Single 1 g dose of cefotaxime in the treatment of infections due to penicillinase-producing strains of Neisseria gonorrhoeae.
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Abstract:
One hundred and two patients with an uncomplicated infection due to penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) were treated with a single 1 g dose of cefotaxime. At follow-up within 15 days all genital and rectal infections were cured. Pharyngeal infections also seemed to respond to this treatment. A relatively high proportion (30.9%) of patients, however, developed post-gonococcal urethritis.Keywords:
Neisseria gonorrhoeae
Spectinomycin
Neisseria
Neisseriaceae
The discovery that penicillinase production in Neisseria gonorrhoeae was plasmid mediated and the spread of the β-lactamase encoding plasmids in gonococcal isolates since 1976, raise the possibility that a nonpathogenic indigenous bacterium could serve as a reservoir for these plasmids. We initiated studies to define the ability of commensal Neisseria species and Branhamella catarrhalis strains, as well as strains of the pathogen Neisseria meningitidis, to serve as recipients in conjugation with Neisseria gonorrhoeae. We found that with N. gonorrhoeae as the donor, 3 of 5 Neisseria cinerea, 2 of 5 Neisseria flava, 0 of 1 Neisseria flavescens, 1 of 3 Neisseria subflava, 0 of 6 B. catarrhalis, 0 of 7 Neisseria lactamica, 1 of 5 Neisseria mucosa, 1 of 7 Neisseria perflava/sicca, and 0 of 13 N. meningitidis strains gave detectable conjugation frequencies (>10−8). N. cinerea was the only species found to maintain the gonococcal conjugal plasmid (pLE2451). A N. cinerea transconjugant containing pLE2451 was observed to transfer both the β-lactamase plasmid and pLE2451 to N. gonorrhoeae at high frequency.
Neisseria gonorrhoeae
Neisseria
Neisseriaceae
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The API NeIdent system (Analytab Products, Plainview, N.Y.) was evaluated for identifying Neisseria spp. and Branhamella catarrhalis commonly isolated from clinical specimens. The system identified 90% of 303 Neisseria gonorrhoeae isolates, 71% of 113 Neisseria meningitidis isolates, and 63% of 16 Neisseria lactamica isolates but failed to identify any of 22 B. catarrhalis isolates. Testing of gonococcal strains of various auxotypes revealed no relationship between nutritional requirements and NeIdent profile numbers. With the Neisseria species, interpretation of the cinnamaldehyde-coupled beta-naphthylamine reactions was difficult and resulted in profile numbers not listed in the Profile Register. Positive resazurin-glucose reactions resulted in unlisted numbers for all B. catarrhalis strains. Inconsistent results were also obtained when 62 N. gonorrhoeae isolates were tested more than once on the strip. In all cases, profile variability and failure to identify these organisms were related to the beta-naphthylamide substrate tests. Expansion of the data base and modification of the substrate formulations or their interpretive criteria may increase the reliability of the NeIdent system for identifying Neisseria spp. and B. catarrhalis.
Neisseria
Neisseriaceae
Neisseria gonorrhoeae
Moraxella (Branhamella) catarrhalis
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Anticarbohydrate monoclonal antibodies were tested for their ability to bind to various strains of Neisseria. A monoclonal antibody that binds to the ganglio-series glycosphingolipid, ganglio-N-triaosylceramide, also bound to strains of Neisseria gonorrhoeae but not to other species of Neisseria. An antibody specific for the globo-series glycosphingolipid, globotriaosylceramide, also bound to strains of N. gonorrhoeae, Neisseria meningitidis, Neisseria lactamica, and Branhamella catarrhalis but not to any other strains of nonpathogenic Neisseria.
Neisseria gonorrhoeae
Neisseria
Neisseriaceae
Glycosphingolipid
Globotriaosylceramide
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Identicult-Neisseria (Scott Laboratories, Inc., Fiskeville, R.I.), a rapid enzymatic method with chromogenic substrates, was tested in our laboratories for the identification of Neisseria gonorrhoea, Neisseria meningitidis, and Neisseria lactamica. The test correlated very highly in its identification of pathogenic Neisseria spp. with modified New York City fermentation medium. Identicult-Neisseria appeared to be more sensitive in its detection of prolylaminopeptidase activity in N. meningitidis than most of the currently available systems.
