Prameshwara, Almarissa Ajeng
Unknown Affiliation

Published : 2 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 2 Documents
Search

Neisseria gonorrhoeae and Chlamydia trachomatis coinfection in a 20-year-old man with recurrent urethritis: a case report Prawarni, Vidyadhari Puspa; Prameshwara, Almarissa Ajeng; Susetiati, Devi Artami; Nuryastuti, Titik
Journal of Clinical Microbiology and Infectious Diseases Vol. 4 No. 2 (2024): Available online : 1 December 2024
Publisher : Indonesian Society for Clinical Microbiology (Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jcmid.v4i2.67

Abstract

Introduction: Neisseria gonorrhoeae and Chlamydia trachomatis are the two pathogens most commonly reported to cause sexually transmitted infections (STIs) worldwide. Coinfection between these two pathogens has been widely reported, but the incidence is still rarely reported due to challenges in diagnosis to prove the involvement of the two pathogens simultaneously. The molecular diagnostic approach is an effective option for this case and optimizing this method will able to help clinicians deciding management for the patients and prevent the spreading of the disease. This study aimed to present a case of N. gonorrhoeae and C. trachomatis coinfection in a 20-year-old man with recurrent urethritis. Case Description: A 20-year-old man presented to the Dermatology and Venereology clinic at Dr. RSUP. Sardjito with purulent discharge from the penis started a week prior. From the anamnesis and physical examination, the doctors suspected this patient with N. gonorrhoeae infection. N. gonorrhoeae was detected by microscopic examination, culture, and Real-Time Polymerase Chain Reaction (RT-PCR) examination, while C. trachomatis was also detected in RT-PCR. The patient was treated with azithromycin 1-gram single dose and cefixime 400 mg single dose. Discussion: The World Health Organization (WHO) reported that the incidence of STIs is always increasing. Most STIs are usually asymptomatic, but it can be presented as urethritis in male patients. For females, it can be given as leucorrhoea, pelvic inflammatory disease (PID), or other pregnancy complications. N. gonorrhoeae and C. trachomatis are the two main pathogens always reported annually and often found as coinfection. Due to the virulence factors of these bacteria, N. gonorrhoeae and C. trachomatis are very hard to diagnose with conventional culture methods, and the molecular approach is now an effective option to detect them and help prevent recurrence. Conclusion: Coinfection of N. gonorrhoeae and C. trachomatis is a case that is quite often encountered in clinical practice, but the incidence is rarely reported due to supporting examination methods to help confirm the presence of these two microorganisms are still limited. In cases of suspected infection by N. gonorrhoeae, C. trachomatis, or both simultaneously, the most recommended microbiological examination is to use molecular diagnostics such as PCR.
Ceftriaxone-and-cefixime-resistant Neisseria gonorrhoeae in a 26-year-old-male with gonococcal urethritis: a case report Prameshwara, Almarissa Ajeng; Prawarni, Vidyadhari Puspa; Susetiati, Devi Artami; Nuryastuti, Titik
Journal of Clinical Microbiology and Infectious Diseases Vol. 4 No. 2 (2024): Available online : 1 December 2024
Publisher : Indonesian Society for Clinical Microbiology (Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jcmid.v4i2.68

Abstract

Introduction: Gonorrhoea is the most prevalent sexually transmitted infection (STI) in Indonesia. The increasing resistance of Neisseria gonorrhoeae to antibiotics has prompted the World Health Organization (WHO) to classify gonorrhoea as an urgent public health threat. Reports of resistance to third generation extended-spectrum cephalosporins (ESCs), such as cefixime and ceftriaxone, against N. gonorrhoeae are rare in Indonesia. This study aims to present a case of cefixime and ceftriaxone resistance in a 26-year-old man with gonococcal urethritis. Case Description: A 26-year-old man presented to an STI clinic with a two-week history of increased urethral discharge. He reported a history of sexual activity with multiple partners. Physical examination revealed mucopurulent exudate and thick greenish-white pus from the external genitalia. Microscopic examination of a urethral smear identified numerous polymorphonuclear cells (>10 PMN/high-power field) and Gram-negative intracellular diplococci. Bacterial culture confirmed the presence of Gram-negative diplococci consistent with N. gonorrhoeae. Polymerase chain reaction (PCR) testing further confirmed N. gonorrhoeae. Susceptibility testing revealed resistance to both cefixime and ceftriaxone. The patient was treated with dual therapy, consisting of a single oral dose of azithromycin (1 g) and cefixime (400 mg). Complete symptom resolution was achieved within one week. Conclusion: Third-generation ESCs, including injectable ceftriaxone and orally administered cefixime, are the most commonly used antibiotics for gonorrhoea treatment. Resistance to these drugs represents a significant global health threat. Discrepancies between antibiotic susceptibility test results and clinical outcomes highlight the need for further investigation into underlying factors contributing to treatment efficacy.