| Autor: |
Jairo de Souza Gomes, Purificação Pereira da Silva Maria Da, Ligia Maria Bedeschi Costa, Marcos André Schörner, Pinto Da Silva Maria De Fátima, Thais Mattos Santos, Hanalydia de Melo Machado, Cláudio Campos do, Carvalho da Silva Roberto José, Maria Luiza Bazzo, William Antunes Ferreira, Felipe de Rocco, Fonseca Andrade Lidiane da, de Oliveira Arnhold Guilherme Henrique, Ana Flavia Nacif Pinto Coelho Pires, Leonor Henriette de Lannoy, Souza Coelho Muniz Chayane Ariel, Pâmela Cristina Gaspar, Rosan Barboza de Matos, Adele Schwartz Benzaken, Luciane Guimarães Dias, Jessica Motta Martins, Lisléia Golfetto, Waldemara de Souza Vasconcelos, Fátima Mendes Pereira Lúcia de, Loeci Natalina Timm, Letícia Maria Eidt, Mauro Cunha Ramos, Faria de Carvalho Simone Veloso, Miriam Franchini |
| Rok vydání: |
2017 |
| Předmět: |
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| Zdroj: |
Epidemiology, Monitoring and Evaluation. |
| Popis: |
Introduction The threat of multidrug resistant Neisseria gonorrhoeae (NG) is a concern worldwide, especially in settings with emerging resistance to the extended spectrum cephalosporins. Since 2009 WHO recommendation to the countries to perform Antimicrobial Surveillance has been reinforced. Brazilian’s sexually transmitted infection guideline recommends dual therapy to treat gonococcal infection (ciprofloxacin plus azithromycin). However, regional studies performed in three Brazilian states demonstrated quinolone resistance. For these states it was recommended to replace the quinolones by third generation cephalosporin. The aim of this study was to perform a Brazilian national gonococcal antimicrobial surveillance. Methods The surveillance study included seven collection sites representing five geographic regions of Brazil. A total of 550 NG isolates from male urethral discharge was sent to the gonococcal national reference laboratory for analysis. The minimum inhibitory concentration (MIC) with the agar dilution method was performed for penicillin, tetracycline, ciprofloxacin, ceftriaxone, cefixime and azithromycin. Results The sensitivity profile of the NG isolates was performed in 131 isolates from the Southeast, 104 from the Northeast, 100 from the North, 68 from the Center-West and 147 from the South. In addition to penicillin and tetracycline, a high level of resistance for ciprofloxacin (47% to 78% of isolates) was observed in the isolates of all the regions. All the isolates were sensitive to ceftriaxone and cefixime, although one isolate was found with elevated MIC. Regarding azithromycin sensitivity, the majority of the isolates were sensitive, but the emergence of an intermediate (5% to 15%) or resistant (4% to 10%) profile needs to be monitored. Conclusion The national survey confirmed the high level of ciprofloxacin resistance already described worldwide. These results indicate the need to urgently change Brazilian recommendation for gonorrhoeae treatment and the importance of systematic gonococcal resistance surveillance. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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