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Abstract

Background

antibiotic resistance surveillance is important to maintain adequate treatment. We analysed 2007–15 data from the Gonococcal Resistance to Antimicrobials Surveillance (GRAS), which currently includes 19 of 25 sexually transmitted infection (STI) centres in the Netherlands. : From each patient with a gonorrhoea culture, the minimum inhibitory concentration (MIC) for several antibiotics was determined. Time trends were assessed by geometric means and linear regression of logarithmic MIC. Determinants for decreased susceptibility to ceftriaxone (MIC > 0.032 mg/L) and resistance to cefotaxime (MIC > 0.125 mg/L) and azithromycin (MIC > 0.5 mg/L) were assessed using stratified logistic regression. : 11,768 isolates were analysed. No ceftriaxone resistance was found. In 2015, 27 of 1,425 isolates (1.9%) were resistant to cefotaxime and 176 of 1,623 (10.9%) to azithromycin. Ceftriaxone susceptibility showed no trend (p = 0.96) during the study period, but cefotaxime MIC decreased (p < 0.0001) and azithromycin MIC increased (p < 0.0001) significantly. Concerning ceftriaxone, isolates of men who have sex with men (MSM) from 2013 (p = 0.0005) and 2014 (p = 0.0004) were significantly associated with decreased susceptibility. Significant determinants for cefotaxime resistance were having ≥ 6 partners for women (p = 0.0006). For azithromycin,

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2018-09-06
2019-08-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.36.1700565
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References

  1. World Health Organization (WHO). Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae. Geneva: WHO; 2012.
  2. Van den Broek IVF, van Aar F, van Oeffelen AAM, Op de Coul ELM, Woestenberg PJ, Heijne JCM, et al. Sexually transmitted infections in the Netherlands in 2015. Bilthoven: National Institute for Public Health and the Environment (RIVM); 2016. Available from: https://www.rivm.nl/bibliotheek/rapporten/2016-0027.html
  3. Koedijk FD, van Veen MG, de Neeling AJ, Linde GB, van der Sande MA. Increasing trend in gonococcal resistance to ciprofloxacin in The Netherlands, 2006-8. Sex Transm Infect. 2010;86(1):41-5.  https://doi.org/10.1136/sti.2009.037135  PMID: 19703843 
  4. Yokoi S, Deguchi T, Ozawa T, Yasuda M, Ito S, Kubota Y, et al. Threat to cefixime treatment for gonorrhea. Emerg Infect Dis. 2007;13(8):1275-7. PMID: 17953118 
  5. Unemo M, Golparian D, Syversen G, Vestrheim DF, Moi H. Two cases of verified clinical failures using internationally recommended first-line cefixime for gonorrhoea treatment, Norway, 2010. Euro Surveill. 2010;15(47):19721.  https://doi.org/10.2807/ese.15.47.19721-en  PMID: 21144442 
  6. Ison CA, Hussey J, Sankar KN, Evans J, Alexander S. Gonorrhoea treatment failures to cefixime and azithromycin in England, 2010. Euro Surveill. 2011;16(14):19833. PMID: 21492528 
  7. Unemo M, Golparian D, Stary A, Eigentler A. First Neisseria gonorrhoeae strain with resistance to cefixime causing gonorrhoea treatment failure in Austria, 2011. Euro Surveill. 2011;16(43):19998. PMID: 22085601 
  8. Unemo M, Golparian D, Nicholas R, Ohnishi M, Gallay A, Sednaoui P. High-level cefixime- and ceftriaxone-resistant Neisseria gonorrhoeae in France: novel penA mosaic allele in a successful international clone causes treatment failure. Antimicrob Agents Chemother. 2012;56(3):1273-80.  https://doi.org/10.1128/AAC.05760-11  PMID: 22155830 
  9. Allen VG, Mitterni L, Seah C, Rebbapragada A, Martin IE, Lee C, et al. Neisseria gonorrhoeae treatment failure and susceptibility to cefixime in Toronto, Canada. JAMA. 2013;309(2):163-70.  https://doi.org/10.1001/jama.2012.176575  PMID: 23299608 
  10. Lewis DA, Sriruttan C, Müller EE, Golparian D, Gumede L, Fick D, et al. Phenotypic and genetic characterization of the first two cases of extended-spectrum-cephalosporin-resistant Neisseria gonorrhoeae infection in South Africa and association with cefixime treatment failure. J Antimicrob Chemother. 2013;68(6):1267-70.  https://doi.org/10.1093/jac/dkt034  PMID: 23416957 
