence of antibiotic resistance,” CDC officials wrote. “Clinicians should treat uncomplicated gonorrhea with the recommended dual therapy and maintain vigilance for treatment failure. Continued surveillance for antimicrobial resistance to N. gonorrhoeae is essential for effective disease prevention and control.”
In an editorial note, officials wrote that, “The lack of any reported sex partners in common among the five men and the later discovery of four new isolates with high minimal inhibitory concentrations to azithromycin, also in MSM, suggest that azithromycin-resistant strains might be circulating among MSM in San Diego County.”
CDC. MMWR. 2011;60;579-581.
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