Gonorrhoea epidemiology and antimicrobial resistance最新文献

{"title":"O09.1 Trends and regional differences of Neisseria gonorrhoeae antimicrobial resistance in the Netherlands, 2013–2019","authors":"M. Visser, H. Götz, A. V. Dam, B. Benthem","doi":"10.1136/SEXTRANS-2021-STI.98","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.98","url":null,"abstract":"Gonococcal antimicrobial resistance is emerging worldwide, and is monitored in the Netherlands in 18 out of 24 Sexual Health Centres (SHC) that perform culture and susceptibility testing for patients with gonorrhoea. This study describes trends, determinants and regional differences in azithromycin resistance and ceftriaxone decreased susceptibility in 2013–2019. Data on person characteristics, STI diagnoses and MIC values (Minimum Inhibitory Concentration, measured by E-test) for gonorrhoea were reported by participating SHC. We describe azithromycin resistance (AZI-R, MIC >1 mg/L) and ceftriaxone decreased susceptibility (CEF-DS, MIC >0.032 mg/L) over time and per SHC. We use multilevel logistic regression analysis to describe determinants of AZI-R/CEF-DS among MSM and heterosexuals, correcting for SHC region. A separate multilevel model was made to quantify the effect of population differences on the regional variance of AZI-R and CEF-DS. A total of 13,000 isolates were included from 2013–2019. AZI-R significantly increased from 2.8% (95% Confidence Interval 2.1–3.9%) to 9.3% (8.2–10.5%). CEF-DS significantly decreased from 7.0% (5.7–8.5%) to 2.9% (2.3–3.6%). Overall, regional differences were seen between SHC: AZI-R varied from 0.0% to 16.9%, CEF-DS from 0.0% to 7.0%. Regional variance could not be explained by population characteristics. Regression analyses found pharyngeal strain origin and year of consultation significantly associated with AZI-R and CEF-DS among MSM and heterosexuals. Among heterosexuals also a high number of partners was associated with AZI-R and CEF-DS. No resistance or decreasing susceptibility was found for ceftriaxone, the first line gonorrhoea treatment in the Netherlands. However, azithromycin resistance is increasing, similar to trends worldwide. Differing levels of resistance/decreased susceptibility per SHC could not be explained by differences in population characteristics. This indicates the need for nationwide surveillance and reporting of results on a regional level. The association of pharyngeal strain origin with resistance/decreased susceptibility underlines the importance of including extragenital infections in gonococcal antimicrobial resistance surveillance.","PeriodicalId":377092,"journal":{"name":"Gonorrhoea epidemiology and antimicrobial resistance","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117239165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O09.5 Characteristics of People with Gonorrhea with Reduced Azithromycin Antimicrobial Susceptibility in 8 Jurisdictions in the United States, 2018–2019","authors":"E. Learner, K. Gieseker, K. Mauk, K. Town, Cau Pham, S. Cyr, D. Shrestha, L. Barbee, C. Mcneil, Justin L Holderman, Kimberly Johnson, T. Nguyen, T. Albano, Karen Schlanger, R. Kirkcaldy","doi":"10.1136/SEXTRANS-2021-STI.102","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.102","url":null,"abstract":"Background In the USA, reduced azithromycin susceptibility (AZM-RS) gonococci have been observed in men who have sex with men (MSM), women, and men who have sex with women only (MSW). However AZM-RS prevalence and epidemiological characteristics among women and MSW are not well-described. We examined epidemiological characteristics of MSM and a combined group of women and MSW with susceptible and AZM-RS gonorrhea to investigate differences between groups. Methods We analyzed epidemiological and susceptibility data from people attending STD and community clinics in eight jurisdictions participating in CDC’s Strengthening U.S. Response to Resistant Gonorrhea project during 2018–2019. We defined people with AZM-RS gonorrhea as those with ≥1 gonococcal isolate demonstrating a minimum inhibitory concentration of AZM ≥2.0µg/mL. We used inverse variance weighting to account for heterogeneity in sample size across jurisdictions to estimate pooled AZM-RS prevalences and 95% confidence intervals. Results Across eight sites, 8,859 people (4,521 MSM, 758 women, and 3,580 MSW) provided at least one isolate for susceptibility testing; 1,052 people (10.4% [95% CI: 6.4%–14.4%]) had gonorrhea demonstrating AZM-RS. AZM-RS prevalence was markedly high among MSM (15.1% [95% CI: 10.2%–20.0%]), and lower yet elevated among women and MSW combined (5.3% [95% CI: 2.9%–7.7%]). Among MSM with AZM-RS gonorrhea, 16.2% (95% CI: 10.9%–21.4%) reported having 3+ sexual partners in the last 2–3 months and 16.7% (95% CI: 12.6%–20.9%) reported previous gonococcal infections. Among women/MSW with AZM-RS, 6.2% (95% CI: 3.7%–8.7%) reported 3+ recent sexual partners, and 4.8% (95% CI: 2.4%–7.3%) reported previous gonococcal infections. Conclusions AZM-RS prevalence among women/MSW was lower than among MSM but still elevated, and a lower