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Associations between antimicrobial susceptibility/resistance of Neisseria gonorrhoeae isolates in European Union/European Economic Area and patients' gender, sexual orientation and anatomical site of infection, 2009–2016.

Authors :
Jacobsson, Susanne
Cole, Michelle J.
Spiteri, Gianfranco
Day, Michaela
Unemo, Magnus
on behalf of The Euro-GASP Network
Eder, Claudia
Pleininger, Sonja
Indra, Alexander
Huhlescu, Steliana
De Baetselier, Irith
Vanden Berghe, Wim
Hunjak, Blaženka
Blažić, Tatjana Nemeth
Maikanti-Charalambous, Panayiota
Pieridou, Despo
Zákoucká, Hana
Žemličková, Helena
Hoffmann, Steen
Schwartz, Lasse Jessen
Source :
BMC Infectious Diseases. 3/19/2021, Vol. 21 Issue 1, p1-12. 12p.
Publication Year :
2021

Abstract

Background: The emergence and spread of antimicrobial resistance (AMR) in Neisseria gonorrhoeae, nationally and internationally, is a serious threat to the management and control of gonorrhoea. Limited and conflicting data regarding the epidemiological drivers of gonococcal AMR internationally have been published. We examined the antimicrobial susceptibility/resistance of gonococcal isolates (n = 15,803) collected across 27 European Union/European Economic Area (EU/EEA) countries in 2009–2016, in conjunction to epidemiological and clinical data of the corresponding patients, to elucidate associations between antimicrobial susceptibility/resistance and patients' gender, sexual orientation and anatomical site of infection. Methods: In total, 15,803 N. gonorrhoeae isolates from the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP), 2009–2016, were examined. Associations between gonococcal susceptibility/resistance and patients' gender, sexual orientation and anatomical site of infection were investigated using univariate and multivariate logistic regression analysis. Statistical significance was determined by Pearson χ2-test or Fisher's exact test with two-tailed p-values of < 0.05 indicating significance. Results: The overall gonococcal resistance from 2009 to 2016 was 51.7% (range during the years: 46.5–63.5%), 7.1% (4.5–13.2%), 4.3% (1.8–8.7%), and 0.2% (0.0–0.5%) to ciprofloxacin, azithromycin, cefixime, and ceftriaxone, respectively. The level of resistance combined with decreased susceptibility to ceftriaxone was 10.2% (5.7–15.5%). Resistance to cefixime and ciprofloxacin, and resistance combined with decreased susceptibility to ceftriaxone were positively associated with urogenital infections and heterosexual males, males with sexual orientation not reported and females (except for ciprofloxacin), i.e. when compared to men-who-have-sex-with-men (MSM). Azithromycin resistance was positively associated with heterosexual males, but no association was significant regarding anatomical site of infection. Conclusions: Overall, sexual orientation was the main variable associated with gonococcal AMR. Strongest positive associations were identified with heterosexual patients, particularly males, and not MSM. To provide evidence-based understanding and mitigate gonococcal AMR emergence and spread, associations between antimicrobial susceptibility/resistance and patients' gender, sexual orientation and anatomical site of infection need to be further investigated in different geographic settings. In general, these insights will support identification of groups at increased risk and targeted public health actions such as intensified screening, 3-site testing using molecular diagnostics, sexual contact tracing, and surveillance of treatment failures. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
14712334
Volume :
21
Issue :
1
Database :
Academic Search Index
Journal :
BMC Infectious Diseases
Publication Type :
Academic Journal
Accession number :
149371136
Full Text :
https://doi.org/10.1186/s12879-021-05931-0