WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study
Summary: Background: Gonorrhoea and antimicrobial resistance (AMR) in Neisseria gonorrhoeae are major health concerns globally. Increased global surveillance of gonococcal AMR is essential. We aimed to describe the 2017–18 data from WHO's global gonococcal AMR surveillance, and to discuss prio...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-11-01
|
| Series: | The Lancet Microbe |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666524721001713 |
| _version_ | 1818739490532884480 |
|---|---|
| author | Magnus Unemo, ProfPhD Monica M Lahra, ProfFRCPA Martina Escher, MD Sergey Eremin, MD Michelle J Cole, DBMS Patricia Galarza, PhD Francis Ndowa, MD Irene Martin, BSc Jo-Anne R Dillon, ProfPhD Marcelo Galas, MD Pilar Ramon-Pardo, MD Hillard Weinstock, MD Teodora Wi, MD |
| author_facet | Magnus Unemo, ProfPhD Monica M Lahra, ProfFRCPA Martina Escher, MD Sergey Eremin, MD Michelle J Cole, DBMS Patricia Galarza, PhD Francis Ndowa, MD Irene Martin, BSc Jo-Anne R Dillon, ProfPhD Marcelo Galas, MD Pilar Ramon-Pardo, MD Hillard Weinstock, MD Teodora Wi, MD |
| author_sort | Magnus Unemo, ProfPhD |
| collection | DOAJ |
| description | Summary: Background: Gonorrhoea and antimicrobial resistance (AMR) in Neisseria gonorrhoeae are major health concerns globally. Increased global surveillance of gonococcal AMR is essential. We aimed to describe the 2017–18 data from WHO's global gonococcal AMR surveillance, and to discuss priorities essential for the effective management and control of gonorrhoea. Methods: We did a retrospective observational study of the AMR data of gonococcal isolates reported to WHO by 73 countries in 2017–18. WHO recommends that each country collects at least 100 gonococcal isolates per year, and that quantitative methods to determine the minimum inhibitory concentration of antimicrobials, interpreted by internationally standardised resistance breakpoints, are used. Findings: In 2017–18, 73 countries provided AMR data for one or more drug. Decreased susceptibility or resistance to ceftriaxone was reported by 21 (31%) of 68 reporting countries and to cefixime by 24 (47%) of 51 reporting countries. Resistance to azithromycin was reported by 51 (84%) of 61 reporting countries and to ciprofloxacin by all 70 (100%) reporting countries. The annual proportion of decreased susceptibility or resistance across countries was 0–21% to ceftriaxone and 0–22% to cefixime, and that of resistance was 0–60% to azithromycin and 0–100% to ciprofloxacin. The number of countries reporting gonococcal AMR and resistant isolates, and the number of examined isolates, have increased since 2015–16. Surveillance remains scarce in central America and the Caribbean and eastern Europe, and in the WHO African, Eastern Mediterranean, and South-East Asian regions. Interpretation: In many countries, ciprofloxacin resistance was exceedingly high, azithromycin resistance was increasing, and decreased susceptibility or resistance to ceftriaxone and cefixime continued to emerge. WHO's global surveillance of gonococcal AMR needs to expand internationally to provide imperative data for national and international management guidelines and public health policies. Improved prevention, early diagnosis, treatment of index patients and partners, enhanced surveillance (eg, infection, AMR, treatment failures, and antimicrobial use or misuse), and increased knowledge on antimicrobial selection, stewardship, and pharmacokinetics or pharmacodynamics are essential. The development of rapid, accurate, and affordable point-of-care gonococcal diagnostic tests, new antimicrobials, and gonococcal vaccines is imperative. Funding: None. |
| first_indexed | 2024-12-18T01:25:40Z |
| format | Article |
| id | doaj.art-922ede7e692547748081bf8d9959d80b |
| institution | Directory Open Access Journal |
| issn | 2666-5247 |
| language | English |
| last_indexed | 2024-12-18T01:25:40Z |
| publishDate | 2021-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Microbe |
| spelling | doaj.art-922ede7e692547748081bf8d9959d80b2022-12-21T21:25:45ZengElsevierThe Lancet Microbe2666-52472021-11-01211e627e636WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational studyMagnus Unemo, ProfPhD0Monica M Lahra, ProfFRCPA1Martina Escher, MD2Sergey Eremin, MD3Michelle J Cole, DBMS4Patricia Galarza, PhD5Francis Ndowa, MD6Irene Martin, BSc7Jo-Anne R Dillon, ProfPhD8Marcelo Galas, MD9Pilar Ramon-Pardo, MD10Hillard Weinstock, MD11Teodora Wi, MD12WHO Collaborating Centre for Gonorrhoea and Other STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Correspondence to: Prof Magnus Unemo, WHO Collaborating Centre for Gonorrhoea and Other STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro SE 701 85, SwedenWHO Collaborating Centre for Sexually Transmitted Infections and Antimicrobial Resistance, New South Wales Health Pathology, Microbiology, Randwick, NSW, AustraliaDepartment of the Global HIV, Hepatitis and STI programmes, WHO, Geneva, SwitzerlandSurveillance, Evidence and Laboratory Strengthening, Antimicrobial Resistance Division, WHO, Geneva, SwitzerlandNational Infection Service, Public Health England, London, UKWHO Collaborating Centre for Antimicrobial Resistance, National Reference Laboratory for STDs, National Institute of Infectious Diseases–ANLIS Dr Carlos G Malbrán, Buenos Aires, ArgentinaSkin and Genitourinary Medicine Clinic, Harare, ZimbabwePublic Health Agency of Canada, National Microbiology Laboratory, Winnipeg, MB, CanadaVaccine and Infecious Disease Organization–International Vaccine Centre, University of