Overall Low Extended-Spectrum Cephalosporin Resistance but high Azithromycin Resistance in Neisseria gonorrhoeae in 24 European Countries, 2015
| Autor: | Cole, Michelle J, Spiteri, Gianfranco, Jacobsson, Susanne, Woodford, Neil, Tripodo, Francesco, Amato-Gauci, Andrew J, Unemo, Magnus, Euro-GASP network: Indra, Alexander, Maes, Virginie, Crucitti, Tania, Hunjak, Blaženka, Nemeth Blažić, Tatjana, Soteriou, Soteroulla, Maikanti-Charalambous, Panayiota, Pieridou, Despo, Cowan, Susan, Hoffmann, Steen, Epstein, Jevgenia, Viktorova, Jelena, Ndeikoundam, Ndeindo, Goubard, Agathe, Kohl, Peter, Buder, Susanne, Bremer, Viviane, Jansen, Klaus, Tzelepi, Eva, Konte, Vasileia, Balla, Eszter, Dudás, Mária, Sigmundsdóttir, Guðrún, Svanborg Hauksdóttir, Guðrún, Igoe, Derval, Crowley, Brendan, Suligoi, Barbara, Stefanelli, Paola, Pakarna, Gatis, Mavcutko, Violeta, Barbara, Christopher, Vella, Francesca, Melillo, Jackie Maistre, Dam, Alje Van, Van Benthem, Birgit, Linde, Ineke, Kløvstad, Hilde, Bergheim, Thea, Majewski, Slawomir, Mlynarczyk-Bonikowska, Beata, Azevedo, Jacinta, Borrego, Maria José, Pavlik, Peter, Truska, Peter, Klavs, Irena, Jeverica, Samo, Vazquez, Julio, Díaz, Asunción, Velicko, Inga, Hughes, Gwenda, Templeton, Kate, Irvine, Neil |
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| Rok vydání: | 2017 |
| Předmět: |
Male
0301 basic medicine Gonorrhea antimicrobial resistance Neisseria gonorrhoeae European Gonococcal Antimicrobial Surveillance Programme Euro_GASP Azithromycin Antimicrobial resistance medicine.disease_cause Agar dilution 0302 clinical medicine Ciprofloxacin Medicine 030212 general & internal medicine Child European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) Cephalosporin Resistance Surveillance Ceftriaxone Middle Aged Anti-Bacterial Agents Europe European Economic Area (EEA) Infectious Diseases Child Preschool Female Research Article medicine.drug Adult medicine.medical_specialty Adolescent 030106 microbiology Microbial Sensitivity Tests lcsh:Infectious and parasitic diseases Microbiology Young Adult 03 medical and health sciences Antibiotic resistance Cefixime Internal medicine Drug Resistance Bacterial Humans lcsh:RC109-216 Infecções Sexualmente Transmissíveis Heterosexuality Aged business.industry Infant medicine.disease Gonorrhoea Treatment Antimicrobial Resistance European Union (EU) business Sentinel Surveillance |
| Zdroj: | BMC Infectious Diseases, Vol 17, Iss 1, Pp 1-9 (2017) BMC Infectious Diseases |
| ISSN: | 1471-2334 |
| Popis: | Euro-GASP collaborating author names - Portugal: Jacinta Azevedo, Maria José Borrego. Background: Surveillance of Neisseria gonorrhoeae antimicrobial susceptibility in Europe is performed through the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP), which additionally provides data to inform the European gonorrhoea treatment guideline; currently recommending ceftriaxone 500 mg plus azithromycin 2 g as first-line therapy. We present antimicrobial susceptibility data from 24 European countries in 2015, linked to epidemiological data of patients, and compare the results to Euro-GASP data from previous years. Methods: Antimicrobial susceptibility testing by MIC gradient strips or agar dilution methodology was performed on 2134 N. gonorrhoeae isolates and interpreted using EUCAST breakpoints. Patient variables associated with resistance were established using logistic regression to estimate odds ratios (ORs). Results: In 2015, 1.7% of isolates were cefixime resistant compared to 2.0% in 2014. Ceftriaxone resistance was detected in only one (0.05%) isolate in 2015, compared with five (0.2%) in 2014. Azithromycin resistance was detected in 7.1% of isolates in 2015 (7.9% in 2014), and five (0.2%) isolates displayed high-level azithromycin resistance (MIC ≥ 256 mg/L) compared with one (0.05%) in 2014. Ciprofloxacin resistance remained high (49.4%, vs. 50.7% in 2014). Cefixime resistance significantly increased among heterosexual males (4.1% vs. 1.7% in 2014), which was mainly attributable to data from two countries with high cefixime resistance (~11%), however rates among men-who-have-sex-with-men (MSM) and females continued to decline to 0.5% and 1%, respectively. Azithromycin resistance in MSM and heterosexual males was higher (both 8.1%) than in females (4.9% vs. 2.2% in 2014). The association between azithromycin resistance and previous gonorrhoea infection, observed in 2014, continued in 2015 (OR 2.1, CI 1.2–3.5, p < 0.01). Conclusions: The 2015 Euro-GASP sentinel system revealed high, but stable azithromycin resistance and low overall resistance to ceftriaxone and cefixime. The low cephalosporin resistance may be attributable to the effectiveness of the currently recommended first-line dual antimicrobial therapy; however the high azithromycin resistance threatens the effectiveness of this therapeutic regimen. Whether the global use of azithromycin in mono- or dual antimicrobial therapy of gonorrhoea is contributing to the global increases in azithromycin resistance remains to be elucidated. The increasing cefixime resistance in heterosexual males also needs close monitoring. The study was funded by the European Centre for Disease Prevention and Control (Framework Contract No. ECDC/2013/015). info:eu-repo/semantics/publishedVersion |
| Databáze: | OpenAIRE |
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