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6. Diversity of isolates of penicillinase-producing Neisseria gonorrhoeae (PPNG) in Honolulu, Hawaii: 1982-1991

Author

Sarafian, Samuel K., Rice, Roselyn J., Ohye, Roy G., Higa, Henry, and Knapp, Joan S.

Subjects
Honolulu, Hawaii -- Health aspects, Drug resistance in microorganisms -- Demographic aspects, Neisseria gonorrhoeae, Health
Abstract

Background and Objectives: Gonococcal infections caused by penicillinase-producing Neisseria gonorrhoeae (PPNG) isolates have increased in geographic distribution and prevalence. It was postulated that PPNG strains would become endemic in Honolulu and that, in turn, this city would serve as a reservoir for the introduction of PPNG strains into the continental United States. Goal of this Study: To assess the role of Honolulu as a reservoir for PPNG strains by assessing the diversity and persistence of PPNG strains between 1982 and 1991. Study Design: A total of 432 PPNG strains were characterized by auxotype/serovar (A/S) class and plasmid content, and their distribution during the 10-year period was studied. Results: Of 432 isolates, 373 (86.4%) possessed a 4.4-Mdal [beta]-lactamase plasmid; 39 (9.0%) possessed a 3.2-Mdal [beta]-lactamase plasmid; and 20 (4.6%) possessed a 3.05-Mdal [beta]-lactamase plasmid. A total of 53 A/S classes were identified. Asian, African, and Toronto PPNG strains belonged to 49 (92.5%), 15 (28.3%), and 11 (20.7%) A/S classes, respectively. Though all Toronto PPNG strains possessed a 24.5-Mdal conjugative plasmid, these plasmids could not be transferred by conjugation. Although some apparent microepidemics of PPNG strains were identified, most strins were isolated sporadically. Conclusions: A large number of different strains have been associated with PPNG infections in Honolulu, but there was no evidence that any strain persisted endemically during the study period. These observations have important implications for the design and assessment of community gonorrhea control strategies., Honolulu does not appear to be serving as a reservoir for introducing penicillin-resistant strains of gonorrhea into the continental United States. Between 1982 and 1991, 432 different strains of penicillin-resistant strains were isolated by the Hawaii Department of Health in Honolulu and the military clinics. Although it appeared that microepidemics of certain strains occurred from time to time, no evidence was found that any particular strain had become endemic. The predominance of certain strains appeared to be due to repeated reintroduction.

Published
1994

9. Multidrug‐ResistantNeisseria gonorrhoeaewith Decreased Susceptibility to Cefixime—Hawaii, 2001

Author

Wang, Susan A., primary, Lee, Maria Veneranda C., additional, O’Connor, Norman, additional, Iverson, Christopher J., additional, Ohye, Roy G., additional, Whiticar, Peter M., additional, Hale, Judith A., additional, Trees, David L., additional, Knapp, Joan S., additional, Effler, Paul V., additional, and Weinstock, Hillard S., additional

Published
2003
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11. False-Positive Gonorrhea Test Results with a Nucleic Acid Amplification Test: The Impact of Low Prevalence on Positive Predictive Value.

Author

Effler, Paul V., Ohye, Roy G., Brouillet, Barbara, Lee, Maria Veneranda C., Whiticar, Peter M., and Katz, Alan R.

Subjects
*GONORRHEA diagnosis, *SEXUALLY transmitted diseases, *SEXUAL health, *LABORATORY techniques
Abstract

Five false-positive gonorrhea test results from a private laboratory using a nucleic acid amplification test led to an investigation by the Hawaii State Department of Health. No unexplained increase or variation in the laboratory's positive gonorrhea test results was detected. The proportion of positive gonorrhea test results among tests performed in the population was 1.06%. The calculated positive predictive value (PPV) of the test in this setting was 60%. Documentation of sexual histories was lacking for all cases. It is imperative to obtain a sexual history for both assessing sexually transmitted disease (STD) risk and interpreting STD test results. The possibility that positive test results may be false should be considered when patients have unanticipated positive test results. Clinicians who perform STD screening tests should know the approximate prevalence of STDs in the population being screened and have a conceptual understanding of PPV and the impact of low prevalence on screening tests with imperfect specificity. [ABSTRACT FROM AUTHOR]

Published
2004

12. Multidrug-Resistant Neisseria gonorrhoeae with Decreased Susceptibility to Cefixime--Hawaii, 2001.

Author

Wang, Susan A., Lee, Maria Veneranda C., O'Connor, Norman, Iverson, Christopher J., Ohye, Roy G., Whiticar, Peter M., Hale, Judith A., Trees, David L., Knapp, Joan S., Effler, Paul V., and Weinstock, Hillard S.

Subjects
NEISSERIA gonorrhoeae, PENICILLIN, DRUG resistance in microorganisms
Abstract

Focuses on four urogenital Neisseria gonorrhea isolates recovered from three patients that demonstrated resistance to penicillin, tetracycline and ciprofloxacin and reduced susceptibility to cefixime. Implications of the emergence of multidrug resistance for clinicians and public health officials; Ability of N. gonorrhea to readily acquire antimicrobial resistance to a variety of agents.

Published
2003
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13. Diversity of Isolates of PenicillinaseProducing Neisseria gonorrhoeae PPNG in Honolulu Hawaii

Author

SARAFIAN, SAMUEL K., RICE, ROSELYN J., OHYE, ROY G., HIGA, HENRY, and KNAPP, JOAN S.

Abstract

Gonococcal infections caused by penicillinase-producing Neisseria gonorrhoeae(PPNG) isolates have increased in geographic distribution and prevalence. It was postulated that PPNG strains would become endemic in Honolulu and that, in turn, this city would serve as a reservoir for the introduction of PPNG strains into the continental United States.

Published
1994

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