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...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Sexually transmitted diseases 2013-01, Vol.40 (1), p.46-51
Hauptverfasser: 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
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 &amp; 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 &amp; 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 &amp; 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 &amp; 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 &amp; 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 &amp; Wilkins, a business of Wolters Kluwer Health</general><general>Lippincott Williams &amp; 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 &amp; 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 &amp; 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 &amp; Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing &amp; 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 &amp; 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