proportion of women/MSW reported multiple recent sexual partners and previous gonococcal infections. These data highlight differences in the epidemiology of reduced gonococcal susceptibility and the need to tailor resistant gonorrhea control approaches to affected populations.","PeriodicalId":377092,"journal":{"name":"Gonorrhoea epidemiology and antimicrobial resistance","volume":"210 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120874604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O09.2 Lack of association between azithromycin-resistant Neisseria gonorrhoeae infection and prior exposure to azithromycin among persons attending a Sexual Health Clinic","authors":"E. Rowlinson, O. Soge, A. Berzkalns, C. Thibault, R. Kerani, M. Golden, L. Barbee","doi":"10.1136/SEXTRANS-2021-STI.99","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.99","url":null,"abstract":"","PeriodicalId":377092,"journal":{"name":"Gonorrhoea epidemiology and antimicrobial resistance","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121371423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O09.6 Typing outer membrane vesicle proteins of Neisseria gonorrhoeae provides insight into antimicrobial resistance","authors":"A. Unitt, C. Rodrigues, J. Bray, K. Jolley, C. Tang, M. Maiden, O. Harrison","doi":"10.1136/SEXTRANS-2021-STI.103","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.103","url":null,"abstract":"gonococcal isolate demonstrating a minimum inhibitory concentration of AZM 2.0mg/mL. We used inverse variance weighting to account for heterogeneity in sample size across jurisdictions to estimate pooled AZM-RS prevalences and 95% confidence intervals. Results Across eight sites, 8,859 people (4,521 MSM, 758 women, and 3,580 MSW) provided at least one isolate for susceptibility testing; 1,052 people (10.4% [95% CI: 6.4%– 14.4%]) had gonorrhea demonstrating AZM-RS. AZM-RS prevalence was markedly high among MSM (15.1% [95% CI: 10.2%–20.0%]), and lower yet elevated among women and MSW combined (5.3% [95% CI: 2.9%–7.7%]). Among MSM with AZM-RS gonorrhea, 16.2% (95% CI: 10.9%–21.4%) reported having 3+ sexual partners in the last 2–3 months and 16.7% (95% CI: 12.6%–20.9%) reported previous gonococcal infections. Among women/MSW with AZM-RS, 6.2% (95% CI: 3.7%–8.7%) reported 3+ recent sexual partners, and 4.8% (95% CI: 2.4%–7.3%) reported previous gonococcal infections. Conclusions AZM-RS prevalence among women/MSW was lower than among MSM but still elevated, and a lower proportion of women/MSW reported multiple recent sexual partners and previous gonococcal infections. These data highlight differences in the epidemiology of reduced gonococcal susceptibility and the need to tailor resistant gonorrhea control approaches to affected populations.","PeriodicalId":377092,"journal":{"name":"Gonorrhoea epidemiology and antimicrobial resistance","volume":"191 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123653884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O09.3 Gonococcal pharyngeal susceptibility to ceftriaxone, cefixime and azithromycin among men and women in eGISP, 2018 – 2020","authors":"S. Cyr, Cau Pham, Elizabeth Torrone, H. Weinstock","doi":"10.1136/SEXTRANS-2021-STI.100","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.100","url":null,"abstract":"Background Most gonorrhea treatment failures on ceftriaxone-based regimens, the foundation of current treatment recom-mendations, have been associated with pharyngeal infections; however, antimicrobial susceptibility data for pharyngeal infections are limited. We present preliminary pharyngeal susceptibility data collected through a U.S. sentinel surveillance project. Methods The enhanced Gonococcal Isolate Surveillance Project (eGISP) collects gonococcal isolates from male and female genital and extragenital sites. Samples are collected for cul-ture from symptomatic and/or exposed patients at participating STD clinics. Gonococcal isolates undergo antimicrobial susceptibility testing by agar dilution with results reported as minimum inhibitory concentrations (MIC). Since eGISP began, 13 clinical sites across the U.S. have participated in eGISP. Two ceftriaxone (MIC (cid:1) 0.125 m g/mL), overall point prevalence 0.3%; both isolates among MSM. One isolate in an MSM displayed susceptibility to cefixime (MIC (cid:1) 0.25 m g/ mL), prevalence of 0.2%","PeriodicalId":377092,"journal":{"name":"Gonorrhoea epidemiology and antimicrobial resistance","volume":"69 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117236881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O09.4 Changes in gonococcal incidence, screening, and reporting as explanations for increased gonococcal case reports between 2008 and 2018, United States","authors":"I. Spicknall","doi":"10.1136/SEXTRANS-2021-STI.101","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.101","url":null,"abstract":"","PeriodicalId":377092,"journal":{"name":"Gonorrhoea epidemiology and antimicrobial resistance","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122033788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}