Abstract

PIP: This study aims to determine the prevalence of penicillinase-producing Neisseria gonorrhea (PPNG), as well as to differentiate gonococcal isolates based on susceptibility pattern, penicillinase production, serogroup, auxotype, protein and plasmid profile among women attending tertiary level health centers and sexually transmitted disease (STD) clinics in Mumbai (formerly Bombay), India. An association between auxotypes, serogroups and antibiotic susceptibilities of Neisseria gonorrhea was determined. Subjects were screened for Neisseria gonorrhea; the minimal inhibitory concentration testing was performed according to National Committee for Clinical Laboratory Standards (NCCLS) guidelines. The antibiotics tested were penicillin, tetracycline, ciprofloxacin, and spectinomycin. The ability of various typing methods to distinguish different isolates was calculated using the discrimination index. Results showed that in the susceptibility testing group 16 (48.5%) were resistant to penicillin and 28 (84.8%) showed chromosomally mediated resistance to tetracycline. 5 isolates (15.2%) showed resistance to ciprofloxacin, while 12 (36.4%) showed reduced susceptibility. 27 (81.8%) isolates belonged to the WI serogroup, and 15 (46.7%) were penicillinase producers. In auxotyping, 17 (51.5%) isolates were of the nonrequiring auxotype, while 7 (21.2%) were proline requiring. 15 (55.6%) of the isolates belonged to the nonrequiring-WI auxotype/serogroup (A/S) class. In plasmid pattern, 10 of the PPNG isolates possessed the 4.4 MDa plasmid, while 4 had the 3.2 MDa plasmid. Increases in the molecular weight of the major outer membrane protein were observed. In conclusion, the combined use of auxotyping and serogrouping offers a good method for discriminating gonococcal isolates. A high prevalence of chromosomal resistance to penicillin and tetracycline was observed. The 4.4 MDa plasmid was the most prevalent among the PPNG isolates. The nonrequiring auxotype was the most prevalent, followed by the proline requiring auxotype. WI serogroup was commonly observed among the isolates, while the nonrequiring/WI A/S class was the most prevalent among PPNG isolates.