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R J Rice

Publications and source records attributed to R J Rice.

17 recordsLinked to original sources
PubMed1991

Sociodemographic distribution of gonorrhea incidence: implications for prevention and behavioral research.

BACKGROUND: Despite a declining incidence during the AIDS era, gonorrhea remains the most frequently reported communicable disease in the United States. METHODS: During 1986 and 1987 we supplemented gonorrhea case reporting with laboratory surveillance in King County, Washington. Incidence rates were correlated with demographic variables. RESULTS: Overall incidence of gonorrhea was similar for men and women, but highest for 16- to 21-year-old females and urban Seattle residents. Incidence rates by ethnicity were Blacks, 3033; Native Americans, 843; Hispanics, 617; Asians, 190; and Whites, 121. Census tracts representing the lowest socioeconomic status (SES) quartile accounted for 58% of reported gonorrhea. Black female teenagers residing in the lowest SES urban areas had highest incidence rates: aged 14 to 15, 3.4%; 16 to 17, 10.4%; 18, 17.0%; and 19, 15.4%. Rates in female teenagers were even higher after adjustment for estimated proportion of those who were sexually experienced. CONCLUSIONS: Gonorrhea incidence is associated with age, gender, ethnicity, SES, and residence. Identification of populations at highest risk for gonorrhea can direct interventions against all sexually transmitted diseases. Clearly, interventions to alter high-risk behaviors must be initiated in early adolescence.

Adolescent↗
PubMed1989

Localized outbreak of penicillinase-producing Neisseria gonorrhoeae. Paradigm for introduction and spread of gonorrhea in a community.

In King County, Washington, penicillinase-producing Neisseria gonorrhoeae infections increased from 0.8% of reported cases of gonorrhea in 1986 to 6.8% of cases in the third quarter of 1987, then stabilized at 2.7% to 3.6% of cases. Of 268 penicillinase-producing N gonorrhoeae isolates tested, 159 (59%) belonged to a single clone, as evidenced by auxotyping, protein-I serotyping, plasmid analysis, and antimicrobial susceptibility testing. As this strain spread, the predominance of cases shifted from whites to blacks and from men to equal numbers of men and women. The proportion of cases associated with illicit drug use rose steadily from 19% in the first quarter of 1987 to 82% in the fourth quarter. Sixty percent of cases occurred in prostitutes or recent sexual contacts of prostitutes. These results suggest that core gonorrhea transmitters in King County are predominantly black illicit drug users, prostitutes, and their sexual partners. These are priority target populations for behavioral intervention and other measures to control the spread of all sexually transmitted diseases, including human immunodeficiency virus infection.

Black or African American↗
PubMed1989

Comparison of isolates of Neisseria gonorrhoeae causing meningitis and report of gonococcal meningitis in a patient with C8 deficiency.

We studied a previously healthy 20-year-old woman who presented with gonococcal meningitis. The gonococcal isolate, HT-1, was prototrophic by auxotyping, was protein I serovar IB-1, and agglutinated with wheat germ lectin. This isolate differed from the proline-requiring, serovar IA-1 and IB-4, wheat germ-agglutination-negative gonococcal isolates recovered from three patients during a recent outbreak of gonococcal meningitis in Philadelphia. HT-1 was killed by normal pooled human sera (greater than or equal to 98% at 30 min) but not effectively killed by the convalescent-phase sera of the patient (greater than 30% survival at 30 min). Similar results were obtained when mucosal and cerebrospinal fluid isolates from a Philadelphia patient were exposed to these sera, but mucosal and blood isolates from another Philadelphia case showed increased resistance to killing by normal pooled human sera. Further characterization revealed multiple differences in outer membrane and cellular proteins and lipopolysaccharide between case isolates. Absence of the L8 lipopolysaccharide epitope was noted for all isolates. Sera of our patient were found to have low total hemolytic complement (CH100 = 21 U/ml; normal = 55 to 100 U/ml) due to deficiency of C8 (C8 less than 1,000 CH50 U/ml; normal = greater than or equal to 16,000 CH50 U/ml). This is the first reported case of gonococcal meningitis occurring in a patient with a terminal-complement deficiency. Gonococcal meningitis is a rare complication of gonococcal bacteremia. Both defects in host defenses (e.g., terminal-complement deficiency) and organisms with unusual virulence appear to contribute to the pathogenesis of this complication of gonococcal bacteremia.

Adult↗
PubMed1986

Chromosomally mediated resistance in Neisseria gonorrhoeae in the United States: results of surveillance and reporting, 1983-1984.

