Neisseria gonorrhoeae Antimicrobial Resistance among Men who Have Sex with Men and Men who Have Sex with Women, the Gonococcal Isolate Surveillance Project, 2005–2010

Details

• Alternative Title:
  Ann Intern Med
• Personal Author:
  Kirkcaldy, Robert D. ; Zaidi, Akbar ; Hook, Edward W. ; Holmes, King H. ; Soge, Olusegun ; del Rio, Carlos ; Hall, Geraldine ; Papp, John ; Bolan, Gail ; Weinstock, Hillard S.
• Description:
  Background:
  
  Gonorrhea treatment has been complicated by antimicrobial resistance in Neisseria gonorrhoeae. Gonococcal fluoroquinolone resistance emerged more rapidly among men who have sex with men (MSM) than among men who have sex exclusively with women (MSW).
  
  Objective:
  
  To determine whether N. gonorrhoeae urethral isolates from MSM were more likely than isolates from MSW to exhibit resistance to or elevated minimum inhibitory concentrations (MICs) of antimicrobials used to treat gonorrhea.
  
  Design:
  
  Six years of surveillance data from the Gonococcal Isolate Surveillance Project (GISP)
  
  Setting:
  
  Publicly-funded sexually transmitted disease clinics in 30 United States cities
  
  Patients:
  
  Men with a total of 34,600 episodes of symptomatic urethral gonorrhea
  
  Measurements:
  
  Primary outcomes included percentage of isolates exhibiting resistance or elevated MICs, and adjusted odds ratios for resistance or elevated MICs among isolates from MSM compared to isolates from MSW.
  
  Funding Source:
  
  GISP is funded by the CDC, an agency of the US Department of Health and Human Services.
  
  Results:
  
  Isolates from MSM were significantly more likely than isolates from MSW to exhibit elevated cephalosporin MICs (P <=0.028). Isolates from MSM had a high prevalence of resistance to ciprofloxacin, penicillin, and tetracycline and were significantly more likely to exhibit antimicrobial resistance than isolates from MSW (P <0.001).
  
  Limitations:
  
  Sentinel surveillance might not be representative of all patients with gonorrhea. HIV status, travel history, and antimicrobial use data were missing for some patients.
  
  Conclusions:
  
  MSM are vulnerable to the emerging threat of multidrug-resistant N. gonorrhoeae. Because antimicrobial susceptibility testing is not routinely performed in clinical practice, clinicians should monitor for treatment failures among MSM diagnosed with gonorrhea. Strengthened prevention strategies for MSM and new antimicrobial treatment options are needed.
  
  
• Subjects:
  Adult Anti-Bacterial Agents Article Azithromycin Ceftriaxone Ciprofloxacin Doxycycline Drug Resistance, Bacterial Female GISP Gonorrhea Heterosexuality Homosexuality Humans Logistic Models Male Men Who Have Sex With Men Microbial Sensitivity Tests Neisseria Gonorrhoeae Penicillins Resistance Sensitivity And Specificity Sentinel Surveillance Tetracycline

  More +
• Source:
  Ann Intern Med. 158(5 Pt 1):321-328
• Pubmed ID:
  23460055
• Pubmed Central ID:
  PMC6697257
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHS/United States ; H25 PS001412/PS/NCHHSTP CDC HHS/United States ; P30 AI050409/AI/NIAID NIH HHS/United States
• Volume:
  158
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:7ad0df17396ace347bb6d6ddeb300e906eeb33ff906a309027680bb86e0dd667
• Download URL:
  https://stacks.cdc.gov/view/cdc/80742/cdc_80742_DS1.pdf
• File Type:
  [PDF - 424.30 KB ]