International Journal of Microbiological Research 4 (2): 167-176, 2013
ISSN 2079-2093
© IDOSI Publications, 2013
DOI: 10.5829/idosi.ijmr.2013.4.2.73153
Corresponding Author: Aktar Uzzaman Chouduri, Department of Pharmacy, University of Rajshahi Rajshahi-6205,
Bangladesh. Tel: +88-0721-711110, (Office) Cel: +88-01712792350,
Fax: +88-0721-750064.
167
Multi-Drug Resistant Neisseria gonorrhea
Among Hotel-Based Sex Workers in Rajshahi, Bangladesh
Lutfun Nesa, Abdus Salam, Anwar Ul Islam and Aktar Uzzaman Chouduri
1 2 1 1
Department of Pharmacy, University of Rajshahi, Rajshahi-6205, Bangladesh
1
Department of Pathology, Rajshahi Medical College Hospital, Rajshahi-6000, Bangladesh
2
Abstract: Information on antimicrobial sensitivity pattern of Neisseria gonorrhea among commercial sex
workers in worldwide many cities have already been reported but are yet to be investigated in Rajshahi city,
Bangladesh. This study aimed to determine the antimicrobial resistance profile in N. gonorrhea among
hotel-based sex workers in this city. N. gonorrhea strain was isolated from endocervical swab specimen from
sex workers and identified by biochemical analysis. In vitro susceptibility test of gonorrhea isolates was
performed by disk diffusion method with traditional and widely used antimicrobials, e.g. penicillin, tetracycline,
ciprofloxacin, erythromycin, ceftriaxone and cefixime. Sex workers’ mean age ranged 20-30 years having either
hidden or obvious gonococcal infection. All isolated N. gonorrhea strains were highly or intermediately
resistant against tetracycline, penicillin, ciprofloxacin, ceftriaxone. High-level resistance was found in three
isolates against tetracycline, erythromycin and ciprofloxacin. Eythromycin was resistant against three
isolates but was highly active against one isolate. Only cefixime was potentially active against all isolates
indicating that cefixime is currently the choice of drug for gonorrhea treatment. However, tested antibiotics
exhibited a case-specific effectiveness on gonorrhea isolates. Obtained drug resistance pattern varied on the
case of individual, some other factors associated with lifestyle of individual and geographic location.
Multi-drug resistant N. gonorrhea was in alerting level that bears a risk of transmission of STD to general
public. The need of surveillance and counseling to sex workers, prevention and control of infection should be
undertaken seriously otherwise it would cause a devastating epidemic in near future.
Key words: Sex Workers Gonorrhea Multi-Drug Resistance Bangladesh
INTRODUCTION gonorrhea are often susceptible to HIV and tend to show
Commercial sex workers (CSWs) serve as the risk of HIV transmission by 3-5 folds [4-5].
reservoir of sexually transmitted diseases (STDs). CSWs sustain very high rates of transmission of
Gonorrhea is one of the classical STD with human by the STDs; among them, gonorrhea with multiple antibiotic
causative microbe, Neisseria gonorrhea. The globally resistance is common [6]. The development of resistance
estimated number of gonorrhea cases is 200 million per to antimicrobials in N. gonorrhea is a result of both wide
year [1]. Prevalence rate of this disease varies greatly dissemination of resistant clones and the emergence of
among countries in the developed and developing world, strains with novel resistance mechanisms [7]. Despite of
the highest being in South and Southeast Asia followed a sharp decline in the incidence of gonococcal infection
by Africa and Latin America [2]. Many years ago this in developed countries during the last decade, it still
disease was easily killed with a shot of penicillin but now remains one of the most common venereal diseases in
a day is increasingly becoming a life-threatening microbe. developing countries and a global health problem [1].
Soon, the world may face a version that cannot be killed Several problems are associated with the development of
by any existing antibiotic. However, patients infected with resistance such as self-prescription, inappropriate drug
complications [3]. Gonococcal infection also increases the