From 1992 to 2001, penicillin resistance of betalactamase-producing Neisseria gonorrhoeae was supervised by Institute of Dermato-Venereology. Results: the rate of penicillin-resistant gonococcal strains was highest in1995 (about 76%), and in 1996 (73.11%), especially in 3 years (1999-2001) this rate decreased significantly: 51.3%, 47.10%, and 35.54%, respectively
Neisseria gonorrhoeae ; Neisseria ; penicillinase

Penicillinase producing Neisseria gonorrhoeae(PPNG) have been reported from various cauntries throughout the world. We have been tr ying to assess the prevalence of PPNG in Korea since May, 1980 by means of chromogenic cephalosporin method. The total number of isolated Neisseria gonorrhoeae strains in 1983 was 733, among which 679 were tested for p-lactamase production, among which 178(26. 2%) were PPNGs. In 1984, 791 strains were isolated, among which 214(27.1%) were PPNGs. In all, 392(26.7%) strains were found to be PPNGs arnong 1470 Neisseria gonorrhoeae strains tested between 1983-1984.
Korea* ; Neisseria ; Neisseria gonorrhoeae ; Penicillinase ; Prevalence* ; Seoul*

Between December 18, 1985 and May 31, 1986 at the VD Clinic, Choong-ku Public Health Center, in Seoul, 274 male patients with uncomplicated gonococcal infection, including 124 penicillinase producing Neisseria gonorrhoeae(PPNG) infection, were entered into the study. They were divided randomly into the group A and the group B. In the group A, treated with kanamycin 2g, im regimen, 126 of 137 patients were followed and 86 patients(68.3%) were cured. In the group B, treated with gentamicin 240mg, im regimen, 125 of 137 patients were followed and 78 patients(62.4%) were cured. The cure rates in PPNG urethritis were 63.9%(39/61) in the group A and 50.9%(29/57) in the group B. The cure rates in non PPNG urethritis were 72.3%(47/65) in the group A and 72.1% (49/68) in the group B. No significant difference was observed in cure rates between two groups. It is suggested that. both kanamycin 2g, im regimen and gentamicin 240mg, im regimen is not suitable for a first line treatment for uncomplicated gonococcal urethritis.
Gentamicins* ; Humans ; Kanamycin* ; Male* ; Neisseria ; Penicillinase ; Public Health ; Seoul ; Urethritis*

At the Venereal Disease Clinic of Choong-ku Public Health Center in Seoul ]03 male patients with uncomplicated gonococcal urethritis were allocated randomly into one of 2 treatment regimens and 101 patients were followed. All 51 patients, including PPNG infections, treated with clavulanate-potentiated amoxycillin, 375 mg, PO, t.i.d. for 5 days recovered(100%), Two(4%) of 50 patients treated with clavulanate-potentiated amoxycillin, 3. 25g, PO plus probenecid, lg, PO failed to recover. These cases were 2 of 25 Penicillinase Froducing Neisseria gonorrhoeae(PPNG) infections(failure rate of 8%) and all 25 non-PPNG infections recovered(100%). It is suggested that both of these clavulanate-potentiated amoxycillin regimens ha.ve similarly good effect with minimal side effects in the treatment of gonococcal urethritis and, because of high rate of PPNGs among circulating N, gonorrhoeae, they can be recommended as the first line treatment for gonorrhoa ir Korea.
Amoxicillin* ; Clavulanic Acid* ; Humans ; Korea ; Male* ; Neisseria ; Penicillinase ; Probenecid ; Public Health ; Seoul ; Sexually Transmitted Diseases ; Urethritis*

In this study, the effect of kanamycin sulfate was compared with fortified penicillin G in the treatment of uncomplicated penicillinase negative Neisseria gonorrhoeae(nonPPNG) urethritis in male. The subjects were 250 male patients with uncomplicated non-PPNG urethritis, at the Venereal Disease Clinic of Choong-ku Public Health Center in Seoul from May 1982 to August 1982. Among 103 patients treated with kanamycin sulfate, 2. 0 gm, IM, 92 recovered and 11(10. 7%) failed. Among 100 patients treated with fortified penicillin G, 6 megaunits IM, plus probenecid, l. 0 gm, 92 recovered and 8(8%) failed. No significant difference in the effect was found between these two regimens for non-PPNG urethritis. It is concluded that kanamycin sulfate as well as fortified penicillin G. have a good effect in the treatment of non-PPNG urethritis.
Humans ; Kanamycin ; Korea* ; Male ; Neisseria ; Penicillin G ; Penicillinase ; Probenecid ; Public Health ; Seoul* ; Sexually Transmitted Diseases ; Urethritis

