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We studied the antimicrobial susceptibility and prevalence of the bla TEM-1 and bla TEM-135 genes in Neisseria gonorrhoeae isolates obtained in Thailand. The isolates were tested using the disk diffusion method, and 100% of 370 isolates were found susceptible to cefixime, ceftriaxone, cefotaxime, ceftazidime, cefepime, spectinomycin, and azithromycin. Some of the isolates were resistant to penicillin (85.7%), ciprofloxacin (88.0%), ofloxacin (97.4%), or tetracycline (89.1%). Penicillinase-producing N. gonorrhoeae accounted for 83.8% of isolates, with 70.0% of these further identified as penicillinase-producing plus tetracycline resistant N. gonorrhoeae. Penicillin, tetracycline, and ciprofloxacin are not recommended for treatment because of the high prevalence (89.7%) of multidrug resistant gonococci. A study of genes controlling enzyme of beta-lactamase production (bla TEM-1 and bla TEM-135 ) was performed using mismatch amplification mutation assay PCR method and DNA sequencing. Beta-lactamase positive N. gonorrhoeae carried bla TEM-1 (69.6%) and bla TEM-135 (30.4%), indicating that there is a significant increase and spread of bla TEM-135 among gonococci in Thailand.

We surveyed the rate of chlamydial and gonococcal infections among human immunodeficiency virus (HIV)-seropositive patients in Thailand as well as the current status of antimicrobial resistance of Neisseria gonorrhoeae and determined the prevalence of penicillinase-producing N. gonorrhoeae (PPNG) in Thailand. A total of 1,158 endocervical swabs from 824 HIV-seropositive patients were collected to detect both organisms by Gen-Probe. The prevalences of chlamydial and gonococcal infection were 9.7 and 1.3%, respectively. Susceptibility of 122 gonococcal isolates to 6 drugs was determined by the disk diffusion method. None of the isolates was susceptible to penicillin or tetracycline. With respect to fluoroquinolones, more than 90% of the isolates were resistant to ciprofloxacin and ofloxacin. No gonococcal isolate with resistance to cefotaxime and ceftriaxone was detected. Among the 122 isolates, 83.6% or 102 isolates were PPNG, and most (79.5%) of these 122 isolates were further identified as PPNG plus tetracycline-resistant N. gonorrhoeae, with only 4.1% being PPNG alone. All of the 102 isolates identified as PPNG contained the bla(TEM) gene. We then performed a preliminary molecular study and identified, for the first time in Thailand, a PPNG isolate producing beta-lactamase and containing the bla(TEM) gene which was identical to the beta-lactamase TEM protein of Salmonella enterica identified as TEM-135.