The antimicrobial susceptibility testing panel should, at a minimum, include a fluoroquinolone, cefixime, ceftriaxone, spectinomycin
, azithromycin, and any other drugs in local use for gonorrhea treatment.
However, it demonstrated susceptibility to spectinomycin
(16 [micro]/mL) and reduced susceptibility to azithromycin (0.
For those unable to tolerate a cephalosporin, spectinomycin
should be used.
For patients who may have acquired infection in certain parts of Asia, clinicians should consider treatment with cefixime, ceftriaxone, or spectinomycin
when treatment with a cephalosporin is contraindicated.
Interpretive criteria based on expected treatment failure rates for single-agent therapy with penicillin, tetracycline, spectinomycin
, or ceftriaxone have been selected (Table 1).
Susceptibility tests were performed for tetracycline (D and M), erythromycin (D and M), streptomycin (D and M), kanamycin (D), norfloxacin (D), pencillin (D), clindamycin (D), fusidic acid (D), rifampicin (D), cefoxitin (D), ceftiofur (M), chloramphenicol (M), ciprofloxacin (M), florfenicol (M), spectinomycin
(M), sulfamethoxazole (M), tiamulin (M), and trimethoprim (M).
section]) Antimicrobial drugs (breakpoint final concentrations): S, streptomycin (16 mg/L); Su, sulfonamide (64 mg/L); T, tetracycline (8 mg/L); Cf, cefuroxime (16 mg/L); C, chloramphenicol (8 mg/L); Sp, spectinomycin
(64 mg/L); Tm, trimethoprim (2 mg/L); A, ampicillin (8 mg/L]; G, gentamicin (4 mg/L); Ne, neomycin (8 mg/L) K, kanamycin (8 mg/L); Ak, amikacin (4 mg/L); Cx, cefalexin (16 mg/L); Cr, cefradine (16 mg/L); Cn, ceftriaxone (1 mg/L); Ct, cefotaxime (I m,-/L); Fu, furazolidone (8 mg/L); Nx, nalidixic acid (16 m,-/L).
For these 8 isolates, MICs of penicillin G, tetracycline, cefixime, cefdinir, cefodizime, ceftriaxone, levofloxacin, azithromycin, and spectinomycin
were determined on chocolate agar (GC) medium base supplemented with 1% IsoVital X (Becton Dickinson, Franklin Lakes, N J, USA) and containing serial 2-fold dilutions of each agent (2).
Traditionally, most HA-MRSA isolates in the United States carry SCCmec type II (and to a lesser extent, SCCmec type III) that encodes resistance to [beta]-lactam antimicrobial agents bleomycin, macrolide-lincosamide-streptogamin B, aminoglycosides, and spectinomycin
2] before being spread on blood agar plates containing 500 [micro]g/mL spectinomycin
Specimens from all 70 patients had the same unique pattern of lysis when phage typed, had the same profile when examined by pulsed-field gel electrophoresis, and were resistant to ampicillin, streptomycin, spectinomycin
, sulfonamides, tetracyclines, and trimethoprim.
One type, which is resistant to streptomycin, spectinomycin
, trimethoprim, and sulfonamides, carries a chromosomally located class 2 integron with the dfrA1-sat1-aadA1 (Tn7) array of gene cassettes (2).