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WHO global antimicr...
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Unemo, Magnus,1970-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,WHO Collaborating Centre for Gonorrhoea and Other STIs, Department of Laboratory Medicine
(author)
WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017-18 : a retrospective observational study
- Article/chapterEnglish2021
Publisher, publication year, extent ...
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Elsevier,2021
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:oru-95653
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-95653URI
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https://doi.org/10.1016/S2666-5247(21)00171-3DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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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.
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Lahra, Monica M.WHO Collaborating Centre for Sexually Transmitted Infections and Antimicrobial Resistance, New South Wales Health Pathology, Microbiology, Randwick NSW, Australia
(author)
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Escher, MartinaDepartment of the Global HIV, Hepatitis and STI programmes Geneva, Switzerland
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Eremin, SergeyWHO, Surveillance, Evidence and Laboratory Strengthening, Antimicrobial Resistance Division, Geneva, Switzerland
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Cole, Michelle J.National Infection Service, Public Health England, London, England
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Galarza, PatriciaWHO Collaborating Centre for Antimicrobial Resistance, National Reference Laboratory for STDs, National Institute of Infectious Diseases–ANLIS Dr Carlos G Malbrán, Buenos Aires, Argentina
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Ndowa, FrancisSkin and Genitourinary Medicine Clinic, Harare, Zimbabwe
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Martin, IrenePublic Health Agency of Canada, National Microbiology Laboratory, Winnipeg MB, Canada
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Dillon, Jo-Anne R.Vaccine and Infecious Disease Organization–International Vaccine Centre, University of Saskatchewan, Saskatoon SK, Canada
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Galas, MarceloEnvironmental Determinants of Health, Pan American Health Organization, Washington DC, USA
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Ramon-Pardo, PilarEnvironmental Determinants of Health, Pan American Health Organization, Washington DC, USA
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Weinstock, HillardDivision of STD Prevention, Centers for Disease Control and Prevention, Atlanta GA, USA
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Wi, Teodora
(author)
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Örebro universitetInstitutionen för medicinska vetenskaper
(creator_code:org_t)
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In:Lancet Microbe: Elsevier2:11, s. E627-E6362666-5247
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