Auxotypes and antimicrobial susceptibilities of Neisseria gonorrhoeae in black and white patients.

Isolates of Neisseria gonorrhoeae from 100 white and 113 black patients attending a venereal disease clinic were examined for their susceptibility to ampicillin, penicillin, tetracycline, and spectinomycin. The isolates were also characterised by gonococcal auxotyping. Gonococcal isolates from black patients were more resistant to the antibiotics than those from white patients, since the former were infected with the more antibiotic-resistant auxotypes (Pro, Zero, and Arg) whereas the latter were infected with the more antibiotic-susceptible auxotypes (AHU and others). These data indicate a preferential infection by sub-populations of Neisseria gonorrhoeae in two racial groups.     

Changes in the prevalence of auxotypes of Neisseria gonorrhoeae among black and white patients attending a clinic for sexually transmitted diseases

Before 1978, isolates of Neisseria gonorrhoeae from white patients attending a venereal disease clinic were more susceptible to penicillin G than were isolates from black patients, because the whites were more frequently infected with the Arg- Hyx- Ura- auxotype that was highly susceptible to penicillin. Recent isolates from the same clinic show a change both in the auxotypes and in the penicillin susceptibility of N. gonorrhoeae infecting the two patient groups. Of 211 isolates studied in 1978, the four most common auxotypes were, in decreasing frequency: Pro-, nonrequiring, Arg- Hyx- Ura- and Arg-. In the present study of 265 isolates, the order of frequency was nonrequiring; Pro-; Pro- Arg-(Orn*) Ura-; and Arg- Hyx- Ura-. The Pro- Arg-(Orn*) Ura- auxotype was new to the clinic and was significantly more frequent in white than in black patients and significantly more resistant to penicillin than were gonococci of the remaining auxotypes. With the appearance of the Pro- Arg-(Orn*) Ura- auxotype among white patients, there was no significant difference in the susceptibility to penicillin of isolates of N. gonorrhoeae from the two groups of patients.     

Pharyngeal colonisation by Neisseria gonorrhoeae and Neisseria meningitidis in black and white patients attending a venereal disease clinic.

Pharyngeal colonisation by Neisseria gonorrhoeae and Neisseria meningitidis was studies in 2000 patients attending a venereal disease clinic. Of these patients, 64% were white and 36% were black. The incidence of gonococcal infections was highest in the period from June to August. The incidence of genital or rectal infections or both was higher in the black patients. Pharyngeal colonisation by gonococci was present in 1.3% of the patients. There was no significant associations between pharyngeal colonisation and the pharyngeal symptoms, race, sex, or marital state of the patients. Pharyngeal colonisation was more frequent in patients with gonococcal infections at other sites. However, in 40.7% of the patients with pharyngeal colonisation, the pharynx was the only culture-positive site. There was no significant difference in the auxotypes or in the antibiotic susceptibility of the pharyngeal and the rectal-genital isolates except in the susceptibility to spectinomycin. Our findings do not indicate that gonococci isolated from the pharynx differ significantly from gonococci isolated from rectal or genital sites. It was notable that meningococcal colonisation of the pharynx was significantly more frequent in the white patients. This may be a genetically determined phenomenon.     

Pharyngeal colonisation by Neisseria gonorrhoeae and Neisseria meningitidis in black and white patients attending a venereal disease clinic.

Pharyngeal colonisation by Neisseria gonorrhoeae and Neisseria meningitidis was studies in 2000 patients attending a venereal disease clinic. Of these patients, 64% were white and 36% were black. The incidence of gonococcal infections was highest in the period from June to August. The incidence of genital or rectal infections or both was higher in the black patients. Pharyngeal colonisation by gonococci was present in 1.3% of the patients. There was no significant associations between pharyngeal colonisation and the pharyngeal symptoms, race, sex, or marital state of the patients. Pharyngeal colonisation was more frequent in patients with gonococcal infections at other sites. However, in 40.7% of the patients with pharyngeal colonisation, the pharynx was the only culture-positive site. There was no significant difference in the auxotypes or in the antibiotic susceptibility of the pharyngeal and the rectal-genital isolates except in the susceptibility to spectinomycin. Our findings do not indicate that gonococci isolated from the pharynx differ significantly from gonococci isolated from rectal or genital sites. It was notable that meningococcal colonisation of the pharynx was significantly more frequent in the white patients. This may be a genetically determined phenomenon.     

