Penicillinase producing Neisseria gonorrhoeae (PPNG) and Tetracycline resistant Neisseria gonorrhoeae (TRNG) from Central Kerala

Gonorrhea is one of the oldest sexually transmitted disease, which has been mentioned in the Bible and ancient Chinese literature. As per WHO, the global incidence of gonorrhea is 106 million. The incidence of gonorrhea in Asia is 8.37 million. The incidence of gonorrhea in many countries is not known due to the suboptimal diagnostics, poor case reporting and lack of surveillance. Reports of gonorrhea from our country appear to be low, with hardly any documented case from Kerala. Here, we report a 24-year-old male, with a history of exposure, who presented with complaints of pus at the urethral meatus for three weeks duration. On examination; there was muco-purulent discharge from the urethra. The patient was diagnosed as suffering from gonorrhea by smear and culture. The patient was treated with ceftriaxone 1 gm IV and was discharged in three days. Gonorrhea usually co–exists with other sexually transmitted diseases like HIV and chlamydial infection. These infections are usually transmitted by an asymptomatic population. The emergence of strains of Neisseria gonorrhoeae with decreased susceptibility to cephalosporins and resistance to penicillins, sulfonamides, tetracyclines and recently quinolones and azithromycin is of concern. The speedy rise in treatment failure will give rise to disease progression as in the pre-antibiotic era. To overcome the problem of ongoing drug resistant of N,gonorrhoeae, two overlapping goals have to be met: they are public health approach and control of drug resistance which will curtail the spread of these resistant strains. Keywords: PPNG, TRNG, Gonorrhea, Drug resistance, STI, Urethritis