Increased incidences of multidrug-resistant gonorrhea in Taiwanese men: Experiences from a single institute

Objectives: Our objective was to examine the detection rate of routine urine cultures and genital discharge swab cultures for the detection of gonococcal urethritis in male patients. In addition, we evaluated the results of urinalysis for gonococcal infections and investigated the drug sensitivity of Neisseria gonorrhoeae strains isolated from these patients. Materials and methods: From August 2009 to October 2015, 202 men diagnosed with gonococcal infection, based on the results of a urine culture or genital discharge swab culture, were enrolled in this study. Initial clinical symptoms and urinalysis results were collected. The susceptibility of N. gonorrhoeae to penicillin, cefmetazole, cefotaxime, ceftazidime, cefuroxime, ceftriaxone, and ofloxacin were determined using agar plate dilution method. Results: The mean age of the patients was 29.67 +/- 10.39 years, and 157 of the 202 male patients (87.6%) were aged between 15 years and 34 years. We determined that the diagnostic value of genital discharge swab culture was significantly higher than that of the urine culture (90.9% vs. 67.4%, respectively). Genital or urethral discharge is the major symptom in these patients (88.89%). The susceptibility of N. gonorrhoeae to cefuroxime, cefmetazole, cefotaxime, ceftazidime, penicillin, and ciproxin revealed an increasing prevalence of resistant strains in recent years. Conclusion: Genital discharge swab culture is a more effective method than urine culture to detect gonorrhea in patients with dysuria and urethral discharge. The increasing numbers of antibiotic-resistant N. gonorrhoeae strains is a major problem in treating gonococcal urethritis. Copyright (C) 2016, Taiwan Urological Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license