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Antibiotic resistance in Neisseria gonorrhoea and treatment outcomes of gonococcal urethritis suspected patients in two large hospitals in Bhutan, 2015.
- Source :
-
PloS one [PLoS One] 2018 Aug 01; Vol. 13 (8), pp. e0201721. Date of Electronic Publication: 2018 Aug 01 (Print Publication: 2018). - Publication Year :
- 2018
-
Abstract
- Introduction: Gonorrhea is a major sexually transmitted infection (STI) globally with increasing trends. Despite limited data, gonorrhea remains an important public health problem in Bhutan.<br />Methods: A descriptive study was carried out in two Bhutanese hospitals; Jigme Dorji Wangchuck National Referral Hospital and Phuentsholing General Hospital in 2015. Patients suspected of gonococcal urethritis were sampled, treated and followed up at two weeks. Gonococcal isolates were identified and tested for antibiotic susceptibility by the Calibrated Dichotomous Sensitivity Test (CDS) method.<br />Results: Of the 524 patients, 2.3% (12) were females. Most (46.6%) patients belonged to the 26-35 years age group. About 58% were lost to follow up; 62% (277) of males and all (12) females. N. gonorrhoea was positive in 76% (398) of microscopy and 73.1% (383) by culture. Resistance against ciprofloxacin, penicillin, tetracycline and nalidixic acid were 85.1%, 99.2%, 84.8% and 99.7% respectively. Nearly all the isolates were sensitive to cefpodoxime, ceftriaxone and azithromycin. Sixty-seven percent (350) were treated with injection ceftriaxone alone, 32% (169) with ceftriaxone and oral doxycycline and 1% (5) with ceftriaxone, doxycycline and metronidazole. Probable treatment failure was seen only in one patient (0.5%).<br />Conclusions: Gonococcal resistance to currently used antibiotics was low and there was a high clinical cure rate. Compliance to treatment guidelines need reinforcement addressing antibiotic regimen, tracing sexual partners and addressing the social stigma. National STI programs should be more women-friendly for effective management, prevention and control of STIs. Laboratories must adopt more reliable susceptibility testing methods, the Minimum Inhibition Concentration method.<br />Competing Interests: The authors have declared that no competing interests exist.
- Subjects :
- Adult
Anti-Bacterial Agents pharmacology
Anti-Bacterial Agents therapeutic use
Bhutan
Female
Follow-Up Studies
Humans
Male
Middle Aged
Treatment Outcome
Young Adult
Drug Resistance, Microbial
Gonorrhea complications
Hospitals statistics & numerical data
Neisseria gonorrhoeae drug effects
Neisseria gonorrhoeae physiology
Urethritis complications
Urethritis drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 13
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 30067836
- Full Text :
- https://doi.org/10.1371/journal.pone.0201721