Detection of alarming increase in antibiotic resistant neisseria gonorrhoeae isolates in karaj, Iran

Background: Of the most common bacteria causing Sextually Transmitted Diseases (STD) is Neisseria gonorrhoeae. Rising gonorrhea rates, growing antimicrobial resistance, and increasingly limited antimicrobial options globally have made gonorrhea an urgent antibiotic-resistant threat. Materials and methods: Two-hundred vaginal swabs were collected from non-pregnant women patients in Karaj, Iran during 2015-2016. The bacterial isolates were identified by gram-staining and biochemical tests. The antibiotic susceptibility of isolates was performed and the MIC and MBC concentration of azithromycin and co-trimoxazole were determined by the micro-broth dilution test according to the CLSI 2016. Results: The mean age of participants was 35.85%. The abundance of married people was 97%, with 148 people having completed post-secondary education. Of the total 200 cervisitis samples, 12 (6%) of them were able to grow in vitro on the Thayer martin agar medium. all the isolates were resistant to cephixime and the majority of them (11/12 or 91.7%) were resistant to ceftriaxone, cefotaxime, ciprofloxacine, ceftizoxime, ceftizoxime, spectinomycin, and gentamicin. most of N. gonorrhea isolates were susceptible to azithromycin and co-trimoxazole in the MIC determination test. Conclusion: In our study, given that the majority of gonococci had multiple resistances and showed at least three antibiotic classes in the society, this level of multiple resistance seems to be alarming. It is possible that the availability of antibiotics and self-treatment has increased the resistance of N. gonorrhea to antibiotics, which may be due to the lack of education from health care personnel, and more attention to the education provided by health care personnel is helpful.