  11. van Dam AP, van Ogtrop ML, Golparian D, Mehrtens J, de Vries HJ, Unemo M. Verified clinical failure with cefotaxime 1g for treatment of gonorrhoea in the Netherlands: a case report. Sex Transm Infect. 2014;90(7):513-4.  https://doi.org/10.1136/sextrans-2014-051552  PMID: 25114322 
  12. Bignell C, Unemo M. 2012 European guideline on the diagnosis and treatment of gonorrhoea in adults. International Union against Sexually Transmitted Infections (IUSTI). United Kingdom: International Union Against Sexually Transmitted Infections (IUSTI); 2014.Available from: https://www.iusti.org/regions/Europe/pdf/2012/Gonorrhoea_2012.pdf
  13. Workowski KA, Bolan GACenters for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(RR-03):1-137. PMID: 26042815 
  14. World Health Organization (WHO). WHO guidelines for the treatment of Neisseria gonorrhoeae. Geneva: WHO; 2016.
  15. De Vries HJC, van Doornum GJJ, Bax CJ. Multidisciplinaire Richtlijn Seksueel Overdraagbare Aandoeningen voor de 2e lijn. [Multidisciplinary Guideline for Sexually Transmitted Diseases for second-line care]. Bilthoven: Dutch Society for Dermatology and Venereology, 2012. Dutch.
  16. Ohnishi M, Golparian D, Shimuta K, Saika T, Hoshina S, Iwasaku K, et al. Is Neisseria gonorrhoeae initiating a future era of untreatable gonorrhea?: detailed characterization of the first strain with high-level resistance to ceftriaxone. Antimicrob Agents Chemother. 2011;55(7):3538-45.  https://doi.org/10.1128/AAC.00325-11  PMID: 21576437 
  17. Y Chen M, Stevens K, Tideman R, Zaia A, Tomita T, Fairley CK, et al. Failure of 500 mg of ceftriaxone to eradicate pharyngeal gonorrhoea, Australia. J Antimicrob Chemother. 2013;68(6):1445-7.  https://doi.org/10.1093/jac/dkt017  PMID: 23390207 
  18. Read PJ, Limnios EA, McNulty A, Whiley D, Lahra MM. One confirmed and one suspected case of pharyngeal gonorrhoea treatment failure following 500mg ceftriaxone in Sydney, Australia. Sex Health. 2013;10(5):460-2.  https://doi.org/10.1071/SH13077  PMID: 24028864 
  19. Golparian D, Ohlsson A, Janson H, Lidbrink P, Richtner T, Ekelund O, et al. Four treatment failures of pharyngeal gonorrhoea with ceftriaxone (500 mg) or cefotaxime (500 mg), Sweden, 2013 and 2014. Euro Surveill. 2014;19(30):20862.  https://doi.org/10.2807/1560-7917.ES2014.19.30.20862  PMID: 25108533 
  20. Unemo M, Golparian D, Potočnik M, Jeverica S. Treatment failure of pharyngeal gonorrhoea with internationally recommended first-line ceftriaxone verified in Slovenia, September 2011. Euro Surveill. 2012;17(25):20200. PMID: 22748003 
  21. Berçot B, Belkacem A, Goubard A, Mougari F, Sednaoui P, La Ruche G, et al. High-level azithromycin-resistant Neisseria gonorrhoeae clinical isolate in France, March 2014. Euro Surveill. 2014;19(44):20951.  https://doi.org/10.2807/1560-7917.ES2014.19.44.20951  PMID: 25394255 
  22. Gose SO, Soge OO, Beebe JL, Nguyen D, Stoltey JE, Bauer HM. Failure of azithromycin 2.0 g in the treatment of gonococcal urethritis caused by high-level resistance in California. Sex Transm Dis. 2015;42(5):279-80.  https://doi.org/10.1097/OLQ.0000000000000265  PMID: 25868141 
  23. Chisholm SA, Wilson J, Alexander S, Tripodo F, Al-Shahib A, Schaefer U, et al. An outbreak of high-level azithromycin resistant Neisseria gonorrhoeae in England. Sex Transm Infect. 2016;92(5):365-7.  https://doi.org/10.1136/sextrans-2015-052312  PMID: 26601852 
  24. Fifer H, Natarajan U, Jones L, Alexander S, Hughes G, Golparian D, et al. Failure of Dual Antimicrobial Therapy in Treatment of Gonorrhea. N Engl J Med. 2016;374(25):2504-6.  https://doi.org/10.1056/NEJMc1512757  PMID: 27332921 
  25. European Centre for Disease Prevention and Control (ECDC). Gonococcal antimicrobial susceptibility surveillance in Europe, 2013. Stockholm: ECDC; 2015.
