1/3. Multiple drug-resistant chlamydia trachomatis associated with clinical treatment failure.in vitro susceptibility testing and genotyping were done on urogenital isolates of chlamydia trachomatis from 3 patients, 2 of whom showed evidence of clinical treatment failure with azithromycin and one of whom was the wife of a patient. All 3 isolates demonstrated multidrug resistance to doxycycline, azithromycin, and ofloxacin at concentrations >4.0 microg/mL. Recurrent disease due to relapsing infection with the same resistant isolate was documented on the basis of identical genotypes of both organisms. This first report of clinically significant multidrug-resistant C. trachomatis causing relapsing or persistent infection may portend an emerging problem to clinicians and public health officials.- - - - - - - - - - ranking = 1keywords = treatment failure (Clic here for more details about this article) |
2/3. Partial characterization of chlamydia trachomatis isolates resistant to multiple antibiotics.in vitro susceptibility testing was done on urogenital isolates of chlamydia trachomatis from five patients, four of whom were suspected treatment failures. At least one isolate from each patient was resistant to tetracycline at concentrations greater than or equal to micrograms/ml, although less than 1% of a population of organisms showed high-level resistance. Fully resistant populations selected by passage through 8 micrograms/ml tetracycline either died or lost their resistance on further passage in antibiotic-free medium. Relatively large inocula were required to demonstrate resistance, and morphology of inclusions was altered at high tetracycline concentrations. The observed resistance may be a new characteristic of the organism or merely newly recognized. Isolates resistant to tetracycline were resistant to doxycycline, erythromycin, sulfamethoxazole, and clindamycin but sensitive to rifampin, ciprofloxacin, and ofloxacin. Thus, resistance to tetracycline, erythromycin, and clindamycin occurs in C. trachomatis and may be a factor in some treatment failures.- - - - - - - - - - ranking = 2keywords = treatment failure (Clic here for more details about this article) |
3/3. Infections with non-penicillinase-producing neisseria gonorrhoeae treated with cefuroxime: treatment failures.Two men who acquired acute gonococcal urethritis in The netherlands and who were treated with cefuroxime (1.5 g given intramuscularly) failed to respond to this therapy. Pre- and post-treatment isolates of neisseria gonorrhoeae from these patients had MICs of 0.5 and 1.0 microgram of cefuroxime/ml.- - - - - - - - - - ranking = 4keywords = treatment failure (Clic here for more details about this article) |