| Author/Editor | Cole, Michelle; Spiteri, Gianfranco; Jacobsson, Susanne; Pitt, Rachel; Grigorjev, Vlad; Unemo, Magnus; Jeverica, Samo | |
| Title | Is the tide turning again for cephalosporin resistance in Neisseria gonorrhoeae in Europe? | |
| Type | članek | |
| Vol. and No. | , št. Vol. 15 | |
| Publication year | 2015 | |
| Volume | str. 1-8 | |
| ISSN | 1471-2334 - BMC infectious diseases | |
| Language | eng | |
| Abstract | Background: The emerging resistance to the extended-spectrum cephalosporins (ESCs) in Neisseria gonorrhoeae together with increasing incidence of gonorrhoea cases in many countries have been global public health concerns. However, in recent years the levels of ESC resistance have d ecreased in several regions worldwide. We describe the European Gonococcal Antimicrobia l Surveillance Programme (Euro-GASP) data from 2013, and compare them to corresponding data from 2009 - 2012. Methods: During 2013, N. gonorrhoeae isolates from 21 participating countries were examined. Antimicrobial susceptibility testing (Etest or agar dil ution) was performed for cefixime, ceft riaxone, ciprofloxacin, azithromycin, spectinomycin and gentamicin. Statisti cal analyses were performed to identi fy significant cha nges in resistance between years and to investigate associations between patients with resistant gonococcal isolates and collected epidemiological variables. Results: In total, 93 (4.7 %) of 1994 isolates displayed resistance to cefixime, representing an increase compared to the 3.9 % detected in 2012 (p = 0.23). Cefixime resistance was detected in 13 (61.9 %) of the 21 countries. Cefixime resistance among men who have sex with men was on ly 1.2 %, compared to 5.6 % and 6.1 % in females and male heterosexuals, respectively. The un ivariate analysis confirmed that isolate s resistant to cefixime were more likely to be from females (OR 4.87, p < 0.01) or male heterosexuals (OR 5.32, p < 0.01). Seven (0.4 %) isolates displayed ceftriaxone resistance (in addition to cefixime resist ance) compared to three and 10 isolates in 2012 and 2011, respectively. All 93 isolates with cefixi me resistance were additionally resist ant to ciprofloxacin and 16 (17.2 %) were also resistant to azithromycin. Among all tested isolates (n = 1994), the ciprofloxacin resistance level (52.9 %) was higher than in 2012 (50.1 %; p = 0.08), and azithromycin res istance (5.4 %) increased since 2012 (4.5 %; p = 0.16). Conclusions: In 2013, the ESC resistance was again slightly increa sing in Europe. This emphasises the importance of implementing the actions outlined in the European and additional response plans, particularly activities strengthening the surveillance of antimicrobial resistance. Ceftriaxone combined with azithromycin remains a satisfactory option for the first-line treatment of gonorrhoea. However novel antimicrobials (new derivatives of previously developed antimicrobials or newly developed antimicrobials) for effective monotherapy or at least inclusion in new dual antimicrobial therapy regimens (combined with previously developed antimicrobials or novel antimicrobials) will likely be required. | |
| Keywords | Neisseria gonorrhoeae gonorrhoea antimicrobial resistance Neisseria gonorrhoeae gonoreja protimikrobna odpornost |