Chemotaxis of polymorphonuclear leukocytes from donors of different races toward Neisseria gonorrhoeae of three different auxotypes

Urethral gonorrhea is typified by the presence of large numbers of polymorphonuclear leukocytes, which are presumably attracted to the urethra by an as yet uncharacterized chemotaxin. Culture supernatants from three different auxotypes of Neisseria gonorrhoeae, one requiring arginine, hypoxanthine, and uracil (Arg-,Hyx-,Ura-), one requiring proline, arginine (not satisfied by ornithine), and uracil (Pro-,Arg-[Orn*],Ura-), and one requiring proline (Pro-), were tested for their chemotactic activity against leukocytes from men of two racial groups, white and black. These auxotypes were chosen because the Pro- auxotype is isolated more frequently from black patients, and the Arg-,Hyx-,Ura- and the Pro-,Arg-(Orn*),Ura- auxotypes are isolated more frequently from white patients. Chemotaxis was tested in blind-well chambers in the absence of complement; membranes with a pore size of 3 microns were used. The culture supernatants of the Pro- auxotype were the most chemotactic, while those of the Arg-,Hyx-,Ura- were the least chemotactic when analyzed by a three-way analysis of variance: F = 22.83, df = 2.6, P less than .001. There were no differences in migration with respect to the race of the donor. Gonococcal culture supernatants did not require complement for chemotaxis.     

Auxotypes of Neisseria gonorrhoeae isolated from heterosexual men, homosexual men, and heterosexual women

During 1979-1984 we auxotyped 1822 strains of Neisseria gonorrhoeae and recorded the site of isolation and sexual orientation of the patients. Auxotypes were determined by the growth requirements of strains for proline (Pro-), uracil (Ura-), hypoxanthine (Hyx-), citrulline (Cit-), or citrulline replaceable by ornithine (Orn-). Of all isolates from homosexual men, 96% belonged to three auxotypes: nonrequiring (NR), Pro-, or Orn-, and only 1.5% belonged to the Pro-, Cit-, Ura- and Orn-, Ura-, Hyx- auxotypes. Of the isolates from women, 49.9% belonged to these latter two auxotypes. Of the strains isolated from male homosexuals, 19.5% were resistant to 1.0 microgram of erythromycin/ml, whereas only 9.6% of strains from other men and 2.6% of strains from women were resistant to this concentration. We suggest that strains of N. gonorrhoeae infecting homosexual men tend to be less demanding in their nutritional requirements and more resistant to erythromycin than strains infecting heterosexual men and women.     

淋球菌营养型与耐药性及质粒的关系

目的 为了解淋球菌的营养型、耐药性及质粒之间的关系.方法 对重庆市收集的83株淋球菌进行营养型、抗生素敏感性和质粒检测.结果 83株菌共分为8个营养型,以Pro-型(51-8%)和Proto型(18-1%)为主.利用琼脂稀释法检测菌株对青霉素、四环素和壮观霉素的敏感性.青霉素耐药株占15.6%,四环素耐药株占70%,壮观霉素耐药株占1-2%.通过快速碱裂解法对其中的44株菌进行质粒检测,70%菌株含24-5Md质粒,80%含2.6Md质粒,66%同时含24-5Md和2.6Md质粒,16%未查到质粒.并发现Pro^-型菌株中青霉素耐药株高于其它营养型(P<0.05),且含24-5Md质粒菌也显著高于其它营养型(P<0.05).含24-5Md+2.6Md质粒菌株中四环素耐药株更常见(P<0.05).检测到1株产青霉素酶淋球菌(PPNG),经质粒消除试验证实其耐药性由4-4Md质粒介导.结论 本研究不仅表明了重庆地区淋球菌营养型、耐药性及质粒的分布状况,而且揭示了它们之间存在一定关系.这将对该地区淋球菌的流行病学调查和淋病防治提供帮助.     

Stable serum resistance of Neisseria gonorrhoeae as an epidemiological marker.

