Author/Editor     Cole, Michelle; Spiteri, Gianfranco; Town, Katy; Unemo, Magnus; Hoffmann, Steen; Chisholm, Stephanie A.; Amato-Gauci, Andrew; Laar, Marita; Ison, Catherine A.; Jeverica, Samo
Title     Risk factors for antimicrobial-resistant Neisseria gonorrhoeae in Europe
Type     članek
Vol. and No.     Letnik 41, št. 12
Publication year     2004
Volume     str. 723-729
ISSN     0148-5717 - Sexually transmitted diseases
Language     eng
Abstract     Background: The European Gonococcal Antimicrobial Surveillance Programme performs antimicrobial resistance surveillance and is coordinated by the European Centre for Disease Prevention and Control. This study used epidemiological and behavioral data combined with the gonococcal susceptibility profiles to determine risk factors associated with harboring resistant gonococci in Europe. Method: From 2009 to 2011, gonococcal isolates from 21 countries were submitted to the European Gonococcal Antimicrobial Surveillance Programme for antimicrobial susceptibility testing. Patient variables associated with resistance to azithromycin, cefixime, and ciprofloxacin were identified using univariate and multivariable logistic regression analyses of odds ratios. Geometric means for ceftriaxone and cefixime minimum inhibitory concentrations (MICs) were compared for patients of different sexual orientation and sex. Results: A total of 5034 gonococcal isolates were tested from 2009 to 2011. Isolates exhibiting resistance to cefixime (MIC > 0.125 mg/L) and ciprofloxacin (MIC > 0.5 mg/L) were significantly associated with infection in heterosexuals (males only for ciprofloxacin), older patients (>25 years of age), or those without a concurrent chlamydial infection in the multivariable analysis. The geometric mean of cefixime and ceftriaxone MICs decreased from 2009 to 2011, most significantly for men who have sex with men, and isolates from male heterosexuals exhibited the highest MICs in 2011. Conclusion: The linking of epidemiological and behavioral data to the susceptibility profiles of the gonococcal isolates has allowed those at higher risk for acquiring antimicrobial resistant Neisseria gonorrhoeae to be identified. Improved data numbers and representativeness are required before evidence-based risk groups can be identified, and subsequent focused treatments or public health intervention strategies can be initiated with confidence.
Keywords     Neisseria gonorrhoeae
resistance
risk factors
Neisseria gonorrhoeae
odpornost
dejavniki tveganja