Antimicrobial susceptibility of Neisseria gonorrhoeae strains isolated in 2004-2006 in Bangui, Central African Republic; Yaoundé, Cameroon; Antananarivo, Madagascar; and Ho Chi Minh Ville and Nha Trang, Vietnam.

Goal: To investigate the in vitro antimicrobial susceptibility of Neisseria gonorrhoeae strains isolated in 2004 and 2005 in Bangui, Central African Republic; Yaoundé, Cameroon; Antananarivo, Madagascar; and Ho Chi Minh Ville and Nha Trang, Vietnam.
Study Design: Antimicrobial susceptibility testing was performed by both disk diffusion and agar dilution methods according to Clinical and Laboratory Standards Institute (CLSI) recommendations. Minimum inhibitory concentrations (MICs) to 5 antimicrobials (penicillin G, ceftriaxone, ciprofloxacin, spectinomycin, and tetracycline) were determined when feasible. Penicillinase-producing N. gonorrhoeae (PPNG) was analyzed by the paper acidometric method (nitrocefin test).
Results: Thirty N. gonorrhoeae isolates from Bangui could be studied, 79 from Yaoundé, 126 from Antananarivo, 56 from Nha Trang, and 126 from Ho Chi Minh Ville in 2004 and 2005. Unfortunately, because of problems of electricity supply, no strains could be recovered for the determination of MICs in Yaoundé, and only 68 strains could be tested in Antananarivo and 121 in Ho Chi Minh Ville. Patterns of resistance were similar in Antananarivo, Bangui, and Yaoundé but different from those observed in Vietnam. Ciprofloxacin was highly effective in Africa, but nearly all strains in Vietnam were resistant to this drug. Overall, ceftriaxon and spectinomycin were the best antibiotics, with one strain resistant to spectinomycin in Antananrivo and one strain resistant to ceftriaxon in Ho Chi Minh Ville.
Conclusions: Ciprofloxacin remains highly efficient in Madagascar and Central Africa, ceftriaxone and spectinomycin should be used as the first-line antimicrobial agents in treating gonorrhea in Vietnam.