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Gonococcal isolate surveillance program (GISP) protocol
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May 2016
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Description:The treatment and control of Neisseria gonorrhoeae infections have been complicated by the organism’s ability to acquire antimicrobial resistance. The increasing prevalence of strains with plasmid-mediated resistance to penicillin (PPNG) prompted the abandonment of penicillin as single-dose therapy for gonorrhea in 1987. The development of plasmid-mediated resistance to tetracycline, i.e., TetM, caused the Centers for Disease Control and Prevention (CDC) to recommend, in 1985, that tetracycline not be used for the treatment of gonococcal infections. The prevalence of chromosomally-mediated resistance to fluoroquinolones reached levels in the United States at which fluoroquinolones were no longer recommended for gonorrhea treatment by 2007. Occasional chromosomal-mediated resistance to spectinomycin has also been reported. Minimum inhibitory concentrations (MICs) of oral cephalosporins, such as cefixime, have increased in many regions of the world, including the United States. Isolates with high azithromycin MICs have been detected sporadically.
The Gonococcal Isolate Surveillance Program (GISP) was established in 1986 to monitor antimicrobial susceptibility trends in N. gonorrhoeae strains in the United States and to establish a rational basis for the selection of gonococcal therapies. Data from this project have been reported and used to revise the CDC's STD treatment recommendations in 1989, 1993, 1998, 2002, 2006, 2010, and 2015. This protocol supersedes all previous protocols for the project.
gisp-protocol-may-2016.pdf
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