Report on Surveillance of Gonococci-National Isolate Collection for Epidemiology (G-NICE), 2009

Kun-Yen Lin, Chun-Chen Chen, Shu-Ying Li

2011 Vol.27 NO.23

Correspondence Author： Kun-Yen Lin

Abstract：

The surveillance program of Gonococci-National Isolate Collection for Epidemiology (G-NICE) was implemented during January to December, 2009, enrolling 31 hospitals and clinics. The program collected 519 gonococcal isolates nationwide, including 427 isolates from northern Taiwan, 63 from southern Taiwan, and 29 from central Taiwan. None was obtained from eastern Taiwan or offshore islands. Using disk diffusion test, the proportions of isolates resistant to penicillin, ciprofloxacin, cefixime, cefpodoxime, and ceftriaxone were 66.7%, 93.4%, 3.3%, 5.2%, and 1.3%, respectively. The Minimum Inhibition Concentration (MIC) of ceftriaxone and cefixime were 0.125mg/L and 0.38mg/L, respectively.
The 519 isolates were delineated into 193 sequence types (STs) by Neisseria gonorrhoeae- multi-antigen sequence type (NG- MAST) molecular subtyping method. Among the 193 STs, 13 had more than 5 isolates collected, including ST421 (n=60), ST419 (n=31), ST225 (n=20), ST2175 (n=19), ST2194 (n=18), ST2178 (n=14), ST3684 (n=12), ST2179 (n=9), ST 3382 (n=8), ST3694 (n=8), ST359 (n=6), ST2253 (n=6), and ST1971 (n=5). Each ST exhibited distinct antibiotic susceptibility pattern. For example, ST2253 was highly resistant to penicillin, ciprofloxacin, cefixime, and cefpodoxim and was only sensitive to ceftriaxone while ST539 was sensitive to all antibiotics tested.
Based on the surveillance results of G-NICE for drug resistance, quinolones is no longer recommended for treating gonorrhea infection, and the 3rd generation of cephalosporin should be used instead. Combined molecular subtypes and drug susceptibility patterns of their isolates, patients could be clustered into different sexual networks. Patients from high-risk sexual network should receive medical consultation, diagnosis and treatment of other concurrent sexually-transmitted infections, and encourage their sexual partners to seek proper medical care.