An Insight Into The Drug Resistance Profile And Mechanism Of Drug Resistance In Neisseria Gonorrhoeae

CHARACTERISTICS OF NEISSERIC GONORHOEAE
    Neisseria gonorrhoeae is a gram – negative diplococci and is know to infect human only.  It is closely related to and probably derived from Neisseria meningitides, but has because highly adapted to survival in the genital tract.  It is transmitted by human-to- human contact and survives poorly outside the human   body.  Neisseria gonorrhoea is a very successful pathogen as it can evade or adapt to host defenses persist without severally damaging the host, and be transmitted to and infect other hosts, thereby maintaining itself.
 Particularly in women, gonococci may produce only mildly symptomatic or asymptomatic disease.  This adaptation allows the organism to persist and disseminate over long periods (Brunham and Plummer 1993).
The most important characteristic of Neisseria gonorrhoeae, in the content of antimicrobial resistance pattern are its phenotypic and genotypic variability which enable it to evade the host response.  Phenotypic variability occurs through differential expression of existing parts of the genome.  Genotypic variation is achieved by incorporation of new genetic material, which can be acquired either by conjugation are transformation.  
It is because of this feature that N. gonorrhoeae has acquired penicillin’s producing plasmids. Another important feature of N. gonorrhoeae is its antigenic variability.  This helps the bacterium to survive in its limited host i.e. human.  Antigenic variability of N. gonorrhoeae is partially due to its ability to acquire genetic material from related organism.  (Sarafian and Knapp 1989).
EPIDEMIOLOGY    
Single dose therapy for Neisseria gonorrhoeae infection bas become the norm in most of the countries through out the world.  The basic reason behind this is that single close therapy is most effective and assures adequate treatment.  World Health Organization (WHO) recommendations for selecting any treatment for gonorrhoea.  States that the antimicrobial prescribed should be such that the cure rate is about 95 percent (Quinn, 1996). More over, during the past few year N. gonorrhoeae has started developing resistance against most of the antimicrobials that are described for its therapy.  Therefore, surveillance of the antimicrobial resistance becomes very important in monitoring the emergence and spread of resistance and in planning appropriate treatment regimens.     
Gonorrhea is a disease mainly found in resource poor settings where laboratory facilities are limited or unavailable. Due to this reason, culture and antimicrobial susceptibility testing of N. gonorrhoeae is hardly done in developing countries. Developed countries had collected the data in a proper manner due to availability of adequate resources which help in monitoring resistance data obtained from developing countries are mainly from point presence studies, which can not be use to follow the trends.  Such epidemiological study need to be done at a regular basis because the prevailing strains of the bacteria and their antimicrobial susceptibility profiles keep on changing. (Tapsall 2001).