Cephalosporin and Azithromycin Susceptibility in Neisseria gonorrhoeae Isolates by Site of Infection, British Columbia, 2006 to 2011
Widespread resistance of Neisseria gonorrhoeae to penicillin, tetracycline, and fluoroquinolones has challenged effective treatment and control; recent international case reports of cefixime, ceftriaxone, and azithromycin resistance suggest that the remaining treatment options are now additionally t...
Gespeichert in:
Veröffentlicht in: | Sexually transmitted diseases 2013-01, Vol.40 (1), p.46-51 |
---|---|
Hauptverfasser: | , , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 51 |
---|---|
container_issue | 1 |
container_start_page | 46 |
container_title | Sexually transmitted diseases |
container_volume | 40 |
creator | Hottes, Travis S. Lester, Richard T. Hoang, Linda M.N. McKay, Rachel Imperial, Miguel Gilbert, Mark Patrick, David M. Wong, Tom Martin, Irene Ogilvie, Gina |
description | Widespread resistance of Neisseria gonorrhoeae to penicillin, tetracycline, and fluoroquinolones has challenged effective treatment and control; recent international case reports of cefixime, ceftriaxone, and azithromycin resistance suggest that the remaining treatment options are now additionally threatened. To explore trends in antimicrobial susceptibility of N. gonorrhoeae, we reviewed provincial laboratory data from British Columbia, 2006 to 2011.
Susceptibility testing was performed for all N. gonorrhoeae isolates detected in-house or forwarded to the reference laboratory. Resistance or intermediate resistance (nonsusceptibility) was defined by standard breakpoints for penicillin, tetracycline, ciprofloxacin, and spectinomycin. Elevated minimum inhibitory concentrations (MICs) at serial dilutions of 0.064 μg/mL or greater were explored for cefixime/ceftriaxone and 0.5 μg/mL or greater for azithromycin. Nonsusceptibility/elevated MIC was compared by year, site of infection, sex, and age.
A total of 1837 isolates representing 22% of all reported gonorrhea cases were analyzed. Nonsusceptibility to penicillin was established at baseline. Nonsusceptibility to tetracycline and ciprofloxacin increased over the study period, reaching 96% and 36%, respectively, in 2011. Sixteen isolates (1%) had a cefixime MIC of 0.25 μg/mL (none ≥0.5), none had a ceftriaxone MIC of 0.25 μg/mL or greater, and 15 (1%) had an azithromycin MIC of 2.0 μg/mL or greater. Elevated MIC of these agents showed an increasing trend over time. Nonsusceptibility and elevated MIC were consistently highest at the rectal and pharyngeal sites and higher in isolates from males, including when stratified to the pharyngeal site.
Increases in elevated MIC of cefixime/ceftriaxone/azithromycin were superimposed on a background of established resistance to penicillin, tetracycline, and ciprofloxacin and may signal impending gonococcal resistance to first-line treatments. Ongoing surveillance will inform timely shifts in treatment recommendations. |
doi_str_mv | 10.1097/olq.0b013e31827bd64c |
format | Article |
fullrecord | <record><control><sourceid>jstor_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1463069913</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><jstor_id>48511523</jstor_id><sourcerecordid>48511523</sourcerecordid><originalsourceid>FETCH-LOGICAL-c502t-c3e60458497a178913f4cfe07dd5f9e85adbb1f6bd5d97f962096c6b45ef1ee03</originalsourceid><addsrcrecordid>eNqFkU1v1DAQhi0EotvCPwBkiUsPTfH4I06OZcXHSisqVDhHdjJhvUri1HYOy5kfjldbeuiF06uZeebVjF5C3gC7BlbrD364v2aWgUABFde2K2X7jKxACV1IxeE5WTGQVaE06DNyHuOeHWsGL8kZF1wxwWBF_qxx3pnBx9kHN1EzdfTmt0u74MdDmxt3S2xxTs66waUDzZ1v6GLE4Az95Scfws6jQbqJfjAJI7UHeucSUt_TzdRjm5yfrujH4JKLO7r2wzJaZ64oZ6ykyWcFeEVe9GaI-PpBL8jPz59-rL8W29svm_XNtmgV46loBZZMqkrW2oCuahC9bHtkuutUX2OlTGct9KXtVFfrvi45q8u2tFJhD4hMXJDLk-8c_P2CMTWjy-8Ng5nQL7EBWQpW1tn4_yjXQigAeXR9_wTd-yVM-ZFMSS51rdmRkieqDT7GgH0zBzeacGiANcdAm9vt9-ZpoHnt3YP5YkfsHpf-JZiBtydgH5MPj3NZ5eMUF-Iv6QGmZA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1242479700</pqid></control><display><type>article</type><title>Cephalosporin and Azithromycin Susceptibility in Neisseria gonorrhoeae Isolates by Site of Infection, British Columbia, 2006 to 2011</title><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>Jstor Complete