WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study

Summary: 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 prio...

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Autores principales:	Magnus Unemo, ProfPhD, Monica M Lahra, ProfFRCPA, Martina Escher, MD, Sergey Eremin, MD, Michelle J Cole, DBMS, Patricia Galarza, PhD, Francis Ndowa, MD, Irene Martin, BSc, Jo-Anne R Dillon, ProfPhD, Marcelo Galas, MD, Pilar Ramon-Pardo, MD, Hillard Weinstock, MD, Teodora Wi, MD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Medicine (General) R5-920 Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/922ede7e692547748081bf8d9959d80b
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spelling	oai:doaj.org-article:922ede7e692547748081bf8d9959d80b2021-11-04T04:40:58ZWHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study2666-524710.1016/S2666-5247(21)00171-3https://doaj.org/article/922ede7e692547748081bf8d9959d80b2021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2666524721001713https://doaj.org/toc/2666-5247Summary: 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. Funding: None.Magnus Unemo, ProfPhDMonica M Lahra, ProfFRCPAMartina Escher, MDSergey Eremin, MDMichelle J Cole, DBMSPatricia Galarza, PhDFrancis Ndowa, MDIrene Martin, BScJo-Anne R Dillon, ProfPhDMarcelo Galas, MDPilar Ramon-Pardo, MDHillard Weinstock, MDTeodora Wi, MDElsevierarticleMedicine (General)R5-920MicrobiologyQR1-502ENThe Lancet Microbe, Vol 2, Iss 11, Pp e627-e636 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920 Microbiology QR1-502
spellingShingle	Medicine (General) R5-920 Microbiology QR1-502 Magnus Unemo, ProfPhD Monica M Lahra, ProfFRCPA Martina Escher, MD Sergey Eremin, MD Michelle J Cole, DBMS Patricia Galarza, PhD Francis Ndowa, MD Irene Martin, BSc Jo-Anne R Dillon, ProfPhD Marcelo Galas, MD Pilar Ramon-Pardo, MD Hillard Weinstock, MD Teodora Wi, MD WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study
description	Summary: 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. Funding: None.
format	article
author	Magnus Unemo, ProfPhD Monica M Lahra, ProfFRCPA Martina Escher, MD Sergey Eremin, MD Michelle J Cole, DBMS Patricia Galarza, PhD Francis Ndowa, MD Irene Martin, BSc Jo-Anne R Dillon, ProfPhD Marcelo Galas, MD Pilar Ramon-Pardo, MD Hillard Weinstock, MD Teodora Wi, MD
author_facet	Magnus Unemo, ProfPhD Monica M Lahra, ProfFRCPA Martina Escher, MD Sergey Eremin, MD Michelle J Cole, DBMS Patricia Galarza, PhD Francis Ndowa, MD Irene Martin, BSc Jo-Anne R Dillon, ProfPhD Marcelo Galas, MD Pilar Ramon-Pardo, MD Hillard Weinstock, MD Teodora Wi, MD
author_sort	Magnus Unemo, ProfPhD
title	WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study
title_short	WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study
title_full	WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study
title_fullStr	WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study
title_full_unstemmed	WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study
title_sort	who global antimicrobial resistance surveillance for neisseria gonorrhoeae 2017–18: a retrospective observational study
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/922ede7e692547748081bf8d9959d80b
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WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study

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