Recent data indicate an increasing resistance to
ciprofloxacin in Neisseria gonorrhoeae, especially among men who have
sex with men.
As treatment failures for oral cephalosporins are
documented in Asia, and strains with reduced susceptibility to cephalosporins
have begun to appear in the West, including the United States, the origins and
causes of increased drug resistance in N. gonorrhoeae need to be
understood in order to improve control measures for emerging resistant strains
and thereby maintain the utility of the few existing antimicrobial drug options
for treatment of gonorrhea, the researchers wrote.
Researchers from the Harvard School of Public Health
used data from the Gonococcal Isolate Surveillance Project to study
ciprofloxacin resistance in N. gonorrhoeae in the United States from
2002 to 2007. Data included in this project include sexual orientation, travel
history and resistance to ciprofloxacin, penicillin and tetracycline.
Among MSM, resistance reached higher levels compared to
heterosexual men. At peak, the resistance rate was 42.5% for MSM and 9.1% for
heterosexual men. Strains resistant to ciprofloxacin, tetracycline and
penicillin were the fastest-growing class of ciprofloxacin-resistant strains
among MSM. Strains resistant to only ciprofloxacin were also more prevalent
Recent travel did not have any effect on the prevalence
of strains resistant to ciprofloxacin among MSM, but travel was related to an
increase in the prevalence of strains resistant to ciprofloxacin among
Our study on the rise of ciprofloxacin resistance
sheds some light on the possible mechanisms that might contribute to the
emergence of cephalosporin resistance, the researchers wrote.
Importation of resistance and acquisition through domestic travel are
likely to play a substantial role in the initial rise in resistance
Goldstein E. Emerg Infect Dis. 2012;18.
The researchers report no relevant financial