Antimicrobial resistance in Neisseria gonorrhoeae isolates from foreign-born population in the European Gonococcal Antimicrobial Surveillance Programme

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Hernando Rovirola, CristinaPreventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agència de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain (author)

Antimicrobial resistance in Neisseria gonorrhoeae isolates from foreign-born population in the European Gonococcal Antimicrobial Surveillance Programme

Article/chapterEnglish2020

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2020-02-04
BMJ Publishing Group Ltd,2020
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LIBRIS-ID:oai:DiVA.org:oru-79942
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-79942URI
https://doi.org/10.1136/sextrans-2018-053912DOI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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OBJECTIVES: infections worldwide. We compared the prevalence of AMR gonococcal isolates among native persons to foreign-born (reporting country different from country of birth) persons, and describe the epidemiological and clinical characteristics of foreign-born patients and their associations to AMR.METHODS: We analysed isolates and patient data reported to the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) 2010-2014 (n=9529).RESULTS: Forty-three per cent of isolates had known country of birth and 17.2% of these were from persons born abroad. Almost 50% of foreign-born were from the WHO European Region (13.1% from non-European Union [EU] and the European Economic Area [EEA] countries). Compared with isolates from natives, isolates from foreign-born had a similar level (p>0.05) of azithromycin resistance (7.5% vs 7.2%), ciprofloxacin resistance (50.0% vs 46.3%) and of decreased susceptibility to ceftriaxone (1.9% vs 2.8%); a lower rate of cefixime resistance (5.7% vs 3.6%, p=0.02), and a higher proportion of isolates producing penicillinase (8.4% vs 11.7%, p=0.02). Among isolates from persons born outside EU/EEA, the level of decreased susceptibility to ceftriaxone was higher (1.8% vs 3.5%, p=0.02), particularly in those from the WHO Eastern Mediterranean Region and non-EU/EEA WHO European countries (1.9% vs 9.6% and 8.7%, respectively, p<0.01). In multivariable analysis, foreign-born patients with AMR isolates were more likely to be from non-EU/EEA WHO European countries (adjusted OR [aOR]: 3.2, 95% CI 1.8 to 5.8), WHO Eastern Mediterranean countries (aOR: 1.8, 95% CI 1.1 to 3.3) and heterosexual males (aOR: 1.8, 95% CI 1.2 to 2.7).CONCLUSIONS: Importation of AMR strains remains an important threat in the EU/EEA. Research to improve understanding of sexual networks within foreign born and sexual tourism populations could help to inform effective tailor-made interventions. The Euro-GASP demonstrates the public health value of quality-assured surveillance of gonococcal AMR and the need for strengthened AMR surveillance, particularly in the non-EU/EEA WHO European Region.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Infektionsmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Infectious Medicine hsv//eng
Euro-GASP
Europe
antimicrobial resistance
ceftriaxone
gonorrhoea
migrants
surveillance
treatment

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Spiteri, GianfrancoEuropean Centre for Disease Prevention and Control, Stockholm, Sweden (author)
Sabidó, MeritxellTransLab, Medical Science Department, Universitat de Girona, Girona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain (author)
Montoliu, AlexandraCentre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agència de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain; Health Sciences Research Institute of the Germans Trias i Pujol Foundation (IGTP), Badalona, Spain (author)
Gonzalez, VictoriaCentre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agència de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain; Laboratory of Microbiology, Germans Trias i Pujol Hospital (HGTiP), Badalona, Spain (author)
Casabona, JordiCentre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agència de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Health Sciences Research Institute of the Germans Trias i Pujol Foundation (IGTP), Badalona, Spain; Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Badalona, Spain (author)
Cole, Michelle JayneNational Infection Service, Public Health England, London, UK (author)
Noori, TeymurEuropean Centre for Disease Prevention and Control, Stockholm, Sweden (author)
Unemo, Magnus,1970-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,WHO Collaborating Centre for Gonorrhoea and other STIs(Swepub:oru)muo (author)
Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agència de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, SpainEuropean Centre for Disease Prevention and Control, Stockholm, Sweden (creator_code:org_t)

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In:Sexually Transmitted Infections: BMJ Publishing Group Ltd96:3, s. 204-2101368-49731472-3263

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