Guidelines recommend that clinical laboratories perform phenotypic tests (nitrocefin-based test and penicillin 10-U [P10] or 1-U [P1] zone edge tests) to detect penicillinase in Staphylococcus aureus isolates. This study aimed to assess the prevalence of blaZ encoding penicillinase and perform various phenotypic tests in S. aureus isolates from Japan. We prospectively collected 200 methicillin-susceptible S. aureus isolates from June 2015 to January 2016 and performed six phenotypic tests (nitrocefin-based test, P10 zone edge test/P10 diffusion test, penicillin 2-U [P2] zone edge test/P2 diffusion test, and cloverleaf test) on each sample. We confirmed the presence of blaZ (two blaZ-positive isolates) using PCR. Using blaZ PCR as a standard, we observed a low sensitivity (50%) and positive predictive value (PPV, 50%) of the nitrocefin-based test, low PPV (18.2%) of the P10 zone edge test, low sensitivity (50%) of the P10 diffusion test, low PPV (50% and 22.2%) of the P2 zone edge test and P2 diffusion test, respectively, and low sensitivity (50%) of the cloverleaf test. These data suggest a low performance (sensitivity and PPV) of these six phenotypic tests because of the low prevalence (1%) of blaZ in S. aureus isolates from Japan.
Diffusion ; Japan* ; Penicillinase* ; Penicillins ; Polymerase Chain Reaction ; Prevalence* ; Prospective Studies ; Staphylococcus aureus* ; Staphylococcus*

Decreased sensitivity of N. gonorrhoeae to many existing antibiotics and the emergence and increase of penicillinase producing and of spectinomycin resistant N. gonorrhoeae necessitate intensive efforts to study on resistance. Male patients with uncomplicated gonococcal urethritis treated during the year 1990 at the VD clinic of Choong-ku Public Health Center in Seoul were included in this study. A total of 85 strains, 44 strains of non-PPNG and 41 strains of PPNG isolated from the patients were studied to evaluate their sensitivities to ampicillin, penicillin, cefoxitin, kanamycin, tetracycline, erythromycin, spectinomycin and cotrimazole. The results are summerized as follw: In non-PPNG strains, the range of MICs. MIC50 and MIC90 for both ampicillin and penicillin were 0.125-32, 2 and 16 mcg/ml respectively. For cefoxitin, they were 0.125-8, s and 16 mcg/ml respectively, and for kanamycin, 8--<64, 32 and 64 mcg/ml, respectively. For tetracycline, they were 1-64, 8 and 32 mcg/ml, while for erythromycin, 0.06-16, 2 and 8 mcg/ml respectively. For spectinomycin, they were 4--<64, 32 and 64 mcg/ml and for cotrimazole, 5--<160, 40 and 160 mcg/ml respectively. In the case of PPNG, the range of MICS, MIC50 and MIC90 for ampicillin were 8--<128, 32 and 128 mcg/ml respectively but for penicillin, 8--<128, 64 and 128 mcg/ml respectively. And for cefoxitin, they were 0.5-32, 4 and 16 mcg/ml while for kanamycin, 16--<64, 64 and >64 mcg/ml respectively. For tetracycline, the values were 2-64, 16 and 32 mcg/ml, and for erythromycin, they were 0.5-16, 4 and 8 mcg/ml respectively. for spectinomycin, they were 8--<64, 32, and 64 mcg/ml and finally for cotrimazole, 5--<160, 80 and 160 mcg/ml respectively. From these results, it is concluded that the MICs of both PPNG and non-PPNG were about 2 folds higher than the results of sensitivity tests at the same instituition in 1985. 2) The prevalence of PPNG among 35 gonorrhoeae patients who received treatment before the visit was 60% (21/35), while that among the patients without previous treatment was 40% (20/50). 3) In the cases of ampicillin, penicillin and cotrimazole, their MIC values were found to be significantly higher for the strains isolated from the patients with previous treatment history than those without previous treatment (p<0.05). 4) In non-PPNG strains, a significant positive correlation is found between the sensitivities to most pairs of ampicillin, penicillin, cefoxitin, kanamycin, tetracycline, erythromycin and spectinomycin. However this excludes some pairs such as : tetracycline-cefoxitin, erythromycin-penicillin, erythromycin-cefoxitin, spectinomycin-penicillin, and spectinomycincefoxitin (p<0.05). 5) In PPNG strains, a significant positive correlation is also found between the sensitivities to most pairs of ampicillin, penicillin, cefoxitin, tetracycline, erythromycin and spectinomycin. However, the exceptional cases include tetracycline-cefoxitin, erythromyoinpenicillin, erythromycin-cefoxitin, spectinomycin-penicillin, and spectinomycin-cefoxitin pairs. In addition, the sensitivity to kanamycin was found to be strongly correlated with that to tetracycline, erytheromycin and spectinomycin (p<0.05). Therefore it is essential for the management fo gonorrhoeae, together with a correct diagnosis, to use currently most effective treatment regimens which would also prevent the emergence of resistant strains. It is also suggested that when a treatment is failed, to use the durg which do not show correlation in sensitivities on re-treatment.
Ampicillin ; Anti-Bacterial Agents ; Antibodies* ; Cefoxitin ; Diagnosis ; Erythromycin ; Humans ; Kanamycin ; Male ; Penicillinase ; Penicillins ; Prevalence ; Public Health ; Seoul ; Spectinomycin ; Tetracycline ; Urethritis

