Monitoring antimicrobial resistance in Neisseria gonorrhoeae in selected countries of the WHO South-East Asia Region between 2009 and 2012: a retrospective analysis
Objective The aim of the present study was to retrospectively analyse the data reported on antimicrobial resistance (AMR) in Neisseria gonorrhoeae in six South-East Asia Region countries from 2009 to 2012 following the revitalisation of the WHO global Gonococcal Antimicrobial Surveillance Program (G...
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| Veröffentlicht in: | Sexually transmitted infections 2013-12, Vol.89 (Suppl 4), p.iv28-iv35 |
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| creator | Bala, Manju Kakran, Monika Singh, Vikram Sood, Seema Ramesh, V |
| description | Objective The aim of the present study was to retrospectively analyse the data reported on antimicrobial resistance (AMR) in Neisseria gonorrhoeae in six South-East Asia Region countries from 2009 to 2012 following the revitalisation of the WHO global Gonococcal Antimicrobial Surveillance Program (GASP). Methods AMR data were generated for 7 antibiotics of 4675 isolates in 18 focal point laboratories using the calibrated dichotomous sensitivity (CDS) or Clinical and Laboratory Standards Institute (CLSI) methods and minimal inhibitory concentration testing by Etest in some of the centres. The results were interpreted using the breakpoints recommended. Results High-level resistance to traditional antibiotics, penicillin (25% to 100%) and tetracycline (10% to 100%) and the previously recommended ciprofloxacin (38% to 100%) was observed in all the countries. Overall, >90% of less susceptible and resistant isolates to penicillin and ciprofloxacin were identified from 15 laboratories. Decreased susceptibility to ceftriaxone and cefpodoxime was reported by nine and eight centres, respectively. Resistance to spectinomycin (0.6% to 10.5%) and azithromycin ( |
| doi_str_mv | 10.1136/sextrans-2012-050904 |
| format | Article |
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Methods AMR data were generated for 7 antibiotics of 4675 isolates in 18 focal point laboratories using the calibrated dichotomous sensitivity (CDS) or Clinical and Laboratory Standards Institute (CLSI) methods and minimal inhibitory concentration testing by Etest in some of the centres. The results were interpreted using the breakpoints recommended. Results High-level resistance to traditional antibiotics, penicillin (25% to 100%) and tetracycline (10% to 100%) and the previously recommended ciprofloxacin (38% to 100%) was observed in all the countries. Overall, >90% of less susceptible and resistant isolates to penicillin and ciprofloxacin were identified from 15 laboratories. Decreased susceptibility to ceftriaxone and cefpodoxime was reported by nine and eight centres, respectively. Resistance to spectinomycin (0.6% to 10.5%) and azithromycin (<5%) was reported only by three centres. The increasing trends of resistance towards penicillin, tetracycline and ciprofloxacin were demonstrated in Bhutan, India, Sri Lanka and Thailand, and no large intercountry variations were evident. Insignificant trends in decreased susceptibility towards ceftriaxone were reported. Conclusions Expansion of the WHO GASP facilitated enhanced AMR surveillance to meet the ongoing challenges of control of gonococcal AMR. The results highlight that the emergence of decreased susceptibility to ceftriaxone and resistance to spectinomycin and azithromycin will unavoidably lead to loss of therapeutic options, and a search for new effective agents needs to be initiated to respond to the emergence of resistant isolates.</description><identifier>ISSN: 1368-4973</identifier><identifier>ISSN: 1472-3263</identifier><identifier>EISSN: 1472-3263</identifier><identifier>DOI: 10.1136/sextrans-2012-050904</identifier><identifier>PMID: 24243876</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject>Animals ; Anti-Bacterial Agents - pharmacology ; Antibiotic Resistance ; Asia, Southeastern - epidemiology ; Drug Resistance, Bacterial ; Epidemiological Monitoring ; Female ; Gonorrhea - epidemiology ; Gonorrhea - microbiology ; Humans ; Male ; Microbial Sensitivity Tests ; Neisseria Gonorrhoea ; Neisseria gonorrhoeae ; Neisseria gonorrhoeae - drug effects ; Neisseria gonorrhoeae - isolation & purification ; Prevalence ; Retrospective Studies ; Surveillance ; Syndromic Management ; World Health Organization</subject><ispartof>Sexually transmitted infections, 2013-12, Vol.89 (Suppl 4), p.iv28-iv35</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Copyright: 2013 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b446t-82e94baed3e68aa0872049cda08647b569144596a70b0d3ceb51d4bd560e9ef43</citedby><cites>FETCH-LOGICAL-b446t-82e94baed3e68aa0872049cda08647b569144596a70b0d3ceb51d4bd560e9ef43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://sti.bmj.com/content/89/Suppl_4/iv28.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://sti.bmj.com/content/89/Suppl_4/iv28.