Legacy</source><source>MEDLINE</source><creator>Hottes, Travis S. ; Lester, Richard T. ; Hoang, Linda M.N. ; McKay, Rachel ; Imperial, Miguel ; Gilbert, Mark ; Patrick, David M. ; Wong, Tom ; Martin, Irene ; Ogilvie, Gina</creator><creatorcontrib>Hottes, Travis S. ; Lester, Richard T. ; Hoang, Linda M.N. ; McKay, Rachel ; Imperial, Miguel ; Gilbert, Mark ; Patrick, David M. ; Wong, Tom ; Martin, Irene ; Ogilvie, Gina</creatorcontrib><description>Widespread resistance of Neisseria gonorrhoeae to penicillin, tetracycline, and fluoroquinolones has challenged effective treatment and control; recent international case reports of cefixime, ceftriaxone, and azithromycin resistance suggest that the remaining treatment options are now additionally threatened. To explore trends in antimicrobial susceptibility of N. gonorrhoeae, we reviewed provincial laboratory data from British Columbia, 2006 to 2011.
Susceptibility testing was performed for all N. gonorrhoeae isolates detected in-house or forwarded to the reference laboratory. Resistance or intermediate resistance (nonsusceptibility) was defined by standard breakpoints for penicillin, tetracycline, ciprofloxacin, and spectinomycin. Elevated minimum inhibitory concentrations (MICs) at serial dilutions of 0.064 μg/mL or greater were explored for cefixime/ceftriaxone and 0.5 μg/mL or greater for azithromycin. Nonsusceptibility/elevated MIC was compared by year, site of infection, sex, and age.
A total of 1837 isolates representing 22% of all reported gonorrhea cases were analyzed. Nonsusceptibility to penicillin was established at baseline. Nonsusceptibility to tetracycline and ciprofloxacin increased over the study period, reaching 96% and 36%, respectively, in 2011. Sixteen isolates (1%) had a cefixime MIC of 0.25 μg/mL (none ≥0.5), none had a ceftriaxone MIC of 0.25 μg/mL or greater, and 15 (1%) had an azithromycin MIC of 2.0 μg/mL or greater. Elevated MIC of these agents showed an increasing trend over time. Nonsusceptibility and elevated MIC were consistently highest at the rectal and pharyngeal sites and higher in isolates from males, including when stratified to the pharyngeal site.
Increases in elevated MIC of cefixime/ceftriaxone/azithromycin were superimposed on a background of established resistance to penicillin, tetracycline, and ciprofloxacin and may signal impending gonococcal resistance to first-line treatments. Ongoing surveillance will inform timely shifts in treatment recommendations.</description><identifier>ISSN: 0148-5717</identifier><identifier>EISSN: 1537-4521</identifier><identifier>DOI: 10.1097/olq.0b013e31827bd64c</identifier><identifier>PMID: 23250301</identifier><identifier>CODEN: STRDDM</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins, a business of Wolters Kluwer Health</publisher><subject>Adult ; Anti-Bacterial Agents - pharmacology ; Anti-Bacterial Agents - therapeutic use ; Azithromycin - pharmacology ; Azithromycin - therapeutic use ; British Columbia - epidemiology ; Cephalosporins - pharmacology ; Cephalosporins - therapeutic use ; Cervix Uteri - microbiology ; Drug resistance ; Drug Resistance, Bacterial ; Female ; Gonorrhea ; Gonorrhea - drug therapy ; Gonorrhea - epidemiology ; Gonorrhoea ; Humans ; Laboratories ; Male ; Medical treatment ; Microbial Sensitivity Tests ; Neisseria gonorrhoeae - drug effects ; Neisseria gonorrhoeae - isolation & purification ; Original Study ; Penicillin ; Pharynx - microbiology ; Rectum - microbiology ; Resistance ; Susceptibility ; Tetracycline ; Urethra - microbiology ; Young Adult</subject><ispartof>Sexually transmitted diseases, 2013-01, Vol.40 (1), p.46-51</ispartof><rights>Copyright © 2012 American Sexually Transmitted Diseases Association</rights><rights>Copyright Lippincott Williams & Wilkins Jan 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c502t-c3e60458497a178913f4cfe07dd5f9e85adbb1f6bd5d97f962096c6b45ef1ee03</citedby><cites>FETCH-LOGICAL-c502t-c3e60458497a178913f4cfe07dd5f9e85adbb1f6bd5d97f962096c6b45ef1ee03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/48511523$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/48511523$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,799,27901,27902,30976,30977,57992,58225</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23250301$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hottes, Travis S.