Antimicrobial resistance in Neisseria gonorrhoeae and its risk groups in 23 European countries in 2022 within the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP): a retrospective observational study

IF 13.6 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Europe Pub Date : 2025-05-10 DOI:10.1016/j.lanepe.2025.101318

Susanne Jacobsson , Michelle J. Cole , Daniel Schröder , Melissa Jansen van Rensburg , Michaela Day , Csaba Ködmön , Magnus Unemo

{"title":"Antimicrobial resistance in Neisseria gonorrhoeae and its risk groups in 23 European countries in 2022 within the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP): a retrospective observational study","authors":"Susanne Jacobsson , Michelle J. Cole , Daniel Schröder , Melissa Jansen van Rensburg , Michaela Day , Csaba Ködmön , Magnus Unemo","doi":"10.1016/j.lanepe.2025.101318","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Since 2009, the European Centre for Disease Prevention and Control (ECDC) has coordinated the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) to monitor antimicrobial resistance (AMR) in <em>Neisseria gonorrhoeae</em> across the European Union and European Economic Area (EU/EEA). The aims of this study were to report Euro-GASP 2022 data and to compare with the most recently published Euro-GASP data (from 2016 to 2019), to identify changes in AMR and in risk groups for AMR.</div></div><div><h3>Methods</h3><div>In this observational study, 23 EU/EEA countries submitted AMR data for gonococcal isolates from 2022, linked to patient epidemiological data, to The European Surveillance System (TESSy). Statistical analyses (Z-test) were used to determine the significance of the differences between the epidemiological data and proportion of AMR isolates in 2022 versus 2019 and 2016. The risk factors associated with AMR isolates were assessed using univariate and multivariable logistic regression analyses of odds ratios.</div></div><div><h3>Findings</h3><div>Ceftriaxone resistance in 2022 (0.03%, 1/3008) remained low (0.06% (2/3239) in 2019), and cefixime resistance (0.3%, 10/3008) had decreased (0.8% (26/3239) in 2019). Azithromycin resistance (24.9%, 749/3008) and ciprofloxacin resistance (65.8%, 1980/3008) had increased (9.0% (284/3159) and 57.4% (1665/2884), respectively, in 2019). A marked increase in the number (575; 502 in 2019) and proportion (19.2%; 15.8% in 2019) of female gonorrhoea cases was also identified in 2022. In the univariate analysis, azithromycin resistance was associated with oropharyngeal (OR 1.67, CI 1.28–2.18; p < 0.0001) and anorectal infections (OR 1.38, CI 1.08–1.76; p = 0.0094), men-who-have-sex-with-men (MSM) (OR 3.88, CI 2.80–5.37; p < 0.0001), and females (1.71, CI 1.21–2.41; p = 0.0022). In the multivariable logistic regression model, only azithromycin resistance and MSM remained associated (OR 2.85, CI 1.33–4.73; p = 0.0040).</div></div><div><h3>Interpretation</h3><div>While ceftriaxone resistance remains sporadically detected in Euro-GASP, the increase in reports of occasional ceftriaxone resistance in EU/EEA countries and substantial increase in azithromycin resistance underscore the urgent need for enhanced AMR surveillance. The Euro-GASP data is crucial for refining treatment guidelines and mitigating the spread of AMR gonococcal strains. Novel effective antimicrobials for gonorrhoea treatment remain imperative.</div></div><div><h3>Funding</h3><div><span>ECDC</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"54 ","pages":"Article 101318"},"PeriodicalIF":13.6000,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lancet Regional Health-Europe","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666776225001103","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Since 2009, the European Centre for Disease Prevention and Control (ECDC) has coordinated the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) to monitor antimicrobial resistance (AMR) in Neisseria gonorrhoeae across the European Union and European Economic Area (EU/EEA). The aims of this study were to report Euro-GASP 2022 data and to compare with the most recently published Euro-GASP data (from 2016 to 2019), to identify changes in AMR and in risk groups for AMR.

Methods

In this observational study, 23 EU/EEA countries submitted AMR data for gonococcal isolates from 2022, linked to patient epidemiological data, to The European Surveillance System (TESSy). Statistical analyses (Z-test) were used to determine the significance of the differences between the epidemiological data and proportion of AMR isolates in 2022 versus 2019 and 2016. The risk factors associated with AMR isolates were assessed using univariate and multivariable logistic regression analyses of odds ratios.