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,3196,23571,27924,27925,77600,77631</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24243876$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bala, Manju</creatorcontrib><creatorcontrib>Kakran, Monika</creatorcontrib><creatorcontrib>Singh, Vikram</creatorcontrib><creatorcontrib>Sood, Seema</creatorcontrib><creatorcontrib>Ramesh, V</creatorcontrib><creatorcontrib>Members of WHO GASP SEAR Network</creatorcontrib><creatorcontrib>Members of the WHO GASP SEAR Network</creatorcontrib><title>Monitoring antimicrobial resistance in Neisseria gonorrhoeae in selected countries of the WHO South-East Asia Region between 2009 and 2012: a retrospective analysis</title><title>Sexually transmitted infections</title><addtitle>Sex Transm Infect</addtitle><description>Objective The aim of the present study was to retrospectively analyse the data reported on antimicrobial resistance (AMR) in Neisseria gonorrhoeae in six South-East Asia Region countries from 2009 to 2012 following the revitalisation of the WHO global Gonococcal Antimicrobial Surveillance Program (GASP). Methods AMR data were generated for 7 antibiotics of 4675 isolates in 18 focal point laboratories using the calibrated dichotomous sensitivity (CDS) or Clinical and Laboratory Standards Institute (CLSI) methods and minimal inhibitory concentration testing by Etest in some of the centres. The results were interpreted using the breakpoints recommended. Results High-level resistance to traditional antibiotics, penicillin (25% to 100%) and tetracycline (10% to 100%) and the previously recommended ciprofloxacin (38% to 100%) was observed in all the countries. Overall, >90% of less susceptible and resistant isolates to penicillin and ciprofloxacin were identified from 15 laboratories. Decreased susceptibility to ceftriaxone and cefpodoxime was reported by nine and eight centres, respectively. Resistance to spectinomycin (0.6% to 10.5%) and azithromycin (<5%) was reported only by three centres. The increasing trends of resistance towards penicillin, tetracycline and ciprofloxacin were demonstrated in Bhutan, India, Sri Lanka and Thailand, and no large intercountry variations were evident. Insignificant trends in decreased susceptibility towards ceftriaxone were reported. Conclusions Expansion of the WHO GASP facilitated enhanced AMR surveillance to meet the ongoing challenges of control of gonococcal AMR. The results highlight that the emergence of decreased susceptibility to ceftriaxone and resistance to spectinomycin and azithromycin will unavoidably lead to loss of therapeutic options, and a search for new effective agents needs to be initiated to respond to the emergence of resistant isolates.</description><subject>Animals</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Antibiotic Resistance</subject><subject>Asia, Southeastern - epidemiology</subject><subject>Drug Resistance, Bacterial</subject><subject>Epidemiological Monitoring</subject><subject>Female</subject><subject>Gonorrhea - epidemiology</subject><subject>Gonorrhea - microbiology</subject><subject>Humans</subject><subject>Male</subject><subject>Microbial Sensitivity Tests</subject><subject>Neisseria Gonorrhoea</subject><subject>Neisseria gonorrhoeae</subject><subject>Neisseria gonorrhoeae - drug effects</subject><subject>Neisseria gonorrhoeae - isolation & purification</subject><subject>Prevalence</subject><subject>Retrospective Studies</subject><subject>Surveillance</subject><subject>Syndromic Management</subject><subject>World Health Organization</subject><issn>1368-4973</issn><issn>1472-3263</issn><issn>1472-3263</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkctuEzEUhkcIREvhDRCyxIbNUN_GHrOropKCQitxlbqx7JmTxGFip7YH2vfhQXGYtgs2sDpHOt_5z-WvqucEvyaEieME1zkan2qKCa1xgxXmD6pDwiWtGRXsYcmZaGuuJDuonqS0wRgL2ajH1QHllLNWisPq14fgXQ7R-RUyPrut62KwzgwoQnIpG98Bch6dg0sJojNoFXyIcR3A_CkkGKDL0KMujD5HBwmFJcprQN_OLtCnMOZ1fWpSRiepNH-ElQseWcg_ATyiGKsytkf7G94gU4bmGNKuKLofUCpmuClbPK0eLc2Q4NltPKq-vD39PDurFxfzd7OTRW05F7luKShuDfQMRGsMbiXFXHV9yQSXthGKcN4oYSS2uGcd2Ib03PaNwKBgydlR9WrS3cVwNULKeutSB8NgPIQxadI0RDClSPtvlAtK2qKsCvryL3QTxlhOK5RsSUuFlPvZfKLK_1OKsNS76LYm3miC9d5wfWe43j9LT4aXthe34qPdQn_fdOdwAeoJKGbC9X3dxO9aSCYbff51pufqvZjNF5f6svDHE2-3m_9b4TepYMfv</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Bala, Manju</creator><creator>Kakran, Monika</creator><creator>Singh, Vikram</creator><creator>Sood, Seema</creator><creator>Ramesh, V</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><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>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>7QL</scope><scope>7T7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>P64</scope></search><sort><creationdate>20131201</creationdate><title>Monitoring antimicrobial resistance in Neisseria gonorrhoeae in selected countries of the WHO South-East Asia Region between 2009 and 2012: a retrospective analysis</title><author>Bala, Manju ; Kakran, Monika ; Singh, Vikram ; Sood, Seema ; Ramesh, V</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b446t-82e94baed3e68aa0872049cda08647b569144596a70b0d3ceb51d4bd560e9ef43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Animals</topic><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Antibiotic Resistance</topic><topic>Asia, Southeastern - epidemiology</topic><topic>Drug Resistance, Bacterial</topic><topic>Epidemiological Monitoring</topic><topic>Female</topic><topic>Gonorrhea - epidemiology</topic><topic>Gonorrhea - microbiology</topic><topic>Humans</topic><topic>Male</topic><topic>Microbial Sensitivity Tests</topic><topic>Neisseria Gonorrhoea</topic><topic>Neisseria gonorrhoeae</topic><topic>Neisseria gonorrhoeae - drug effects</topic><topic>Neisseria gonorrhoeae - isolation & purification</topic><topic>Prevalence</topic><topic>Retrospective Studies</topic><topic>Surveillance</topic><topic>Syndromic Management</topic><topic>World Health Organization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bala, Manju</creatorcontrib><creatorcontrib>Kakran, Monika</creatorcontrib><creatorcontrib>Singh, Vikram</creatorcontrib><creatorcontrib>Sood, Seema</creatorcontrib><creatorcontrib>Ramesh, V</creatorcontrib><creatorcontrib>Members of WHO GASP SEAR Network</creatorcontrib><creatorcontrib>Members of the WHO GASP SEAR Network</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Sexually transmitted infections</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bala, Manju</au><au>Kakran, Monika</au><au>Singh, Vikram</au><au>Sood, Seema</au><au>Ramesh, V</au><aucorp>Members of WHO GASP SEAR Network</aucorp><aucorp>Members of the WHO GASP SEAR Network</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Monitoring antimicrobial resistance in Neisseria gonorrhoeae in selected countries of the WHO South-East Asia Region between 2009 and 2012: a retrospective analysis</atitle><jtitle>Sexually transmitted infections</jtitle><addtitle>Sex Transm Infect</addtitle><date>2013-12-01</date><risdate>2013</risdate><volume>89</volume><issue>Suppl 4</issue><spage>iv28</spage><epage>iv35</epage><pages>iv28-iv35</pages><issn>1368-4973</issn><issn>1472-3263</issn><eissn>1472-3263</eissn><abstract>Objective The aim of the present study was to retrospectively analyse the data reported on antimicrobial resistance (AMR) in Neisseria gonorrhoeae in six South-East Asia Region countries from 2009 to 2012 following the revitalisation of the WHO global Gonococcal Antimicrobial Surveillance Program (GASP). Methods AMR data were generated for 7 antibiotics of 4675 isolates in 18 focal point laboratories using the calibrated dichotomous sensitivity (CDS) or Clinical and Laboratory Standards Institute (CLSI) methods and minimal inhibitory concentration testing by Etest in some of the centres. The results were interpreted using the breakpoints recommended. Results High-level resistance to traditional antibiotics, penicillin (25% to 100%) and tetracycline (10% to 100%) and the previously recommended ciprofloxacin (38% to 100%) was observed in all the countries. Overall, >90% of less susceptible and resistant isolates to penicillin and ciprofloxacin were identified from 15 laboratories. Decreased susceptibility to ceftriaxone and cefpodoxime was reported by nine and eight centres, respectively. Resistance to spectinomycin (0.6% to 10.5%) and azithromycin (<5%) was reported only by three centres. The increasing trends of resistance towards penicillin, tetracycline and ciprofloxacin were demonstrated in Bhutan, India, Sri Lanka and Thailand, and no large intercountry variations were evident. Insignificant trends in decreased susceptibility towards ceftriaxone were reported. Conclusions Expansion of the WHO GASP facilitated enhanced AMR surveillance to meet the ongoing challenges of control of gonococcal AMR. The results highlight that the emergence of decreased susceptibility to ceftriaxone and resistance to spectinomycin and azithromycin will unavoidably lead to loss of therapeutic options, and a search for new effective agents needs to be initiated to respond to the emergence of resistant isolates.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd</pub><pmid>24243876</pmid><doi>10.1136/sextrans-2012-050904</doi></addata></record> |
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| subjects | Animals Anti-Bacterial Agents - pharmacology Antibiotic Resistance Asia, Southeastern - epidemiology Drug Resistance, Bacterial Epidemiological Monitoring Female Gonorrhea - epidemiology Gonorrhea - microbiology Humans Male Microbial Sensitivity Tests Neisseria Gonorrhoea Neisseria gonorrhoeae Neisseria gonorrhoeae - drug effects Neisseria gonorrhoeae - isolation & purification Prevalence Retrospective Studies Surveillance Syndromic Management World Health Organization |
| title | Monitoring antimicrobial resistance in Neisseria gonorrhoeae in selected countries of the WHO South-East Asia Region between 2009 and 2012: a retrospective analysis |
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