Antimicrobial Susceptibility Profile of Gonococcal Isolates Obtained from Men Presenting with Urethral Discharge: Implication for National Syndromic Treatment guideline

Abstract Background: Neisseria gonorrhoeae (gonococcus) is one of etiologic agent for sexually transmitted diseases with high global significant public health importance. The treatment regimens for gonorrhea have changed frequently over the past few decades due to the organism’s propensity for developing antibiotic resistance. This study was aimed to investigate quinolones, third-generation cephalosporins and other relevant antimicrobials susceptibility patterns of N. gonorrhoeae so that the national treatment regimen could be revised based on the information generated from this study. Methods: Urethral discharge specimens were cultured on Modified Thayer Martín media and suspected gonococcal colonies were confirmed using Oxidase, Superoxol tests followed by commercial identification kit (API-NHR). Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method using ciprofloxacin(5ug), ceftriaxone (30ug), cefixime(5ug), cefoxitin (30 ug), and spectinomycin (100 ug), on enriched GC agar. Minimum Inhibitory Concentration (MIC) was also done using concentration gradient strips (E-test) of the same antimicrobial agents. Results: The prevalence of gonococcal isolates from the current study was 69%. Out of the 361 gonococcal isolates, close to 68% were fluoroquinolone non susceptible with 60% resistant and 7% intermediate status. However, there was no detection of ceftriaxone non susceptible gonococcal isolates. The isolates also showed reduced non susceptible to spectinomycin and cefoxitin. Conclusion: The prevalence of gonococcal isolates from the current study was high. There was a high level of fluoroquinolone resistance in gonococcal isolates recovered in this study. Key words: Neisseria gonorrhoeae, Ciprofloxacin, Ceftriaxone MIC, Ethiopia