  26. Wind CM, Schim van der Loeff MF, van Dam AP, de Vries HJ, van der Helm JJ. Trends in antimicrobial susceptibility for azithromycin and ceftriaxone in Neisseria gonorrhoeae isolates in Amsterdam, the Netherlands, between 2012 and 2015. Euro Surveill. 2017;22(1):30431.  https://doi.org/10.2807/1560-7917.ES.2017.22.1.30431  PMID: 28079519 
  27. Heymans R, Bruisten SM, Golparian D, Unemo M, de Vries HJC, van Dam AP. Clonally related Neisseria gonorrhoeae isolates with decreased susceptibility to the extended-spectrum cephalosporin cefotaxime in Amsterdam, the Netherlands. Antimicrob Agents Chemother. 2012;56(3):1516-22.  https://doi.org/10.1128/AAC.05481-11  PMID: 22214779 
  28. The European Committee on Antimicrobial Susceptibility Testing (EUCAST). Breakpoint tables for interpretation of MICs and zone diameters. Version 7.1. Europe: EUCAST; 2017. Available from: http://www.eucast.org
  29. Ison CA, Town K, Obi C, Chisholm S, Hughes G, Livermore DM, et al. Decreased susceptibility to cephalosporins among gonococci: data from the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) in England and Wales, 2007-2011. Lancet Infect Dis. 2013;13(9):762-8.  https://doi.org/10.1016/S1473-3099(13)70143-9  PMID: 23764300 
  30. Kirkcaldy RD, Hook EW 3rd, Soge OO, del Rio C, Kubin G, Zenilman JM, et al. Trends in Neisseria gonorrhoeae susceptibility to cephalosporins in the United States, 2006-2014. JAMA. 2015;314(17):1869-71.  https://doi.org/10.1001/jama.2015.10347  PMID: 26529166 
  31. Wind CM, de Vries E, Schim van der Loeff MF, van Rooijen MS, van Dam AP, Demczuk WHB, et al. Decreased azithromycin susceptibility of Neisseria gonorrhoeae isolates in patients recently treated with azithromycin. Clin Infect Dis. 2017;65(1):37-45.  https://doi.org/10.1093/cid/cix249  PMID: 28510723 
  32. Unemo M. Performance Standards for Antimicrobial Susceptibility Testing. 27th ed. CLSI supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute; 2017.