Using a simple and rapid microassay, we tested 100 strains of Neisseria gonorrhoeae isolated from 81 patients (41 men and 40 women) for their sensitivity to killing by normal human serum (NHS). The reproducibility of the test was good when the bactericidal end points were taken as the dilution of fresh NHS that killed more than 95% of the test organisms. The bactericidal end points of strains isolated either from different anatomical sites or from sexual partners correlated well with the levels of sensitivity to serum of corresponding isolates, as well as with auxotypes. When the strains were not highly resistant to killing by NHS, this marker gave a precise definition of each strain and permitted the differentiation of isolates belonging to common auxotypes.     

Stable serum resistance of Neisseria gonorrhoeae as an epidemiological marker

Using a simple and rapid microassay, we tested 100 strains of Neisseria gonorrhoeae isolated from 81 patients (41 men and 40 women) for their sensitivity to killing by normal human serum (NHS). The reproducibility of the test was good when the bactericidal end points were taken as the dilution of fresh NHS that killed more than 95% of the test organisms. The bactericidal end points of strains isolated either from different anatomical sites or from sexual partners correlated well with the levels of sensitivity to serum of corresponding isolates, as well as with auxotypes. When the strains were not highly resistant to killing by NHS, this marker gave a precise definition of each strain and permitted the differentiation of isolates belonging to common auxotypes.     

Susceptibility of different auxotypes of Neisseria gonorrhoeae to norfloxacin, cefotaxime, cefuroxime, and erythromycin

Isolates of Neisseria gonorrhoeae from 150 patients attending a venereal disease clinic were examined for their susceptibility to four antibiotics (norfloxacin, cefotaxime, cefuroxime, and erythromycin) by a plate-dilution method. The isolates were also characterized by gonococcal auxotyping. The most frequent auxotypes were nonrequiring, 50%; Pro-, 16.7%; Pro-, Arg-, (Orn*), Ura-, 10.7%; Arg-, Hyx-, Ura-, 12.7%; and a miscellaneous group consisting of 10% of the isolates. Norfloxacin was the most active of the antibiotics; all of the isolates were inhibited by less than or equal to 0.06 microgram/ml. The Arg-, Hyx-, Ura- group of isolates was the most susceptible of the auxotypes to antibiotics. In the present study N. gonorrhoeae of the Arg-, Hyx-, Ura- auxotype fell into two groups with respect to erythromycin, one highly susceptible and one less susceptible. The results of the present study provide further evidence that the nutritional requirements of gonococci are associated with their response to certain antibiotics.     

广州地区淋球菌营养分型和抗生素耐药性的研究

为了解广州地区淋球菌的营养型分布和4种抗生素的耐药性,以广州地区167株淋球菌进行MIC测定和PPNG检测,同时对其中113株淋球菌进行营养分型检测。结果显示,167株菌中检出PPNG菌株9株,TRNG16株,青霉素耐药株109株（65.3%）,环丙沙星耐药株131株（78.4%）,大观霉素、头孢曲松未发现耐药株。113株淋球菌分16种营养型,以Pro^-型、Proto型、Pro^-、Ile^-、Ile^-型、Pro^-Ile^-Ser^-型5种营养型为主,占86.5%,其余11种营养型占13.5%。青霉素和环丙沙星的耐药菌株主要分布于Pro^-型中,TRNG菌株主要分布于Ile^-型,PPNG菌株散在于各种营养型中。研究结果表明广州地区淋球菌的营养型和耐药性的分布状况,有助于该地区淋球菌的流行病学研究和淋病防治。     

The co-existence of genital Mycoplasma and Neisseria gonorrhoeae isolated from the male urethra

Ureaplasma urealyticum and Mycoplasma hominis, separately or together, were co-isolated along with 34 of 102 strains of Neisseria gonorrhoeae cultured from urethral swabs from men with urethritis. For approximately half of the N. gonorrhoeae strains, the mycoplasma(s) persisted for at least five passages on agar medium. U. urealyticum was isolated in 31 of the 34 instances. No association between particular serotype(s) of U. urealyticum or auxotypes of N. gonorrhoeae was identified. The auxotypes of the N. gonorrhoeae isolates were not altered by the presence of U. urealyticum. To screen cultures of N. gonorrhoeae for the presence of genital mycoplasmas, we recommend direct microscopy of growth on agar: for M. hominis, after the colony epifluorescence test, and, for U. urealyticum, after the urease spot test.     

