Abstract
Alternative therapeutics for multidrug-resistant Neisseria gonorrhoeae (MDRNG) was explored. To search for an alternative agent for MDRNG infections, we determined the minimal inhibitory concentration (MIC) of 14 antimicrobials including nitrofurantoin (NIT) and fosfomycin (FOF) against 180 N.gonorrhoeae strains. A total of 180 non-duplicate N.gonorrhoeae strains were collected at Sakura Clinic, Tokyo between 2006 and 2007. The MIC of each drug was determined by Etest. MDRNG was defined as a strain with resistance to 3 different classes of antimicrobials, ciprofloxacin (CIP), tetracycline (TET), and benzylpenicillin (PEN) or cefixime. There were only 44 (24.4%), 46 (25.6%), 4 (2.2%), and 16 (8.9%) strains sensitive to CIP, gatifloxacin, PEN, and TET, respectively. None of the strains were resistant to ceftriaxone or spectinomycin. Eighty-three (46.1%) strains were categorized as MDRNG. Among 5 drugs (NIT, FOF, chloramphenicol, sulfamethoxazole/trimethoprim, and azithromycin) that are not routinely used to treat gonorrhea, there were no isolates including the 83 MDRNG, that were resistant to NIT (MIC, ?128μg/ml) and FOF (MIC, ?256μg/ml) according to tentative breakpoints for Enterobacteriae. Though the susceptibility criteria for NIT and FOF against N.gonorrhoeae have not been established, both drugs might provide effective alternative treatments for MDRNG infections.