Saskatchewan, Saskatoon, SK, CanadaCommunicable Diseases and Environmental Determinants of Health, Pan American Health Organization, Washington, DC, USACommunicable Diseases and Environmental Determinants of Health, Pan American Health Organization, Washington, DC, USADivision of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USADepartment of the Global HIV, Hepatitis and STI programmes, WHO, Geneva, SwitzerlandSummary: Background: Gonorrhoea and antimicrobial resistance (AMR) in Neisseria gonorrhoeae are major health concerns globally. Increased global surveillance of gonococcal AMR is essential. We aimed to describe the 2017–18 data from WHO's global gonococcal AMR surveillance, and to discuss priorities essential for the effective management and control of gonorrhoea. Methods: We did a retrospective observational study of the AMR data of gonococcal isolates reported to WHO by 73 countries in 2017–18. WHO recommends that each country collects at least 100 gonococcal isolates per year, and that quantitative methods to determine the minimum inhibitory concentration of antimicrobials, interpreted by internationally standardised resistance breakpoints, are used. Findings: In 2017–18, 73 countries provided AMR data for one or more drug. Decreased susceptibility or resistance to ceftriaxone was reported by 21 (31%) of 68 reporting countries and to cefixime by 24 (47%) of 51 reporting countries. Resistance to azithromycin was reported by 51 (84%) of 61 reporting countries and to ciprofloxacin by all 70 (100%) reporting countries. The annual proportion of decreased susceptibility or resistance across countries was 0–21% to ceftriaxone and 0–22% to cefixime, and that of resistance was 0–60% to azithromycin and 0–100% to ciprofloxacin. The number of countries reporting gonococcal AMR and resistant isolates, and the number of examined isolates, have increased since 2015–16. Surveillance remains scarce in central America and the Caribbean and eastern Europe, and in the WHO African, Eastern Mediterranean, and South-East Asian regions. Interpretation: In many countries, ciprofloxacin resistance was exceedingly high, azithromycin resistance was increasing, and decreased susceptibility or resistance to ceftriaxone and cefixime continued to emerge. WHO's global surveillance of gonococcal AMR needs to expand internationally to provide imperative data for national and international management guidelines and public health policies. Improved prevention, early diagnosis, treatment of index patients and partners, enhanced surveillance (eg, infection, AMR, treatment failures, and antimicrobial use or misuse), and increased knowledge on antimicrobial selection, stewardship, and pharmacokinetics or pharmacodynamics are essential. The development of rapid, accurate, and affordable point-of-care gonococcal diagnostic tests, new antimicrobials, and gonococcal vaccines is imperative. Funding: None.http://www.sciencedirect.com/science/article/pii/S2666524721001713 |
| spellingShingle | Magnus Unemo, ProfPhD Monica M Lahra, ProfFRCPA Martina Escher, MD Sergey Eremin, MD Michelle J Cole, DBMS Patricia Galarza, PhD Francis Ndowa, MD Irene Martin, BSc Jo-Anne R Dillon, ProfPhD Marcelo Galas, MD Pilar Ramon-Pardo, MD Hillard Weinstock, MD Teodora Wi, MD WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study The Lancet Microbe |
| title | WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study |
| title_full | WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study |
| title_fullStr | WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study |
| title_full_unstemmed | WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study |
| title_short | WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study |
| title_sort | who global antimicrobial resistance surveillance for neisseria gonorrhoeae 2017 18 a retrospective observational study |
| url | http://www.sciencedirect.com/science/article/pii/S2666524721001713 |
| work_keys_str_mv | AT magnusunemoprofphd whoglobalantimicrobialresistancesurveillanceforneisseriagonorrhoeae201718aretrospectiveobservationalstudy AT monicamlahraproffrcpa whoglobalantimicrobialresistancesurveillanceforneisseriagonorrhoeae201718aretrospectiveobservationalstudy AT martinaeschermd whoglobalantimicrobialresistancesurveillanceforneisseriagonorrhoeae201718aretrospectiveobservationalstudy AT sergeyereminmd whoglobalantimicrobialresistancesurveillanceforneisseriagonorrhoeae201718aretrospectiveobservationalstudy AT michellejcoledbms whoglobalantimicrobialresistancesurveillanceforneisseriagonorrhoeae201718aretrospectiveobservationalstudy AT patriciagalarzaphd whoglobalantimicrobialresistancesurveillanceforneisseriagonorrhoeae201718aretrospectiveobservationalstudy AT francisndowamd whoglobalantimicrobialresistancesurveillanceforneisseriagonorrhoeae201718aretrospectiveobservationalstudy AT irenemartinbsc whoglobalantimicrobialresistancesurveillanceforneisseriagonorrhoeae201718aretrospectiveobservationalstudy AT joannerdillonprofphd whoglobalantimicrobialresistancesurveillanceforneisseriagonorrhoeae201718aretrospectiveobservationalstudy AT marcelogalasmd whoglobalantimicrobialresistancesurveillanceforneisseriagonorrhoeae201718aretrospectiveobservationalstudy AT pilarramonpardomd whoglobalantimicrobialresistancesurveillanceforneisseriagonorrhoeae201718aretrospectiveobservationalstudy AT hillardweinstockmd whoglobalantimicrobialresistancesurveillanceforneisseriagonorrhoeae201718aretrospectiveobservationalstudy AT teodorawimd whoglobalantimicrobialresistancesurveillanceforneisseriagonorrhoeae201718aretrospectiveobservationalstudy |