The dominance of a multiresistant strain of Neisseria gonorrhoeae among prostitutes and STD patients in The Gambia.

OBJECTIVE--To study the epidemiology of antibiotic resistant strains of Neisseria gonorrhoeae from sexually transmitted disease clinics in The Gambia. MATERIALS AND METHODS--One hundred and sixty five strains of N gonorrhoeae were tested for their antibiotic susceptibility, auxotype, serotype, and plasmid content. RESULTS--Of the total population 84 (51%) were non-penicillinase producing (nonPPNG) and 81 (49%) penicillinase-producing N gonorrhoeae (PPNG). There were 16 serovars, five auxotypes and 33 auxotype/serovar (A/S) classes in the total population and the nonPPNG. Among PPNG only five serovars, two auxotypes and nine A/S classes were found. One A/S class predominated, NR/IB-7 (86 isolates), of which 66 (77%) were PPNG and the remainder were chromosomally-mediated resistant N gonorrhoeae (CMRNG). These strains also showed reduced susceptibility to ciprofloxacin, ceftriaxone and tetracycline and were evenly distributed among patient groups. CONCLUSION--We have identified a relatively homogeneous gonococcal population with a core group of isolates exhibiting high levels of antibiotic resistance.     

Relation between nutritional requirements and susceptibilities to antibiotics of strains of Neisseria gonorrhoeae from pharyngeal and anogenital sites.

Auxotyping and antibiotic susceptibility testing was carried out on 100 consecutive isolates of non-penicillinase producing strains of Neisseria gonorrhoeae (non-PPNG) taken on the same occasion from throat and anogenital sites, 100 non-PPNG strains isolated from the throat only, and 100 non-PPNG strains from anogenital sites only. Non-requiring, non-requiring and phenylalanine inhibited, proline requiring, amino acid group requiring, and arginine requiring auxotypes predominated in all groups of patients. Strains of the arginine requiring type found in anogenital sites tended to have additional requirements. The auxotypes and susceptibility to antibiotics of 93 of the 100 paired cultures from the throat and anogenital sites were identical. There appeared to be a slight preponderance of moderately susceptible strains in isolates from the throat. A strong correlation was found between nutritional requirements and sensitivity to antibiotics. Auxotypes of and minimum inhibitory concentrations (MICs) for N gonorrhoeae isolated from the throat were mostly the same as the auxotypes of and MICs for strains that were circulating during the study period in Amsterdam.     

Association of auxotypes of Neisseria gonorrhoeae and susceptibility to penicillin G, spectinomycin, tetracycline, cefaclor, cefoxitin, and moxalactam

Isolates of Neisseria gonorrhoeae from 304 patients attending a venereal disease clinic were examined by a plate dilution method for their susceptibility to six antibiotics: penicillin G, spectinomycin, tetracycline, cefaclor, cefoxitin, and moxalactam. The isolates were also characterized by gonococcal auxotyping. The most frequent auxotypes were Nonrequiring, 58%; Pro-, 14%; Pro- Arg (Orn*) Ura-, 14%; Arg- Hyx- Ura-, 6%; and a miscellaneous group consisting of 8% of the isolates. If the entire group of isolates were examined, moxalactam was the most active of the antibiotics; 94% of the isolates were inhibited by less than or equal to 0.25 microgram/ml. The Pro- Arg (Orn*) Ura- isolates were relatively resistant to penicillin G and cefoxitin. The Arg- Hyx- Ura- group of isolates was the most susceptible of the auxotypes to all of the antibiotics except spectinomycin. The uncommon auxotype Arg (Orn*) Ura- has a requirement for arginine that is satisfied by citrulline but not by ornithine. The results of the present study indicate that the nutritional requirements of gonococci may be associated with their response to certain antibiotics.     

Neisseria gonorrhoeae: subdivision of auxogroups by genetic transformation.

Genetic transformation was used in an attempt to subdivide the most prevalent auxotypes of Neisseria gonorrhoeae in local isolates. The large proline requiring (Pro-) group could be divided into two genetic types, as could the less common arginine requiring (Arg-) group. The large arginine, hypoxanthine, and uracil requiring (Arg- Hyp- Ura-) group could not be subdivided by this method. The genetic relation between these and other auxotypes was investigated.     

