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Significant increase in azithromycin “resistance” and susceptibility to ceftriaxone and cefixime in Neisseria gonorrhoeae isolates in 26 European countries, 2019

2022-06-07Artigo científico Acesso aberto
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dc.contributor.authorDay, Michaela J.
dc.contributor.authorJacobsson, Susanne
dc.contributor.authorSpiteri, Gianfranco
dc.contributor.authorKulishev, Carina
dc.contributor.authorSajedi, Noshin
dc.contributor.authorWoodford, Neil
dc.contributor.authorBlumel, Benjamin
dc.contributor.authorvan der Werf, Marieke J.
dc.contributor.authorAmato-Gauci, Andrew J.
dc.contributor.authorUnemo, Magnus
dc.contributor.authorCole, Michelle J.
dc.contributor.authorEder, Claudia
dc.contributor.authorPleininger, Sonja
dc.contributor.authorHuhlescu, Steliana
dc.contributor.authorde Baetselier, Irith
dc.contributor.authorHunjak, Blaženka
dc.contributor.authorBlažić, Tatjana Nemeth
dc.contributor.authorMaikanti-Charalampous, Panagiota
dc.contributor.authorPieridou, Despo
dc.contributor.authorZákoucká, Hana
dc.contributor.authorŽemličková, Helena
dc.contributor.authorHoffmann, Steen
dc.contributor.authorCowan, Susan
dc.contributor.authorPeetso, Rita
dc.contributor.authorViktorova, Jelena
dc.contributor.authorNdeikoundam, Ndeindo
dc.contributor.authorBercot, Beatrice
dc.contributor.authorSampo, Anu Patari
dc.contributor.authorKirjavainen, Vesa
dc.contributor.authorBuder, Susanne
dc.contributor.authorJansen, Klaus
dc.contributor.authorMiriagou, Vivi
dc.contributor.authorBalla, Eszter
dc.contributor.authorDudás, Mária
dc.contributor.authorSigmundsdóttir, Guðrún
dc.contributor.authorAsmundsdottir, Lena Ros
dc.contributor.authorSaab, Sinead
dc.contributor.authorCrowley, Brendan
dc.contributor.authorCarannante, Anna
dc.contributor.authorStefanelli, Paola
dc.contributor.authorPakarna, Gatis
dc.contributor.authorMavcutko, Violeta
dc.contributor.authorCassar, Robert
dc.contributor.authorBarbara, Christopher
dc.contributor.authorVella, Francesca
dc.contributor.authorVan Dam, Alje
dc.contributor.authorLinde, Ineke
dc.contributor.authorCaugant, Dominique
dc.contributor.authorKløvstad, Hilde
dc.contributor.authorMlynarczyk-Bonikowska, Beata
dc.contributor.authorBorrego, Maria-José
dc.contributor.authorPavlik, Peter
dc.contributor.authorKlavs, Irena
dc.contributor.authorKustec, Tanja
dc.contributor.authorVazquez, Julio
dc.contributor.authorDiaz, Asuncion
dc.contributor.authorTorreblanca, Raquel Abad
dc.contributor.authorVelicko, Inga
dc.contributor.authorUnemo, Magnus
dc.contributor.authorFifer, Helen
dc.contributor.authorTempleton, Kate
dc.date.accessioned2023-03-24T11:50:54Z
dc.date.available2023-03-24T11:50:54Z
dc.date.issued2022-06-07
dc.descriptionEuro-GASP network: Claudia Eder, Sonja Pleininger, Steliana Huhlescu, Irith de Baetselier, Blaženka Hunjak, Tatjana Nemeth Blažić, Panagiota Maikanti-Charalampous, Despo Pieridou, Hana Zákoucká, Helena Žemličková, Steen Hoffmann, Susan Cowan, Rita Peetso, Jelena Viktorova, Ndeindo Ndeikoundam, Beatrice Bercot, Anu Patari Sampo, Vesa Kirjavainen, Susanne Buder, Klaus Jansen, Vivi Miriagou, Eszter Balla, Mária Dudás, Guðrún Sigmundsdóttir, Lena Ros Asmundsdottir, Sinead Saab, Brendan Crowley, Anna Carannante, Paola Stefanelli, Gatis Pakarna, Violeta Mavcutko, Robert Cassar, Christopher Barbara, Francesca Vella, Alje Van Dam, Ineke Linde, Dominique Caugant, Hilde Kløvstad, Beata Mlynarczyk-Bonikowska, Maria-José Borrego, Peter Pavlik, Irena Klavs, Tanja Kustec, Julio Vazquez, Asuncion Diaz, Raquel Abad Torreblanca, Inga Velicko, Magnus Unemo, Helen Fifer, Kate Templetonpt_PT