  33. Unemo M, Nicholas RA. Emergence of multidrug-resistant, extensively drug-resistant and untreatable gonorrhea. Future Microbiol. 2012;7(12):1401-22.  https://doi.org/10.2217/fmb.12.117  PMID: 23231489 
  34. Weinstock H, Workowski KA. Pharyngeal gonorrhea: an important reservoir of infection? Clin Infect Dis. 2009;49(12):1798-800.  https://doi.org/10.1086/648428  PMID: 19911969 
  35. Moran JS. Treating uncomplicated Neisseria gonorrhoeae infections: is the anatomic site of infection important? Sex Transm Dis. 1995;22(1):39-47.  https://doi.org/10.1097/00007435-199501000-00007  PMID: 7709324 
  36. Verscheijden MMA, Woestenberg PJ, Götz HM, van Veen MG, Koedijk FDH, van Benthem BHB. Sexually transmitted infections among female sex workers tested at STI clinics in the Netherlands, 2006-2013. Emerg Themes Epidemiol. 2015;12(1):12.  https://doi.org/10.1186/s12982-015-0034-7  PMID: 26322117 
  37. Cole MJ, Spiteri G, Town K, Unemo M, Hoffmann S, Chisholm SA, et al. Risk factors for antimicrobial-resistant Neisseria gonorrhoeae in Europe. Sex Transm Dis. 2014;41(12):723-9.  https://doi.org/10.1097/OLQ.0000000000000185  PMID: 25581808 
  38. McKenna JG, Young H, Moyes A, Smith IW. Is coexisting chlamydial infection more common in gonococcal infections with serogroup WI? Int J STD AIDS. 1990;1(5):340-2.  https://doi.org/10.1177/095646249000100507  PMID: 2129109 
  39. Phillips DJ, Patrizio C, Moyes A, Young H. The sac-4 gene of Neisseria gonorrhoeae and co-existing chlamydial infection. Sex Transm Infect. 2000;76(5):400-2.  https://doi.org/10.1136/sti.76.5.400  PMID: 11141862 
  40. Gretton S, Patrizio C, Young H. The sac-4 gene of Neisseria gonorrhoeae correlates with gonococcal subtype not co-existing chlamydial infection. Int J STD AIDS. 2002;13(3):174-7.  https://doi.org/10.1258/0956462021924866  PMID: 11860694 
  41. Dengler V, McCallum N, Kiefer P, Christen P, Patrignani A, Vorholt JA, et al. Mutation in the C-di-AMP cyclase dacA affects fitness and resistance of methicillin resistant Staphylococcus aureus. PLoS One. 2013;8(8):e73512.  https://doi.org/10.1371/journal.pone.0073512  PMID: 24013956 
  42. Nielsen KL, Pedersen TM, Udekwu KI, Petersen A, Skov RL, Hansen LH, et al. Fitness cost: a bacteriological explanation for the demise of the first international methicillin-resistant Staphylococcus aureus epidemic. J Antimicrob Chemother. 2012;67(6):1325-32.  https://doi.org/10.1093/jac/dks051  PMID: 22378682 
  43. Horváth A, Dobay O, Kardos S, Ghidán Á, Tóth Á, Pászti J, et al. Varying fitness cost associated with resistance to fluoroquinolones governs clonal dynamic of methicillin-resistant Staphylococcus aureus. Eur J Clin Microbiol Infect Dis. 2012;31(8):2029-36.  https://doi.org/10.1007/s10096-011-1536-z  PMID: 22218830 
  44. Trecker MA, Waldner C, Jolly A, Liao M, Gu W, Dillon JA. Behavioral and socioeconomic risk factors associated with probable resistance to ceftriaxone and resistance to penicillin and tetracycline in Neisseria gonorrhoeae in Shanghai. PLoS One. 2014;9(2):e89458.  https://doi.org/10.1371/journal.pone.0089458  PMID: 24586792 
  45. McLean CA, Wang SA, Hoff GL, Dennis LY, Trees DL, Knapp JS, et al. The emergence of Neisseria gonorrhoeae with decreased susceptibility to Azithromycin in Kansas City, Missouri, 1999 to 2000. Sex Transm Dis. 2004;31(2):73-8.  https://doi.org/10.1097/01.OLQ.0000109514.91508.FC  PMID: 14743069 
  46. Town K, Lowndes DM, Hughes G, Obi C, Chisholm S, Ison CAGRASP collaborative group. Can previous first-line therapies for Neisseria gonorrhoeae be targeted to specific patient subgroups to treat gonorrhoea? Sex Transm Infect. 2015;42(1):37-42.  https://doi.org/10.1097/OLQ.0000000000000223  PMID: 24936090 
  47. den Daas C, Goenee M, Bakker BH, de Graaf H, Op de Coul EL. Comparing databases: determinants of sexually transmitted infections, HIV diagnoses, and lack of HIV testing among men who have sex with men. BMC Public Health. 2015;15(1):1114.  https://doi.org/10.1186/s12889-015-2445-3  PMID: 26563102 
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