Findings

Ceftriaxone resistance in 2022 (0.03%, 1/3008) remained low (0.06% (2/3239) in 2019), and cefixime resistance (0.3%, 10/3008) had decreased (0.8% (26/3239) in 2019). Azithromycin resistance (24.9%, 749/3008) and ciprofloxacin resistance (65.8%, 1980/3008) had increased (9.0% (284/3159) and 57.4% (1665/2884), respectively, in 2019). A marked increase in the number (575; 502 in 2019) and proportion (19.2%; 15.8% in 2019) of female gonorrhoea cases was also identified in 2022. In the univariate analysis, azithromycin resistance was associated with oropharyngeal (OR 1.67, CI 1.28–2.18; p < 0.0001) and anorectal infections (OR 1.38, CI 1.08–1.76; p = 0.0094), men-who-have-sex-with-men (MSM) (OR 3.88, CI 2.80–5.37; p < 0.0001), and females (1.71, CI 1.21–2.41; p = 0.0022). In the multivariable logistic regression model, only azithromycin resistance and MSM remained associated (OR 2.85, CI 1.33–4.73; p = 0.0040).

Interpretation

While ceftriaxone resistance remains sporadically detected in Euro-GASP, the increase in reports of occasional ceftriaxone resistance in EU/EEA countries and substantial increase in azithromycin resistance underscore the urgent need for enhanced AMR surveillance. The Euro-GASP data is crucial for refining treatment guidelines and mitigating the spread of AMR gonococcal strains. Novel effective antimicrobials for gonorrhoea treatment remain imperative.

Funding

ECDC.

查看原文本刊更多论文

在欧洲淋球菌抗菌素监测规划（Euro-GASP）范围内，2022年23个欧洲国家淋病奈瑟菌及其危险人群的抗菌素耐药性：一项回顾性观察性研究

自2009年以来，欧洲疾病预防和控制中心（ECDC）协调了欧洲淋球菌抗菌素监测计划（Euro-GASP），以监测整个欧盟和欧洲经济区（EU/EEA）淋病奈瑟菌的抗菌素耐药性（AMR）。本研究的目的是报告Euro-GASP 2022数据，并与最近公布的Euro-GASP数据（2016年至2019年）进行比较，以确定AMR和AMR风险组的变化。方法在这项观察性研究中，23个欧盟/欧洲经济区国家向欧洲监测系统（TESSy）提交了2022年以来淋球菌分离物的AMR数据，并与患者流行病学数据相关。采用统计分析（z检验）确定2022年与2019年和2016年AMR分离株的流行病学数据和比例差异的显著性。使用单变量和多变量logistic回归分析优势比来评估与AMR分离株相关的危险因素。发现2022年头孢曲松耐药性（0.03%,1/3008）保持在较低水平（2019年为0.06%(2/3239)），头孢克肟耐药性（0.3%,10/3008）下降（2019年为0.8%(26/3239)）。2019年，阿奇霉素耐药性（24.9%,749/3008）和环丙沙星耐药性（65.8%,1980/3008）分别上升（9.0%（284/3159）和57.4%(1665/2884)）。数量的显著增加(575；2019年为502人)和比例(19.2%；2022年女性淋病病例的确诊率为15.8%（2019年为15.8%）。在单因素分析中，阿奇霉素耐药与口咽感染相关(OR 1.67, CI 1.28-2.18；p & lt;0.0001)和肛门直肠感染(OR 1.38, CI 1.08-1.76；p = 0.0094)，男男性行为者（MSM） (OR 3.88, CI 2.80-5.37；p & lt;0.0001)，女性(1.71,CI 1.21-2.41；P = 0.0022)。在多变量logistic回归模型中，只有阿奇霉素耐药性与男男性行为相关(OR 2.85, CI 1.33-4.73；P = 0.0040)。虽然在Euro-GASP中仍然偶尔发现头孢曲松耐药，但欧盟/欧洲经济区国家偶尔发现头孢曲松耐药报告的增加和阿奇霉素耐药的大幅增加强调了加强AMR监测的迫切需要。Euro-GASP数据对于完善治疗指南和减轻耐药淋球菌菌株的传播至关重要。用于淋病治疗的新型有效抗菌剂仍是当务之急。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Lancet Regional Health-Europe Multiple-

CiteScore

19.90

自引率

1.40%

发文量

260

审稿时长

9 weeks

期刊介绍： The Lancet Regional Health – Europe, a gold open access journal, is part of The Lancet's global effort to promote healthcare quality and accessibility worldwide. It focuses on advancing clinical practice and health policy in the European region to enhance health outcomes. The journal publishes high-quality original research advocating changes in clinical practice and health policy. It also includes reviews, commentaries, and opinion pieces on regional health topics, such as infection and disease prevention, healthy aging, and reducing health disparities.