Auxotypes and serogroups of penicillinase producing and non-producing strains of Neisseria gonorrhoeae isolated in Franceville, Gabon.

The auxotypes and serogroups of 250 consecutive isolates of Neisseria gonorrhoeae from Franceville, Gabon, including 33 penicillinase producing (PPNG) strains, were identified and the results tabulated for four periods. The PPNG and certain non-PPNG strains were isolated in clusters against a relatively stable pattern of non-PPNG biotypes. Most of the non-PPNG strains were non-requiring or proline requiring strains of serogroup WII or non-requiring strains that could not be grouped with commercially available antisera. No strain requiring arginine, hypoxanthine, and uracil was observed. The PPNG strains were all serogroup WI or ungroupable and non-requiring or proline or arginine dependent auxotypes. Only one non-PPNG strain required proline or arginine and was not serogroup WII.     

Auxotypes and antibiotic susceptibilities of Neisseria gonorrhoeae from women with acute salpingitis. Comparison with gonococci causing uncomplicated genital tract infections in women

An investigation of the MICs of various antibiotics and the nutritional requirements (auxotypes) of Neisseria gonorrhoeae recovered from the cervix, fallopian tubes, and peritoneal cavity of women with acute salpingitis was done. These MICs and auxotypes were compared to those of gonococci isolated from the cervix of women with uncomplicated or asymptomatic genital tract gonorrhea. The MICs of minocycline, penicillin G, ampicillin, cefoxitin, and cefaclor for gonococci isolated from women with acute salpingitis were significantly higher. Significant differences in auxotype patterns were identified between isolates from salpingitis cases and uncomplicated cases. The prototrophic form was the most common (75%) among salpingitis strains. No strains requiring arginine, hypoxanthine, and uracil were identified among the salpingitis isolates. In contrast, strains that required these nutrients were the most frequent auxotype among isolated from women with uncomplicated genital tract gonorrhea. Discriminant analysis revealed that the MIC of minocycline and the auxotype were the most powerful discriminators between groups of patients with different manifestations of gonorrhea.     

Antibiotic susceptibilities, serotypes and auxotypes of Neisseria gonorrhoeae isolated in New Zealand.

OBJECTIVE--The aim of the study was to determine the distribution of auxotypes and serotypes and the prevalence of antibiotic resistance among New Zealand isolates of Neisseria gonorrhoeae. MATERIALS AND METHODS--A total of 486 gonococci isolated in 1988 were auxotyped, serotyped, and tested for susceptibilities to ten antibiotics. RESULTS--The gonococci were susceptible to all the antibiotics tested except penicillin and tetracycline. Eleven (2.2%) produced beta-lactamase, one (0.2%) showed chromosomal penicillin resistance, and 18 (3.7%) were resistant to a low-level of tetracycline. Most of the gonococci belonged to six auxotypes. The three predominant auxotypes were arginine-requiring (Arg-), non-requiring (NR), and arginine, hypoxanthine, uracil-requiring (AHU-). The majority of the isolates belonged to serogroup IB and to six serovars. The most prevalent serovars were IB-3 and IB-1. There was an association between penicillin susceptibility and auxotype or serovar among non-penicillinase producing N. gonorrhoeae (PPNG) isolates. CONCLUSIONS--Antibiotic resistance, including penicillin resistance, remains uncommon among gonococci in New Zealand. Baselines have been established for future epidemiological studies using both auxotyping and serotyping.     

Antimicrobial susceptibility testing, auxotyping, and serotyping of Neisseria gonorrhoeae strains isolated in India

Sixty-four Neisseria gonorrhoeae strains isolated from patients attending sexually transmitted disease clinics at Pune and Delhi between January 2007 and June 2008, were subjected to antimicrobial susceptibility testing, auxotyping, and serotyping. We observed 6 antibiotic resistance patterns, 6 auxotypes, 3 serogroups, and 17 serovars. The combination of auxotyping and serotyping is a potential useful method for typing N. gonorrhoeae as a result of high discriminatory index, rapidity, ease, and relatively lower cost.