Demographic and Behavioral Risk Factors Associated with Reduced Susceptibility of Neisseria gonorrhoeae to First-Line Antimicrobials in South African Men with Gonococcal Urethral Discharge
Autor: | Lindy Gumede, Tendesayi Kufa, Dumisile V. Maseko, David A. Lewis, Ranmini Kularatne |
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Rok vydání: | 2021 |
Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty 030106 microbiology Microbial Sensitivity Tests Azithromycin medicine.disease_cause Odds Epidemiology and Surveillance 03 medical and health sciences Gonorrhea 0302 clinical medicine Antibiotic resistance Anti-Infective Agents Interquartile range Ciprofloxacin Risk Factors Internal medicine Drug Resistance Bacterial medicine Prevalence Humans Pharmacology (medical) 030212 general & internal medicine Pharmacology Univariate analysis business.industry Odds ratio Confidence interval Neisseria gonorrhoeae Anti-Bacterial Agents Infectious Diseases business medicine.drug |
Zdroj: | Antimicrob Agents Chemother |
ISSN: | 1098-6596 |
Popis: | Neisseria gonorrhoeae is the predominant cause of male urethral discharge in South Africa, and escalating prevalence of gonococcal antimicrobial resistance (AMR) is a major health concern both in-country and globally. We analyzed the demographic, behavioral, and clinical characteristics of 685 men presenting with gonococcal urethral discharge to sentinel surveillance clinics over a 3-year period (2017 to 2019) to determine the burden of factors that are known to be associated with N. gonorrhoeae AMR to first-line therapy (defined as group 1 isolates exhibiting resistance or reduced susceptibility to extended-spectrum cephalosporins or azithromycin). Among 685 men with gonococcal urethral discharge, median age was 28 years (interquartile range [IQR], 24 to 32). Only two men (2/632; 0.3%) self-identified as homosexual; however, on further enquiry, another 16 (2%) confirmed that they had sex with men only. Almost 30% practiced oral sex and were at risk for pharyngeal gonococcal infection. In univariate analysis, male circumcision (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.49 to 0.99) and recent sex outside the country (OR, 1.83; 95% CI, 1.21 to 2.76) were significantly associated with having a category 1 N. gonorrhoeae isolate. In a multivariable model, only sex outside South Africa increased the odds of being infected with a decreased susceptible/resistant N. gonorrhoeae isolate (adjusted odds ratio [aOR], 1.64; 95% CI, 1.05 to 2.55). These findings warrant the intensification of N. gonorrhoeae AMR surveillance among recently arrived migrant and overseas traveler populations, as well as the inclusion of extragenital specimens for N. gonorrhoeae AMR surveillance purposes. |
Databáze: | OpenAIRE |
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