Overall Low Extended-Spectrum Cephalosporin Resistance but high Azithromycin Resistance in Neisseria gonorrhoeae in 24 European Countries, 2015

Detalhes bibliográficos
Autor(a) principal: Cole, Michelle J.
Data de Publicação: 2017
Outros Autores: Spiteri, Gianfranco, Jacobsson, Susanne, Woodford, Neil, Tripodo, Francesco, Amato-Gauci, Andrew J., Unemo, Magnus, Euro-GASP network
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.18/5304
Resumo: Euro-GASP collaborating author names - Portugal: Jacinta Azevedo, Maria José Borrego.
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spelling Overall Low Extended-Spectrum Cephalosporin Resistance but high Azithromycin Resistance in Neisseria gonorrhoeae in 24 European Countries, 2015Antimicrobial ResistanceCeftriaxoneEuropeEuropean Economic Area (EEA)European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP)European Union (EU)GonorrhoeaSurveillanceTreatmentInfecções Sexualmente TransmissíveisEuro-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).BioMed CentralRepositório Científico do Instituto Nacional de SaúdeCole, Michelle J.Spiteri, GianfrancoJacobsson, SusanneWoodford, NeilTripodo, FrancescoAmato-Gauci, Andrew J.Unemo, MagnusEuro-GASP network2018-03-07T13:57:18Z20172017-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.18/5304engBMC Infect Dis. 2017 Sep 11;17(1):617. doi: 10.1186/s12879-017-2707-z1471-233410.1186/s12879-017-2707-zinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-20T15:40:48Zoai:repositorio.insa.pt:10400.18/5304Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T18:40:01.188466Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Overall Low Extended-Spectrum Cephalosporin Resistance but high Azithromycin Resistance in Neisseria gonorrhoeae in 24 European Countries, 2015
title Overall Low Extended-Spectrum Cephalosporin Resistance but high Azithromycin Resistance in Neisseria gonorrhoeae in 24 European Countries, 2015
spellingShingle Overall Low Extended-Spectrum Cephalosporin Resistance but high Azithromycin Resistance in Neisseria gonorrhoeae in 24 European Countries, 2015
Cole, Michelle J.
Antimicrobial Resistance
Ceftriaxone
Europe
European Economic Area (EEA)
European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP)
European Union (EU)
Gonorrhoea
Surveillance
Treatment
Infecções Sexualmente Transmissíveis
title_short Overall Low Extended-Spectrum Cephalosporin Resistance but high Azithromycin Resistance in Neisseria gonorrhoeae in 24 European Countries, 2015
title_full Overall Low Extended-Spectrum Cephalosporin Resistance but high Azithromycin Resistance in Neisseria gonorrhoeae in 24 European Countries, 2015
title_fullStr Overall Low Extended-Spectrum Cephalosporin Resistance but high Azithromycin Resistance in Neisseria gonorrhoeae in 24 European Countries, 2015
title_full_unstemmed Overall Low Extended-Spectrum Cephalosporin Resistance but high Azithromycin Resistance in Neisseria gonorrhoeae in 24 European Countries, 2015
title_sort Overall Low Extended-Spectrum Cephalosporin Resistance but high Azithromycin Resistance in Neisseria gonorrhoeae in 24 European Countries, 2015
author Cole, Michelle J.
author_facet Cole, Michelle J.
Spiteri, Gianfranco
Jacobsson, Susanne
Woodford, Neil
Tripodo, Francesco
Amato-Gauci, Andrew J.
Unemo, Magnus
Euro-GASP network
author_role author
author2 Spiteri, Gianfranco
Jacobsson, Susanne
Woodford, Neil
Tripodo, Francesco
Amato-Gauci, Andrew J.
Unemo, Magnus
Euro-GASP network
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Repositório Científico do Instituto Nacional de Saúde
dc.contributor.author.fl_str_mv Cole, Michelle J.
Spiteri, Gianfranco
Jacobsson, Susanne
Woodford, Neil
Tripodo, Francesco
Amato-Gauci, Andrew J.
Unemo, Magnus
Euro-GASP network
dc.subject.por.fl_str_mv Antimicrobial Resistance
Ceftriaxone
Europe
European Economic Area (EEA)
European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP)
European Union (EU)
Gonorrhoea
Surveillance
Treatment
Infecções Sexualmente Transmissíveis
topic Antimicrobial Resistance
Ceftriaxone
Europe
European Economic Area (EEA)
European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP)
European Union (EU)
Gonorrhoea
Surveillance
Treatment
Infecções Sexualmente Transmissíveis
description Euro-GASP collaborating author names - Portugal: Jacinta Azevedo, Maria José Borrego.
publishDate 2017
dc.date.none.fl_str_mv 2017
2017-01-01T00:00:00Z
2018-03-07T13:57:18Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.18/5304
url http://hdl.handle.net/10400.18/5304
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv BMC Infect Dis. 2017 Sep 11;17(1):617. doi: 10.1186/s12879-017-2707-z
1471-2334
10.1186/s12879-017-2707-z
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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