</creatorcontrib><creatorcontrib>Lester, Richard T.</creatorcontrib><creatorcontrib>Hoang, Linda M.N.</creatorcontrib><creatorcontrib>McKay, Rachel</creatorcontrib><creatorcontrib>Imperial, Miguel</creatorcontrib><creatorcontrib>Gilbert, Mark</creatorcontrib><creatorcontrib>Patrick, David M.</creatorcontrib><creatorcontrib>Wong, Tom</creatorcontrib><creatorcontrib>Martin, Irene</creatorcontrib><creatorcontrib>Ogilvie, Gina</creatorcontrib><title>Cephalosporin and Azithromycin Susceptibility in Neisseria gonorrhoeae Isolates by Site of Infection, British Columbia, 2006 to 2011</title><title>Sexually transmitted diseases</title><addtitle>Sex Transm Dis</addtitle><description>Widespread resistance of Neisseria gonorrhoeae to penicillin, tetracycline, and fluoroquinolones has challenged effective treatment and control; recent international case reports of cefixime, ceftriaxone, and azithromycin resistance suggest that the remaining treatment options are now additionally threatened. To explore trends in antimicrobial susceptibility of N. gonorrhoeae, we reviewed provincial laboratory data from British Columbia, 2006 to 2011.
Susceptibility testing was performed for all N. gonorrhoeae isolates detected in-house or forwarded to the reference laboratory. Resistance or intermediate resistance (nonsusceptibility) was defined by standard breakpoints for penicillin, tetracycline, ciprofloxacin, and spectinomycin. Elevated minimum inhibitory concentrations (MICs) at serial dilutions of 0.064 μg/mL or greater were explored for cefixime/ceftriaxone and 0.5 μg/mL or greater for azithromycin. Nonsusceptibility/elevated MIC was compared by year, site of infection, sex, and age.
A total of 1837 isolates representing 22% of all reported gonorrhea cases were analyzed. Nonsusceptibility to penicillin was established at baseline. Nonsusceptibility to tetracycline and ciprofloxacin increased over the study period, reaching 96% and 36%, respectively, in 2011. Sixteen isolates (1%) had a cefixime MIC of 0.25 μg/mL (none ≥0.5), none had a ceftriaxone MIC of 0.25 μg/mL or greater, and 15 (1%) had an azithromycin MIC of 2.0 μg/mL or greater. Elevated MIC of these agents showed an increasing trend over time. Nonsusceptibility and elevated MIC were consistently highest at the rectal and pharyngeal sites and higher in isolates from males, including when stratified to the pharyngeal site.
Increases in elevated MIC of cefixime/ceftriaxone/azithromycin were superimposed on a background of established resistance to penicillin, tetracycline, and ciprofloxacin and may signal impending gonococcal resistance to first-line treatments. Ongoing surveillance will inform timely shifts in treatment recommendations.</description><subject>Adult</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Azithromycin - pharmacology</subject><subject>Azithromycin - therapeutic use</subject><subject>British Columbia - epidemiology</subject><subject>Cephalosporins - pharmacology</subject><subject>Cephalosporins - therapeutic use</subject><subject>Cervix Uteri - microbiology</subject><subject>Drug resistance</subject><subject>Drug Resistance, Bacterial</subject><subject>Female</subject><subject>Gonorrhea</subject><subject>Gonorrhea - drug therapy</subject><subject>Gonorrhea - epidemiology</subject><subject>Gonorrhoea</subject><subject>Humans</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medical treatment</subject><subject>Microbial Sensitivity Tests</subject><subject>Neisseria gonorrhoeae - drug effects</subject><subject>Neisseria gonorrhoeae - isolation & purification</subject><subject>Original Study</subject><subject>Penicillin</subject><subject>Pharynx - microbiology</subject><subject>Rectum - microbiology</subject><subject>Resistance</subject><subject>Susceptibility</subject><subject>Tetracycline</subject><subject>Urethra - microbiology</subject><subject>Young Adult</subject><issn>0148-5717</issn><issn>1537-4521</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqFkU1v1DAQhi0EotvCPwBkiUsPTfH4I06OZcXHSisqVDhHdjJhvUri1HYOy5kfjldbeuiF06uZeebVjF5C3gC7BlbrD364v2aWgUABFde2K2X7jKxACV1IxeE5WTGQVaE06DNyHuOeHWsGL8kZF1wxwWBF_qxx3pnBx9kHN1EzdfTmt0u74MdDmxt3S2xxTs66waUDzZ1v6GLE4Az95Scfws6jQbqJfjAJI7UHeucSUt_TzdRjm5yfrujH4JKLO7r2wzJaZ64oZ6ykyWcFeEVe9GaI-PpBL8jPz59-rL8W29svm_XNtmgV46loBZZMqkrW2oCuahC9bHtkuutUX2OlTGct9KXtVFfrvi45q8u2tFJhD4hMXJDLk-8c_P2CMTWjy-8Ng5nQL7EBWQpW1tn4_yjXQigAeXR9_wTd-yVM-ZFMSS51rdmRkieqDT7GgH0zBzeacGiANcdAm9vt9-ZpoHnt3YP5YkfsHpf-JZiBtydgH5MPj3NZ5eMUF-Iv6QGmZA</recordid><startdate>20130101</startdate><enddate>20130101</enddate><creator>Hottes, Travis S.