Between January 1983 and October 1984, 446 cases of infection due to chromosomally mediated resistance in Neisseria gonorrhoeae (CMRNG) were reported in 23 states. Eighty percent were detected as primary penicillin or ampicillin treatment failures. Gonococcal isolates were submitted from 175 (40%) for confirmation of resistance, susceptibility testing, gonococcal strain typing using monoclonal antibodies specific for outer membrane Protein I, and auxotyping. All were typed as Protein I serogroup IB (WII/WIII), and the majority were proline or prototrophic auxotypes. All were resistant in vitro to less than 1 microgram/ml of either penicillin or tetracycline. Comparing CMRNG with penicillinase-producing Neisseria gonorrhoeae (PPNG), we found that CMRNG were significantly more resistant to tetracycline and erythromycin, but PPNG were more resistant to penicillin (P less than .01). Because of increasing reports of gonococcal resistance in the United States, improved surveillance of clinical and laboratory resistance is needed in support of control and treatment recommendations for gonorrhea.

Amino Acids↗
PubMed1985

Epidemiological characterization of Neisseria gonorrhoeae by lectins.

A total of 101 isolates of penicillinase-producing and non-penicillinase-producing Neisseria gonorrhoeae with known nutritional requirements, plasmid content, and serovars, were examined for lectin agglutination patterns. These isolates were from outbreaks in Georgia, California, Hawaii, and Pennsylvania. Cell suspensions made from 16- to 18-h cultures were mixed with 14 different lectins, and the resultant agglutination patterns were classified as agglutination groups. Among the 101 isolates tested, 24 different agglutination groups were demonstrated. Of the organisms tested, 55% were located in 3 of the 24 groups, and 86% of the isolates reacted with the lectins Trichosanthes kinlowii, Griffonia simplicifolia I, peanut agglutinin, soybean agglutinin, potato agglutinin, and wheat germ agglutinin. One isolate did not react with peanut or potato agglutinin, five isolates lacked reactivity with potato agglutinin, and six isolates did not react with wheat germ agglutinin. Of the wheat germ-negative isolates, four were from Pennsylvania and were identical with regard to auxotype, plasmid content, serovar, and lectin group. The other two wheat germ-negative isolates were from California and were unrelated by the same criteria to the four Pennsylvania isolates and to each other. Among the isolates tested, there were no differences in lectin groups with regard to the sex of the patient. In the Georgia collection, agglutination with one lectin group was confined to isolates of serogroup IA. This association was not observed for the other geographic areas. Some isolates showing identical auxotype, plasmid content, and serovars could be differentiated based on lectin agglutination patterns, whereas other isolates were identical by all testing criteria.

Agglutination Tests↗
PubMed1985

Lectin characterization of gonococci from an outbreak caused by penicillin-resistant Neisseria gonorrhoeae.

A total of 40 Neisseria gonorrhoeae isolates, representing 19 penicillin-resistant isolates (from 8 heterosexual patients and 11 homosexual patients) and 21 penicillin-susceptible isolates (from 15 heterosexual patients and 6 homosexual patients) and obtained from the same geographic area, were examined. Lectin agglutination patterns were based on the reactivity of the isolates with the following 14 lectins: concanavalin A, Lens culinaris, Trichosanthes kinlowii, Griffonia simplicifolia I, Arachis hypogeae (peanut agglutinin), Glycine max (soybean agglutinin), Dolichos bifloris, Griffonia simplicifolia II, Solanum tuberosum (potato starch agglutinin), Triticum vulgaris (wheat germ agglutinin), Limax flavus, Phaseolus vulgaris, Ulex europaeus I, and Lotus tetragonolobus. All isolates were serotyped with monoclonal antibodies specific for gonococcal outer membrane protein I and auxotyped, and the plasmid content was determined. Resistant patient isolates were selected for their decreased penicillin susceptibility, and control isolates were selected for their penicillin susceptibility. Even though the patient isolates demonstrated resistance to penicillin, no phenotypic differences in lectin-grouping patterns were demonstrated between the two study groups; i.e., two predominant lectin groups were observed. No resistance-associated plasmids were detected. All patient isolates were serogroup IB (serovars IB-1, IB-2, and IB-4), whereas 12 of 21 control isolates were serogroup IA (P less than 0.05). Isolates obtained from different anatomical sites in the same patient (cervical and rectal) agreed with regard to lectin patterns and serovars but not auxotypes.

Agglutination Tests↗
PubMedDate not supplied

An unusual case of penicillinase-producing Neisseria gonorrhoeae resistant to spectinomycin in California.

We report a case of gonorrhea due to a penicillinase-producing strain of Neisseria gonorrhoeae resistant to spectinomycin in a 26-year-old man who had not been out of the United States for a year-and-a-half. His sexual contact also had no recent travel out of the United States. The genital and oropharyngeal infections were successfully treated with cefoxitin (1 g im) plus probenecid (1 g orally) and trimethoprim-sulfamethoxazole (80 mg of trimethoprim and 400 mg of sulfamethoxazole). The patient took nine of the latter tablets daily for five days. The organism was a serovar IB-3, proline-requiring auxotype. The patient's isolate contained both 2.6-megadalton and 4.4-megadalton plasmids. Measurement of minimal inhibitory concentrations (MICs) of antibiotics for the isolate confirmed the penicillin resistance and showed an MIC of spectinomycin of greater than 256 micrograms/ml. The epidemiologic investigation suggested that the source of the infection was a male contact with unusual clinical features, including bloody urethral discharge and a possible incubation period of 28 days.