Neisseria
Neisseria gonorrhoeae
Neisseriaceae
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Eight hundred and forty male patients attending sexually transmitted disease (STD) clinic for urethritis were investigated. Out of them, 31.6% had gonococcal urethritis, 16.1% suffered from nongonococcal urethritis due to Ureaplasma urealyticum and in 12.6%, both the organisms were present. Though 14.62% strains of N. Gonorrhoeae were resistant to penicillin, all the strains were sensitive to spectinomycin; while all Ureaplasma strains were sensitive to tetracyclines. As the treatment differs for these two organisms, it is necessary to identify the correct etiological agent.
Neisseria gonorrhoeae
Ureaplasma urealyticum
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Neisseria gonorrhoeae, first described by Neisser in 1879, is a Gram-negative, nonmotile, nonspore-forming diplococcus, belonging to the family Neisseriaceae. It is the etiologic agent of gonorrhea. The other pathogenic species is Neisseria meningitidis, to which N. gonorrhoeae is genetically closely related. Although N. meningitidis is not usually considered to be a sexually transmitted disease, it may infect the mucous membranes of the anogenital area of homosexual men (1). The other members of the genus, which include Neisseria lactamic a, Neisseriapolysaccharea, Neisseria cinerea, and Neisseria flavescens, which are related to Neisseria gonorrhoeae, and saccharolytic strains, such as Neisseria subflava, Neisseria sicca, and Neisseria mucosa, which are less genetically related to the aforementioned, are considered to be nonpathogenic, being normal flora of the nasopharyngeal mucous membranes (2).
Neisseria
Neisseria gonorrhoeae
Neisseriaceae
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One hundred and eighty-seven males with uncomplicated gonorrheal urethritis were treated with spectinomycin hydrochloride in a dosage of 2 g. given intramuscularly. A failure rate of 3.2% was observed and no complications of therapy were encountered. In addition, 310 strains of N. gonorrhoeae were tested for susceptibility to penicillin G and spectinomycin. All strains were sensitive to 20 mug./ml. of spectinomycin and this susceptibility appeared to decrease as penicillin resistance increased. A greater incidence of relative resistance to penicillin G was observed than in similar studies from other Canadian areas.
Spectinomycin
Neisseria gonorrhoeae
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Penicillin-resistant (penr) clinical isolates of Neisseria meningitidis, which do not produce beta-lactamase, were first identified in Spain in 1985; the frequency of their recovery, which has been increasing in the past few years, reached 20% in 1989. Serogrouping, determination of serotypes and subtypes, and multilocus enzyme electrophoresis of the penr strains showed an extensive diversity. Resistance is due, at least in part, to a decreased affinity of penicillin-binding protein (PBP) 2 for penicillin. Similar low-affinity forms of PBP 2 are also found in penr isolates of Neisseria lactamica, Neisseria polysaccharea, and Neisseria gonorrhoeae. Genetic transformation of an N. meningitidis type strain to low-level penicillin resistance with DNA from resistant meningococci and other Neisseria species resulted in transformants that possessed low-affinity forms of PBP 2. These altered forms of PBP 2 have been shown to arise from recombinational events that replace parts of the PBP 2 gene with the corresponding regions from the PBP 2 genes of commensal Neisseria species.
Neisseria
Neisseriaceae
Neisseria gonorrhoeae
Penicillin binding proteins
Molecular Epidemiology
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A comparison was made of carbohydrate degradation reactions of Neisseria gonorrhoeae, Neisseria meningitidis, Neisseria lactamica, Neisseria mucosa, Neisseria sicca, Neisseria subflava, and Branhamella catarrhalis in a rapid (0.5- to 1-h) identification micromethod (RIM-N Kit; Austin Biological Laboratories, Inc., Austin, Tex.) and in a serum-free agar slanted medium (72 h). Reactions after 1 h in the RIM-N system agreed completely with those after 72 h in the conventional system.
Neisseria
Neisseria gonorrhoeae
Neisseriaceae
Moraxella (Branhamella) catarrhalis
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Two groups of 30 patients each suffering from gonococcal urethritis were treated either with minocyclin for 7 days or with a single administration of penicillin or spectinomycin, respectively. 30% of them revealed an additional infection with C. trachomatis or U. urealyticum. On the 8th day, we observed remaining symptoms in only 20% of the patients treated with minocyclin, but in 40% of the group treated with penicillin/spectinomycin.
Spectinomycin
Minocycline
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