Jonathan M. Zenilman

High-level tetracycline resistance resulting from TetM in strains of Neisseria spp., Kingella denitrificans, and Eikenella corrodens.

Similar to Neisseria gonorrhoeae, tetracycline-resistant isolates of N. meningitidis, Kingella denitrificans, and Eikenella corrodens contained 25.2-megadalton plasmids carrying the TetM determinant. In contrast, tetracycline-resistant N. subflava biovar perflava-N. sicca and N. mucosa isolates carried the TetM determinant in the chromosome.

Fleeting foreskins: the misclassification of male circumcision status.

Background Errors in the classification of male circumcision status could bias studies linking infection to lack of circumcision. Goal To determine the frequency and factors associated with the reproducibility of reporting circumcision status. Study Design Secondary analysis of data using logistic regression modeling from a multicenter randomized controlled trial was performed. Results At follow-up assessment, 15.6% of clinician reports on circumcision status disagreed with baseline reports. Disagreement was more common if both clinicians were women than if both were men (odds ratio [OR], 2.8; 95% CI, 1.9–4.1). As compared with whites reported as circumcised (4%, 19/532 visits), the highest disagreement involved uncircumcised Hispanic (OR, 3.3; 95% CI, 1.7–6.3), white (OR, 12.2; 95% CI, 5.8–25.6), or black (OR, 17.1; 95% CI, 10.4–27.9) men. Conclusions This is one study among a small number of studies examining the reproducibility of clinician-reported circumcision status by comparing multiple clinical examinations of the same patient. The magnitude of the misclassification discovered could bias results and indicates the need for greater accuracy in reporting circumcision status in future studies.

Penicillinase-producing Neisseria gonorrhoeae in Dade County, Florida: phenotypic characterization of isolates from 1983, 1984, and 1986.

Penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) have been endemic in Miami, Florida, since 1981. Strains of PPNG isolated in Miami during 1983 (60 isolates), 1984 (41 isolates), and 1986 (107 isolates) were characterized by plasmid content, auxotype/serovar (A/S) class, and susceptibility to antimicrobial agents. In 1986, 95 isolates (89%) possessed the 3.2-Megadalton (MDa) beta-lactamase plasmid; 36 (34%) of these isolates also possessed the 24.5-MDa conjugative plasmid. These results contrast with those from 1984, when 37 PPNG isolates (90%) possessed the 4.4-MDa plasmid, and most possessed the 24.5-MDa conjugative plasmid. This in turn was a reversal of the pattern seen in 1983, when only 42 (69%) possessed the 3.2-MDa plasmid, and the conjugative plasmid was rare. In 1983 and 1986, isolates possessing the 4.4-MDa plasmid were more resistant to penicillin than were isolates containing the 3.2-MDa plasmid. All isolates were susceptible to spectinomycin and ceftriaxone. In early 1986, two A/S classes accounted for 66% of all isolates. Pro/IA-1,2 and Pro/IB-2 accounted for 31 (29%) and 40 (37%), respectively, and were isolated during every week in early 1986. In contrast, isolates belonging to 14 and six A/S classes possessing the 3.2- and 4.4-MDa beta-lactamase plasmid, respectively, were isolated sporadically. The composition of the PPNG strain population in Miami is dynamic, a factor that may have important implications for the use of traditional disease intervention strategies.

Frequency in the united states of non-β-lactamase-producing strains of neisseria gonorrhoeae possessing the 24.5-mdal conjugative plasmid

We characterized 475 non-beta-lactamase-producing gonococcal isolates from five U.S. cities by auxotype, serovar, and plasmid content to determine the frequency of isolates with the 24.5-Mdal gonococcal conjugative plasmid. A total of 150 (32%) of all isolates possessed the 24.5-Mdal plasmid; these isolates represented between 10% and 53% of isolates from each city. Isolates possessing the 24.5-Mdal plasmid belonged to 45 (56%) of 81 auxotype/serovar (A/S) classes, or between 24% and 70% of the A/S classes isolated in each city. Overall, a higher proportion of strains isolated in the southern cities possessed the 24.5-Mdal plasmid than did those from northeastern or northwestern cities. These strains appear to have spread independently of the spread of beta-lactamase-producing Neisseria gonorrhoeae strains. The prevalence of N. gonorrhoeae strains with the 24.5-Mdal conjugative plasmid has increased substantially and may have important implications for the epidemiology of gonorrhea caused by beta-lactamase-producing strains.

High-level tetracycline resistance associated with tetM in Neisseria meningitidis and other Neisseriaceae

Neisseria gonorrhoeae strains with plasmid-mediated, high-level tetracycline resistance (TRNG) have accounted for approximately 5% of gonococcal isolates in patients attending the DeKalb County Health Department Sexually Transmitted Diseases clinic in Atlanta, GA, in August-December, 1985.