Trends and regional variations of gonococcal antimicrobial resistance in the Netherlands, 2013 to 2019

  • Maartje Visser
    Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
  • Hannelore M Götz
    Department Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond (GGD Rotterdam), Rotterdam, the Netherlands
  • Alje P van Dam
    National Reference Laboratory for Neisseria gonorrhoeae, Public Health Laboratory, Amsterdam Health Service, Amsterdam, the Netherlands
  • Birgit HB van Benthem
    Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands

抄録

<jats:sec> <jats:title>Background</jats:title> <jats:p>Gonococcal antimicrobial resistance is emerging worldwide and is monitored in the Netherlands in 18 of 24 Sexual Health Centres (SHC).</jats:p> </jats:sec> <jats:sec> <jats:title>Aim</jats:title> <jats:p>To report trends, predictors and regional variation of gonococcal azithromycin resistance (AZI-R, minimum inhibitory concentration (MIC) > 1 mg/L) and ceftriaxone decreased susceptibility (CEF-DS, MIC > 0.032 mg/L) in 2013–2019.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>SHC reported data on individual characteristics, sexually transmitted infection diagnoses, and susceptibility testing (MIC, measured by Etest). We used multilevel logistic regression analysis to identify AZI-R/CEF-DS predictors, correcting for SHC region. Population differences’ effect on regional variance of AZI-R and CEF-DS was assessed with a separate multilevel model.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>The study included 13,172 isolates, predominantly (n = 9,751; 74%) from men who have sex with men (MSM). Between 2013 and 2019, annual proportions of AZI-R isolates appeared to increase from 2.8% (37/1,304) to 9.3% (210/2,264), while those of CEF-DS seemed to decrease from 7.0% (91/1,306) to 2.9% (65/2,276). Among SHC regions, 0.0‒16.9% isolates were AZI-R and 0.0−7.0% CEF-DS; population characteristics could not explain regional variance. Pharyngeal strain origin and consultation year were significantly associated with AZI-R and CEF-DS for MSM, women, and heterosexual men. Among women and heterosexual men ≥ 4 partners was associated with CEF-DS, and ≥ 10 with AZI-R.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>No resistance or decreasing susceptibility was found for CEF, the first line gonorrhoea treatment in the Netherlands. Similar to trends worldwide, AZI-R appeared to increase. Regional differences between SHC support nationwide surveillance with regional-level reporting. The increased risk of resistance/decreased susceptibility in pharyngeal strains underlines the importance of including extragenital infections in gonococcal resistance surveillance.</jats:p> </jats:sec>

収録刊行物

  • Eurosurveillance

    Eurosurveillance 27 (34), 2022-08-25

    European Centre for Disease Control and Prevention (ECDC)

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