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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

2021-03-18Journal article Open access
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dc.contributor.authorJacobsson, Susanne
dc.contributor.authorCole, Michelle J
dc.contributor.authorSpiteri, Gianfranco
dc.contributor.authorDay, Michaela
dc.contributor.authorUnemo, Magnus
dc.contributor.authorEuro-GASP Network
dc.date.accessioned2022-01-31T16:26:06Z
dc.date.available2022-01-31T16:26:06Z
dc.date.issued2021-03-18
dc.descriptionEuro-GASP Network: Claudia Eder, Sonja Pleininger, Alexander Indra, Steliana Huhlescu, Irith De Baetselier, Wim Vanden Berghe, Blaženka Hunjak, Tatjana Nemeth Blažić, Panayiota Maikanti-Charalambous, Despo Pieridou, Hana Zákoucká, Helena Žemličková, Steen Hoffmann, Lasse Jessen Schwartz, Rita Peetso, Jevgenia Epstein, Jelena Viktorova, Ndeindo Ndeikoundam, Beatrice Bercot, Cécile Bébéar, Florence Lot, Susanne Buder, Klaus Jansen, Vivi Miriagou, Georgios Rigakos, Vasilios Raftopoulos, Eszter Balla, Mária Dudás, Lena Rós Ásmundsdóttir, Guðrún Sigmundsdóttir, Guðrún Svanborg Hauksdóttir, Thorolfur Gudnason, Aoife Colgan, Brendan Crowley, Sinéad Saab, Paola Stefanelli, Anna Carannante, Patrizia Parodi, Gatis Pakarna, Raina Nikiforova, Antra Bormane, Elina Dimina, Monique Perrin, Tamir Abdelrahman, Joël Mossong, Jean-Claude Schmit, Friedrich Mühlschlegel, Christopher Barbara, Francesca Mifsud, Alje Van Dam, Birgit Van Benthem, Maartje Visser, Ineke Linde, Hilde Kløvstad, Dominique Caugant, Beata Młynarczyk-Bonikowska, Jacinta Azevedo, Maria-José Borrego, Marina Lurdes Ramos Nascimento, Peter Pavlik, Irena Klavs, Andreja Murnik, Samo Jeverica, Sandra Kosmac, Tanja Kustec, Julio Vázquez Moreno, Asuncion Diaz, Raquel Abad, Inga Velicko, Magnus Unemo, Gwenda Hughes, Jill Shepherd, Lynsey Pattersonpt_PT
dc.descriptionPortugal: Maria-José Borrego (INSA)pt_PT
dc.description.abstractBackground: 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.pt_PT
dc.description.sponsorshipThe study was funded by the ECDC (Framework Contract No. ECDC/2017/004). Open Access funding provided by Örebro Universitypt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationBMC Infect Dis. 2021 Mar 18;21(1):273. doi: 10.1186/s12879-021-05931-0.pt_PT
dc.identifier.doi10.1186/s12879-021-05931-0pt_PT
dc.identifier.issn1471-2334
dc.identifier.urihttp://hdl.handle.net/10400.18/7896
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.relation.publisherversionhttps://bmcinfectdis.biomedcentral.com/track/pdf/10.1186/s12879-021-05931-0.pdfpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectAnti-Bacterial Agentspt_PT
dc.subjectAzithromycinpt_PT
dc.subjectCefiximept_PT
dc.subjectCeftriaxonept_PT
dc.subjectCiprofloxacinpt_PT
dc.subjectEuropean Unionpt_PT
dc.subjectFemalept_PT
dc.subjectGonorrheapt_PT
dc.subjectHeterosexualitypt_PT
dc.subjectHomosexuality, Malept_PT
dc.subjectHumanspt_PT
dc.subjectMalept_PT
dc.subjectMicrobial Sensitivity Testspt_PT
dc.subjectNeisseria gonorrhoeaept_PT
dc.subjectSexual Behaviorpt_PT
dc.subjectDrug Resistance, Bacterialpt_PT
dc.subjectSex Factorspt_PT
dc.subjectSexual and Gender Minoritiespt_PT
dc.subjectInfecções Sexualmente Transmissíveispt_PT
dc.titleAssociations between antimicrobial susceptibility/resistance of Neisseria gonorrhoeae isolates in European Union/European Economic Area and patients' gender, sexual orientation and anatomical site of infection, 2009-2016pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1pt_PT
oaire.citation.startPage273pt_PT
oaire.citation.titleBMC Infectious Diseasespt_PT
oaire.citation.volume21pt_PT
rcaap.embargofctAcesso de acordo com política editorial da revista.pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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