Antimicrobial susceptibility of Neisseria gonorrhoeae isolated from maternal and child infections in Harare. The Puerperal Sepsis Study Group.

The in vitro antimicrobial susceptibilities of 29 PPNG and 26 non-PPNG isolated from women and neonates in Zimbabwe were investigated. There was evidence of chromosomal resistance to penicillin in many of the non-PPNG strains, with over 60 percent of all isolates having an MIC greater than 1 mg/litre. Reduced susceptibility to tetracycline was evident in about 20 percent of PPNG strains, particularly those containing the 4.4Md plasmid, while over 10 percent of non-PPNGs showed partial resistance to cefuroxime. Less than half of the strains were susceptible to erythromycin (MIC50 greater than 0.5 mg/litre) while all were susceptible to kanamycin and spectinomycin. PPNG containing the 3.2 Md plasmid were very susceptible to thiamphenicol (MIC50 0.25 mg/litre), while other strains were only moderately susceptible (MIC50 2 mg/litre). These findings suggest that penicillin, tetracycline or erythromycin may no longer be relied on for the successful treatment of gonococcal infection in women and babies. Thiamphenicol, Blactamase stable cephalosporins, kanamycin or spectinomycin may be useful alternatives, effective against most strains of both PPNG and non-PPNG. Continued surveillance is recommended to monitor changes in this susceptibility pattern.