Adult↗
PubMedDate not supplied

Gonorrhea in the United States 1975-1984: is the giant only sleeping?

After a decade of increase, the number of cases of gonorrhea declined by 12% in the United States between 1975 and 1984. During the same period gonorrhea rates declined by 20%. We examined age-, sex-, and race-specific gonorrhea cases and rates to determine whether the national trend has been occurring in all population groups. The greatest percentage decline in rates was 22.6% among 25-44-year-old men of other-than-white race, and the only increase (0.5%) occurred among white teenaged women. To control gonorrhea and its complications more effectively, more focused screening of young women and more rapid treatment of their sexual partners are necessary.

Adolescent↗
PubMedDate not supplied

Tissue fluid penetration and anti-treponemal activity of trospectomycin (a new spectinomycin analog) in the rabbit syphilis model.

The antitreponemal activity of trospectomycin (a novel 6'-propyl analog of spectinomycin) was correlated with concentrations in serum and tissue chamber fluid in a cutaneously-infected rabbit model of syphilis. After single-dose intramuscular (im) injections of trospectomycin, spectinomycin hydrochloride, and aqueous procaine penicillin G(APPG), concentrations of the drugs in paired specimens of serum and tissue fluid were determined and correlated with response of Treponema pallidum-infected lesions. Lesions responded most rapidly in APPG-treated animals. Rapid response correlated with more prolonged levels of APPG in both serum and tissue fluid. Trospectomycin, when given in single doses exceeding 40 mg/kg, surpassed penicillin in peak serum levels (greater than 60 micrograms/ml at 1 hr) but not in duration of activity. Higher and prolonged concentrations of trospectomycin in tissue fluid correlated with more effective clearance of treponemes from cutaneous lesions. Animals treated with less than 40 mg of trospectomycin/kg or with 20-80 mg/kg of the parent compound (spectinomycin hydrochloride) had cutaneous lesions that were persistently darkfield-positive, as confirmed by three or more consecutive smears.

Animals↗
PubMedDate not supplied

Penicillinase-producing Neisseria gonorrhoeae in Dade County, Florida: phenotypic characterization of isolates from 1983, 1984, and 1986.

Penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) have been endemic in Miami, Florida, since 1981. Strains of PPNG isolated in Miami during 1983 (60 isolates), 1984 (41 isolates), and 1986 (107 isolates) were characterized by plasmid content, auxotype/serovar (A/S) class, and susceptibility to antimicrobial agents. In 1986, 95 isolates (89%) possessed the 3.2-Megadalton (MDa) beta-lactamase plasmid; 36 (34%) of these isolates also possessed the 24.5-MDa conjugative plasmid. These results contrast with those from 1984, when 37 PPNG isolates (90%) possessed the 4.4-MDa plasmid, and most possessed the 24.5-MDa conjugative plasmid. This in turn was a reversal of the pattern seen in 1983, when only 42 (69%) possessed the 3.2-MDa plasmid, and the conjugative plasmid was rare. In 1983 and 1986, isolates possessing the 4.4-MDa plasmid were more resistant to penicillin than were isolates containing the 3.2-MDa plasmid. All isolates were susceptible to spectinomycin and ceftriaxone. In early 1986, two A/S classes accounted for 66% of all isolates. Pro/IA-1,2 and Pro/IB-2 accounted for 31 (29%) and 40 (37%), respectively, and were isolated during every week in early 1986. In contrast, isolates belonging to 14 and six A/S classes possessing the 3.2- and 4.4-MDa beta-lactamase plasmid, respectively, were isolated sporadically. The composition of the PPNG strain population in Miami is dynamic, a factor that may have important implications for the use of traditional disease intervention strategies.

Disease Outbreaks↗
PubMedDate not supplied

Frequency in the United States of non-beta-lactamase-producing strains of Neisseria gonorrhoeae possessing the 24.5-Mdal conjugative plasmid.

We characterized 475 non-beta-lactamase-producing gonococcal isolates from five U.S. cities by auxotype, serovar, and plasmid content to determine the frequency of isolates with the 24.5-Mdal gonococcal conjugative plasmid. A total of 150 (32%) of all isolates possessed the 24.5-Mdal plasmid; these isolates represented between 10% and 53% of isolates from each city. Isolates possessing the 24.5-Mdal plasmid belonged to 45 (56%) of 81 auxotype/serovar (A/S) classes, or between 24% and 70% of the A/S classes isolated in each city. Overall, a higher proportion of strains isolated in the southern cities possessed the 24.5-Mdal plasmid than did those from northeastern or northwestern cities. These strains appear to have spread independently of the spread of beta-lactamase-producing Neisseria gonorrhoeae strains. The prevalence of N. gonorrhoeae strains with the 24.5-Mdal conjugative plasmid has increased substantially and may have important implications for the epidemiology of gonorrhea caused by beta-lactamase-producing strains.

Conjugation, Genetic↗