Surveillance van penicillinase vormende gonokokken in Nederland; incidentie en prevalentie in 1989

Abstract

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In the series of annual reports about the surveillance of penicillinase producing Neisseria gonorrhoeae (PPNG) in the Netherlands, the results for 1989 are summarized. Our data and those of the department of the Chief Medical Officer of Health show that the sharp decrease in the incidence of gonococcal infections during the last five years has stopped. The number of reported cases in 1989 (approximately 3000) was virtually the same is in 1988. However, the prevalence of PPNG significantly increased from 14% in 1988 to 23% in 1989. In most regions this prevalence is now well above 10%. As a consequence penicillins can no longer be considered as an acceptable choice for blind therapy of gonorrhoea. Virtually all PPNG isolates are sent to the National Institute of Public Health and Environmental Protection for susceptibility testing, plasmid characterization, auxotyping and serotyping. This year the number amounted to 689 (c.f. 416 in 1988). The sharp increase of tetracycline resistant PPNG (TRNG/PPNG) continued. This outbreak started in 1988 in the area of The Hague and Rotterdam where more than 80% of the PPNG were TRNG during the first 9 months of 1989. By the end of the year a decline was noticed. Overall 40% of the 689 PPNG isolates were resistant to tetracyclines. The results of auxotyping (A) and serotyping (S) suggest that this TRNG/PPNG outbreak is caused by epidemic spread of a limited number of A/S classes.