dc.description.abstractBackground: The European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) performs annual sentinel surveillance of Neisseria gonorrhoeae susceptibility to therapeutically relevant antimicrobials across the European Union/European Economic Area (EU/EEA). We present the Euro-GASP results from 2019 (26 countries), linked to patient epidemiological data, and compared with data from previous years. Methods: Agar dilution and minimum inhibitory concentration (MIC) gradient strip methodologies were used to determine the antimicrobial susceptibility (using EUCAST clinical breakpoints, where available) of 3239 N. gonorrhoeae isolates from 26 countries across the EU/EEA. Significance of differences compared with Euro-GASP results in previous years was analysed using Z-test and the Pearson's χ2 test was used to assess significance of odds ratios for associations between patient epidemiological data and antimicrobial resistance. Results: European N. gonorrhoeae isolates collected between 2016 and 2019 displayed shifting MIC distributions for; ceftriaxone, with highly susceptible isolates increasing over time and occasional resistant isolates each year; cefixime, with highly-susceptible isolates becoming increasingly common; azithromycin, with a shift away from lower MICs towards higher MICs above the EUCAST epidemiological cut-off (ECOFF); and ciprofloxacin which is displaying a similar shift in MICs as observed for azithromycin. In 2019, two isolates displayed ceftriaxone resistance, but both isolates had MICs below the azithromycin ECOFF. Cefixime resistance (0.8%) was associated with patient sex, with resistance higher in females compared with male heterosexuals and men-who-have-sex-with-men (MSM). The number of countries reporting isolates with azithromycin MICs above the ECOFF increased from 76.9% (20/26) in 2016 to 92.3% (24/26) in 2019. Isolates with azithromycin MICs above the ECOFF (9.0%) were associated with pharyngeal infection sites. Following multivariable analysis, ciprofloxacin resistance remained associated with isolates from MSM and heterosexual males compared with females, the absence of a concurrent chlamydial infection, pharyngeal infection sites and patients ≥ 25 years of age. Conclusions: Resistance to ceftriaxone and cefixime remained uncommon in EU/EEA countries in 2019 with a significant decrease in cefixime resistance observed between 2016 and 2019. The significant increase in azithromycin "resistance" (azithromycin MICs above the ECOFF) threatens the effectiveness of the dual therapy (ceftriaxone + azithromycin), i.e., for ceftriaxone-resistant cases, currently recommended in many countries internationally and requires close monitoring.pt_PT
dc.description.sponsorshipThe study was funded by the European Centre for Disease Prevention and Control (Framework Contract No. ECDC/2017/004).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationBMC Infect Dis. 2022 Jun 7;22(1):524. doi: 10.1186/s12879-022-07509-wpt_PT
dc.identifier.doi10.1186/s12879-022-07509-wpt_PT
dc.identifier.issn1471-2334
dc.identifier.urihttp://hdl.handle.net/10400.18/8604
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBMCpt_PT
dc.relation.publisherversionhttps://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07509-wpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectAntimicrobial Resistancept_PT
dc.subjectAzithromycinpt_PT
dc.subjectCeftriaxone;pt_PT
dc.subjectEuropept_PT
dc.subjectEuropean Economic Areapt_PT
dc.subjectEuropean Gonococcal Antimicrobial Surveillance Programme (Euro-GASP)pt_PT
dc.subjectEuropean Unionpt_PT
dc.subjectGonorrhoeapt_PT
dc.subjectSurveillancept_PT
dc.subjectTreatmentpt_PT
dc.subjectResistência aos Antimicrobianospt_PT
dc.subjectInfecções Sexualmente Transmissíveispt_PT
dc.titleSignificant increase in azithromycin “resistance” and susceptibility to ceftriaxone and cefixime in Neisseria gonorrhoeae isolates in 26 European countries, 2019pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1pt_PT
oaire.citation.startPage524pt_PT
oaire.citation.titleBMC Infectious Diseasespt_PT
oaire.citation.volume22pt_PT
rcaap.embargofctAcesso de acordo com política editorial da revista.pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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