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Background: Antimicrobial resistance in Neisseria gonorrhoeae is a global public health concern. Tetracycline resistance (TetR) increased from 39.4% to 75.2% between 2016 and 2021 in N. gonorrhoeae isolates collected through national surveillance in England, despite the absence of use of tetracyclines for the treatment of gonorrhoea., Objectives: We investigated whether there was correlation between bacterial sexually transmitted infection (STI) tests performed and treatment with antimicrobials, with increased TetR in N. gonorrhoeae., Methods: We examined correlations between bacterial STI tests, antimicrobial treatment and TetR in N. gonorrhoeae, using national surveillance data from three large sexual health services (SHS) in London during 2016-20. Doxycycline prescribing data and antibiograms of a non-STI pathogen from distinct patient groups (sexual health, obstetric and paediatric), at a large London hospital, were analysed to identify if doxycycline use in SHS was associated with resistance in a non-STI organism., Results: A substantial increase in TetR was observed, particularly in isolates from gay, bisexual and other MSM (GBMSM). Strong positive correlations were observed exclusively in GBMSM between N. gonorrhoeae TetR and both bacterial STI tests (r = 0.97, P = 0.01) and antimicrobial treatment (r = 0.87, P = 0.05). Doxycycline prescribing increased dramatically during the study period in SHS. Prevalence of TetR in Staphylococcus aureus was higher in isolates sourced from SHS attendees than those from other settings., Conclusions: Frequent screening of GBMSM at higher risk of STIs, such as those on pre-exposure prophylaxis (PrEP) leading to/and increased use of doxycycline for the treatment of diagnosed infections, may account for the increase in TetR in N. gonorrhoeae., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.)

Objective: To reduce the rates of wound infection for major colorectal and biliary surgery., Design: Prospective audit of antibiotic prophylaxis by keeping copies of typed notes of operations and annotating them at discharge and at first follow up visit and annual review of prophylactic regimen according to yearly rate of wound infection and modification if necessary., Setting: The work of one consultant surgeon working in a district general hospital., Patients: All patients having major colorectal resection during 1976-89 (400) and cholecystectomy during 1981-9 (500)., Main Outcome Measures: Wound infection, defined as any discharge from the wound as detected by observation during inpatient stay and by specific questioning at the first follow up visit six weeks later., Results: Serial changes in prophylaxis for colorectal surgery resulted in a progressive reduction in the rate of wound infection from 43% in 1976, with no prophylaxis, to 1% during 1986-9 with single intravenous doses of metronidazole and cefuroxime intraoperatively and with lavage of the peritoneal cavity and wound with 0.1% tetracycline. During 1981-7, with no prophylaxis, the rate of infection in biliary surgery was 12% whereas in 1988-9, after the introduction of lavage with tetracycline alone, the rate was reduced to 2%., Implications and Action: Simple prospective audit identified the need for changes in antibiotic prophylaxis; successive rounds of audit resulted in improved rates of wound infection, and lavage with 0.1% tetracycline seemed to be a major factor in achieving this.

A natural outbreak of Salmonella saint-paul infection in two Institute herds was monitored clinically, bacteriologically and immunologically. This paper describes the findings in calves. Morbidity and mortality became apparent 30 days after S. saint-paul was first isolated on routine sampling of neonatal calf faeces. All heifer calves were treated with a tetracycline or ampicillin preparation when they showed clinical signs of disease, while the effects of intradermal vaccination with heat-killed S. saint-paul were assessed in a proportion of the bull calves. Antibiotic treatment reduced mortality and the number of persistent excretors; vaccination did not affect mortality but, if given during the first week of life, reduced the duration of faecal excretion. Calves which were untreated and unvaccinated, or vaccinated when older than 16 days, excreted S. saint-paul for periods of up to 18 months. Of six 'recovered' calves, which had been negative on faecal culture for 5-8 weeks, four yielded S. saint-paul at necropsy. Agglutinating antibody titres were highest in those unvaccinated calves which were persistent excretors.

The current methods of treating and reporting non-specific genital infection (NSGI) are described. The most commonly used drug was tetracycline in one or other form. Epidemiological treatment was widely used, particularly for female sexual contacts. There was considerable variation in the reporting criteria for the quarterly returns. The establishment of acceptable and uniform criteria for notification of NSGI is discussed.