Because of increasing resistance of circulating N. gonorrhoeae and frequent failures in the treatment of gonorrhoea, intensive work on gonorrhoea has become of paramount importance. During January 1980-April 1984, at the Choong-Ku VD Clinic in Seoul, 3,340 male patients with uncomplicated gonococcal urethritis were treated with various treatment regimens. Diagnosis of gonorrhoea and declaration of a treatment failure were made on the basis of positive urethral culture. In 1984, the prevalence of Penicillinase Producing N. gonorrhoeae (PPNG) was about 30%, The pretreatment minimun inhibitory concentration of various antibiotics were quite high. Even for non-PPNG urethritis standard penicillin regimens gave unsatisfactory results. For PPNG urethritis, only spectinomycin, cefoperazone and cefotaxim-probenecid regimens gave satisfactory results. No spectmomycin resistant strain of N. gonorrhoeae has been found since 1982 at the Choong-Ku VD Clinic. As an agent of single drug therapy, spectinomycin seems to be one of the most cost effective drugs in the treatment of uncomplicated gonorrhoea in men.
Anti-Bacterial Agents ; Cefoperazone ; Diagnosis ; Drug Therapy ; Humans ; Male ; Penicillinase ; Penicillins ; Prevalence ; Seoul ; Spectinomycin ; Treatment Failure ; Urethritis

Although penicillin still remains the drug of choice in the treatment of gonorrhoea in many countries, treatment failures are becoming more and more coramon. Recently, the prohlem cauaed, by antibiotic resistant strains of N. gnorrhoeae has been aggravated by appearance of penicillinase producing N. gonorrheeae. Good results were reported with the use of spectinomycin, cefuroxime and efotaxime. These drugs are, as yet, quite expensive. A lower cost regimen has to be sought. In this study, the effect of fortified penicillin G was compared with kanarnycin in the treatment of uncomplicated male gonorrhoeae. The subjects were 446 rnale patients with uncomplieated gonocoacal urethritis at VD clinic of ChoongKu Public Health Center in Seoul between June and November, 1981. The patients are assigned randomly to one of the regimens. Among 181 patients treated with kanamycin, 2. 0 gm, IM, 148 recovered with 27 (19%) postgonococcal urethritis (PGU) and 39(21,6%) failed. Among 168 patients treated with fortified penicillin G, 6 mega-units IM, plus probenecid, l. 0 gm, PO., 100 recovered with 31(81%) PGU and 68(40. 5%) failed. -countinue-
Cefuroxime ; Gonorrhea* ; Humans ; Kanamycin* ; Male* ; Penicillin G* ; Penicillinase ; Penicillins* ; Probenecid ; Public Health ; Seoul ; Spectinomycin ; Treatment Failure ; Urethritis

In this study, the effect of kanamycin sulfate was compared with fortified penicillin G in the treatment of uncomplicated penicillinase negative Neisseria gonorrhoeae(nonPPNG) urethritis in male. The subjects were 250 male patients with uncomplicated non-PPNG urethritis, at the Venereal Disease Clinic of Choong-ku Public Health Center in Seoul from May 1982 to August 1982. Among 103 patients treated with kanamycin sulfate, 2.0 gm, IM, 92 recovered and 11(10. 7%) failed. Among 100 patients treated with fortified penicillin G, 6 megaunits IM, plus probenecid, l.0 gm, 92 recovered and 8(8%) failed. No significant difference in the effect was found between these two regimens for non-PPNG urethritis. It is concluded that kanamycin sulfate as well as fortified penicillin G. have a good effect in the treatment of non-PPNG urethritis.
Gonorrhea* ; Humans ; Kanamycin* ; Male* ; Neisseria gonorrhoeae* ; Neisseria* ; Penicillin G* ; Penicillinase* ; Penicillins* ; Probenecid ; Public Health ; Seoul ; Sexually Transmitted Diseases ; Urethritis