</creator><creator>Lester, Richard T.</creator><creator>Hoang, Linda M.N.</creator><creator>McKay, Rachel</creator><creator>Imperial, Miguel</creator><creator>Gilbert, Mark</creator><creator>Patrick, David M.</creator><creator>Wong, Tom</creator><creator>Martin, Irene</creator><creator>Ogilvie, Gina</creator><general>Lippincott Williams & Wilkins, a business of Wolters Kluwer Health</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7QL</scope><scope>7T2</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20130101</creationdate><title>Cephalosporin and Azithromycin Susceptibility in Neisseria gonorrhoeae Isolates by Site of Infection, British Columbia, 2006 to 2011</title><author>Hottes, Travis S. ; Lester, Richard T. ; Hoang, Linda M.N. ; McKay, Rachel ; Imperial, Miguel ; Gilbert, Mark ; Patrick, David M. ; Wong, Tom ; Martin, Irene ; Ogilvie, Gina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c502t-c3e60458497a178913f4cfe07dd5f9e85adbb1f6bd5d97f962096c6b45ef1ee03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Azithromycin - pharmacology</topic><topic>Azithromycin - therapeutic use</topic><topic>British Columbia - epidemiology</topic><topic>Cephalosporins - pharmacology</topic><topic>Cephalosporins - therapeutic use</topic><topic>Cervix Uteri - microbiology</topic><topic>Drug resistance</topic><topic>Drug Resistance, Bacterial</topic><topic>Female</topic><topic>Gonorrhea</topic><topic>Gonorrhea - drug therapy</topic><topic>Gonorrhea - epidemiology</topic><topic>Gonorrhoea</topic><topic>Humans</topic><topic>Laboratories</topic><topic>Male</topic><topic>Medical treatment</topic><topic>Microbial Sensitivity Tests</topic><topic>Neisseria gonorrhoeae - drug effects</topic><topic>Neisseria gonorrhoeae - isolation & purification</topic><topic>Original Study</topic><topic>Penicillin</topic><topic>Pharynx - microbiology</topic><topic>Rectum - microbiology</topic><topic>Resistance</topic><topic>Susceptibility</topic><topic>Tetracycline</topic><topic>Urethra - microbiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hottes, Travis S.</creatorcontrib><creatorcontrib>Lester, Richard T.</creatorcontrib><creatorcontrib>Hoang, Linda M.N.</creatorcontrib><creatorcontrib>McKay, Rachel</creatorcontrib><creatorcontrib>Imperial, Miguel</creatorcontrib><creatorcontrib>Gilbert, Mark</creatorcontrib><creatorcontrib>Patrick, David M.</creatorcontrib><creatorcontrib>Wong, Tom</creatorcontrib><creatorcontrib>Martin, Irene</creatorcontrib><creatorcontrib>Ogilvie, Gina</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Sexually transmitted diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hottes, Travis S.</au><au>Lester, Richard T.</au><au>Hoang, Linda M.N.</au><au>McKay, Rachel</au><au>Imperial, Miguel</au><au>Gilbert, Mark</au><au>Patrick, David M.</au><au>Wong, Tom</au><au>Martin, Irene</au><au>Ogilvie, Gina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cephalosporin and Azithromycin Susceptibility in Neisseria gonorrhoeae Isolates by Site of Infection, British Columbia, 2006 to 2011</atitle><jtitle>Sexually transmitted diseases</jtitle><addtitle>Sex Transm Dis</addtitle><date>2013-01-01</date><risdate>2013</risdate><volume>40</volume><issue>1</issue><spage>46</spage><epage>51</epage><pages>46-51</pages><issn>0148-5717</issn><eissn>1537-4521</eissn><coden>STRDDM</coden><abstract>Widespread resistance of Neisseria gonorrhoeae to penicillin, tetracycline, and fluoroquinolones has challenged effective treatment and control; recent international case reports of cefixime, ceftriaxone, and azithromycin resistance suggest that the remaining treatment options are now additionally threatened. To explore trends in antimicrobial susceptibility of N. gonorrhoeae, we reviewed provincial laboratory data from British Columbia, 2006 to 2011.
