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    Surveillance van resistentie bij gonokokken in Nederland ; incidentie en frequentie in 1992 en 1993

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    Authors
    van Klingeren B
    van Santen-Verheuvel M
    Dessens-Kroon M
    Type
    Report
    Language
    nl
    
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    Title
    Surveillance van resistentie bij gonokokken in Nederland ; incidentie en frequentie in 1992 en 1993
    Translated Title
    Surveillance of resistance in Neisseria gonorrhoeae in the Netherlands ; incidence and frequency in 1992 and 1993
    Publiekssamenvatting
    In dit rapport worden de resultaten samengevat van de resistentie surveillance bij Neisseria gonorrhoeae in 1992 en 1993. Uit de enquete bij de medische microbiologische laboratoria blijkt dat de landelijke frequentie van penicillinase vormende gonokokken (PVG) na een aanvankelijke daling weer is gestegen tot ruim 20% van alle gonokokken isolaten in 1993. Het onderzoek in het RIVM van een collectie aselect verzamelde N.gonorrhoeae isolaten uit 5 centra toont aan dat in de periode 1991-1993 resistentie tegen tetracycline zich bij non-PVG handhaaft op 6 a 7% en bij PVG op ruim 10%. Resistentie-ontwikkeling tegen cefalosporines is nog niet waargenomen, maar isolaten met verminderde gevoeligheid voor fluorchinolonen worden reeds met een frequentie van ca. 1% gevonden. Uit het auxo- en serotyperingsonderzoek blijkt dat zowel bij PVG als non-PVG een grote diversiteit van A/S klassen voorkomt, waarbij prototrofe stammen en IB-serovars overheersen. Het merendeel van de isolaten zijn overigens geclusterd in een beperkt aantal A/S klassen. In hoeverre de isolaten binnen eenzelfde A/S klasse identiek zijn zal m.b.v. DNA-typering worden onderzocht.

    Within the framework of a continuing surveillance of resistance in Neisseria gonorrhoeae in the Netherlands, the results are presented for the period 1992-1993. An inquiry among the laboratories for medical microbiology showed that, after a temporary decrease, the frequency of penicillinase producing strains (PPGN) among the isolated gonococci increased again to a level of more than 20% in 1993. Susceptibility testing in our laboratory of a random collection of N.gonorrhoeae isolates from 5 centres indicated that in the period 1991-1993 the frequency of resistance against tetracycline among non-PPNG is maintained at 6 a 7% and among PPNG at more than 10%. Development of resistance against cephalosporins has not been observed yet, but isolates showing a decreased susceptibility to fluoroquinolones were found in nearly 1% of the strains. Auxo- and serotyping revealed a great variety of A/S classes among PPNG and non-PPNG with a predominance of auxotrofic strains belonging to IB-serovars. However the majority of the isolates are clustered in a limited number of A/S classes. The identity (clonality) of isolates within clusters will be studied using DNA-typing methods.
    Publisher
    Rijksinstituut voor Volksgezondheid en Milieu RIVM
    Sponsors
    IGZ
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