Imported penicillinase producing Neisseria gonorrhoeae becomes endemic in London.

Abstract

All cases of gonorrhea caused by penicillinase-producing N. gonorrhoeae (PPNG) seen in 1976-1983 at a sexually transmitted disease clinic, which accounted for 11% of all such cases reported in that period in the UK, were reviewed. While the overall incidence of gonorrhea remained relatively stable in this clinic, that of PPNG rose to 4.4% of all such cases by 1982. Until last year, 75% of these cases were imported, mainly from Nigeria and Ghana; a marked change was seen in the 2nd half of 1982, when 71% of cases were indigenous in origin. Casual partners and prostitutes in London were mentioned as the source of infection by 34% of patients, a much higher percentage than that seen previously. Such sources are notoriously difficult to trace. Although rectal infection tends to be asymptomatic, PPNG was isolated in rectal cultures from 2 of 5 homosexuals and 19 of 26 women. There is therefore a risk that PPNG could spread rapidly through the homosexual population. Spectinomycin should no longer be the 1st drug of choice in the treatment of gonorrhea caused by PPNG; it should be replaced by the newer cephalosporins.