Susceptibility testing was performed for all N. gonorrhoeae isolates detected in-house or forwarded to the reference laboratory. Resistance or intermediate resistance (nonsusceptibility) was defined by standard breakpoints for penicillin, tetracycline, ciprofloxacin, and spectinomycin. Elevated minimum inhibitory concentrations (MICs) at serial dilutions of 0.064 μg/mL or greater were explored for cefixime/ceftriaxone and 0.5 μg/mL or greater for azithromycin. Nonsusceptibility/elevated MIC was compared by year, site of infection, sex, and age.
A total of 1837 isolates representing 22% of all reported gonorrhea cases were analyzed. Nonsusceptibility to penicillin was established at baseline. Nonsusceptibility to tetracycline and ciprofloxacin increased over the study period, reaching 96% and 36%, respectively, in 2011. Sixteen isolates (1%) had a cefixime MIC of 0.25 μg/mL (none ≥0.5), none had a ceftriaxone MIC of 0.25 μg/mL or greater, and 15 (1%) had an azithromycin MIC of 2.0 μg/mL or greater. Elevated MIC of these agents showed an increasing trend over time. Nonsusceptibility and elevated MIC were consistently highest at the rectal and pharyngeal sites and higher in isolates from males, including when stratified to the pharyngeal site.
Increases in elevated MIC of cefixime/ceftriaxone/azithromycin were superimposed on a background of established resistance to penicillin, tetracycline, and ciprofloxacin and may signal impending gonococcal resistance to first-line treatments. Ongoing surveillance will inform timely shifts in treatment recommendations.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins, a business of Wolters Kluwer Health</pub><pmid>23250301</pmid><doi>10.1097/olq.0b013e31827bd64c</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0148-5717 |
ispartof | Sexually transmitted diseases, 2013-01, Vol.40 (1), p.46-51 |
issn | 0148-5717 1537-4521 |
language | eng |
recordid | cdi_proquest_miscellaneous_1463069913 |
source | Applied Social Sciences Index & Abstracts (ASSIA); Jstor Complete Legacy; MEDLINE |
subjects | Adult Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use Azithromycin - pharmacology Azithromycin - therapeutic use British Columbia - epidemiology Cephalosporins - pharmacology Cephalosporins - therapeutic use Cervix Uteri - microbiology Drug resistance Drug Resistance, Bacterial Female Gonorrhea Gonorrhea - drug therapy Gonorrhea - epidemiology Gonorrhoea Humans Laboratories Male Medical treatment Microbial Sensitivity Tests Neisseria gonorrhoeae - drug effects Neisseria gonorrhoeae - isolation & purification Original Study Penicillin Pharynx - microbiology Rectum - microbiology Resistance Susceptibility Tetracycline Urethra - microbiology Young Adult |
title | Cephalosporin and Azithromycin Susceptibility in Neisseria gonorrhoeae Isolates by Site of Infection, British Columbia, 2006 to 2011 |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-18T15%3A35%3A02IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-jstor_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cephalosporin%20and%20Azithromycin%20Susceptibility%20in%20Neisseria%20gonorrhoeae%20Isolates%20by%20Site%20of%20Infection,%20British%20Columbia,%202006%20to%202011&rft.jtitle=Sexually%20transmitted%20diseases&rft.au=Hottes,%20Travis%20S.&rft.date=2013-01-01&rft.volume=40&rft.issue=1&rft.spage=46&rft.epage=51&rft.pages=46-51&rft.issn=0148-5717&rft.eissn=1537-4521&rft.coden=STRDDM&rft_id=info:doi/10.1097/olq.0b013e31827bd64c&rft_dat=%3Cjstor_proqu%3E48511523%3C/jstor_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1242479700&rft_id=info:pmid/23250301&rft_jstor_id=48511523&rfr_iscdi=true |