TY - JOUR
T1 - Risk factors for antimicrobial-resistant neisseria gonorrhoeae in Europe
AU - Cole, Michelle J.
AU - Spiteri, Gianfranco
AU - Town, Katy
AU - Unemo, Magnus
AU - Hoffmann, Steen
AU - Chisholm, Stephanie A.
AU - Amato-Gauci, Andrew J.
AU - van de Laar, Marita
AU - Ison, Catherine A.
AU - The Euro-GASP Network
AU - Stary, Angelika
AU - Haller, Maria
AU - Verbrugge, Ruth
AU - Crucitti, Tania
AU - Soteriou, Soteroulla
AU - Cowan, Susan
AU - Sednaoui, Patrice
AU - Kohl, Peter
AU - Bremer, Viviane
AU - Tzelepi, Eva
AU - Konte, Vasileia
AU - Balla, Eszter
AU - Dudás, M. ria
AU - Igoe, Derval
AU - Crowley, Brendan
AU - Suligoi, Barbara
AU - Stefanelli, Paola
AU - Pakarna, Gatis
AU - Mavcutko, Violeta
AU - Barbara, Christopher
AU - Melillo, Jackie Maistre
AU - van Dam, Alje
AU - van Benthem, Birgit
AU - Linde, Ineke
AU - Kløvstad, Hilde
AU - Syversen, Gaute
AU - Azevedo, Jacinta
AU - Borrego, Maria José
AU - Gheorghiu, Viorica
AU - Ionescu, Dan
AU - Pavlik, Peter
AU - Truska, Peter
AU - Klavs, Irena
AU - Jeverica, Samo
AU - Vazquez, Julio
AU - Diez, Mercedes
AU - Velicko, Inga
AU - Hughes, Gwenda
AU - Eastick, Kirstine
PY - 2014
Y1 - 2014
N2 - 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. Methods: 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 9 0.125 mg/L) and ciprofloxacin (MIC 9 0.5 mg/L) were significantly associated with infection in heterosexuals (males only for ciprofloxacin), older patients (925 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. Conclusions: 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.
AB - 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. Methods: 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 9 0.125 mg/L) and ciprofloxacin (MIC 9 0.5 mg/L) were significantly associated with infection in heterosexuals (males only for ciprofloxacin), older patients (925 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. Conclusions: 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.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84925864862&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/25581808
U2 - https://doi.org/10.1097/OLQ.0000000000000185
DO - https://doi.org/10.1097/OLQ.0000000000000185
M3 - Article
C2 - 25581808
SN - 0148-5717
VL - 41
SP - 723
EP - 729
JO - Sexually transmitted diseases
JF - Sexually transmitted diseases
IS - 12
ER -