Alarming Increase in Ciprofloxacin- and Penicillin-Resistant Neisseria gonorrhoeae Isolates in New Delhi, India

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In Brief Background Resistance of ciprofloxacin has been reported in several regions of the world, including India. In India, ciprofloxacin is still being used as single-dose treatment for gonorrhea. Goal The aim of the study was to determine the antimicrobial susceptibility of Neisseria gonorrhoeae isolates from patients with acute gonococcal urethritis in New Delhi. Study Design By means of disc diffusion, we determined the susceptibility profiles of N gonorrhoeae isolates, determined the MICs of ciprofloxacin, penicillin, and ceftriaxone, and compared our data with previous findings. Results On the basis of MIC values, 35.3% and 52.9% of strains were found to be resistant and less sensitive, respectively, to penicillin; 67.3% and 28.2% strains were observed to be resistant and less sensitive, respectively, to ciprofloxacin. Only one isolate (5.9%) was found to be less sensitive to ceftriaxone. Conclusion The significant increase in ciprofloxacin resistance in the current study indicates that resistance has developed under selective antibiotic pressure. In accordance with the World Health Organization's suggestion of global monitoring of resistant strains of Neisseria gonorrhoeae, since 1995 a program in New Delhi, India—where gonorrhea constituted 19.4% of all cases of STD from 1999 to 2001—has been testing the antimicrobial susceptibility of isolates from patients with acute gonococcal urethritis.