Abstract
In this study, we assessed if there was a city-level association between sexually transmitted infection (STI) screening intensity in men who have sex with men and antimicrobial sensitivity in Neisseria gonorrhoeae in the United States, 2007 to 2013. We found positive associations between STI screening intensity and increases in minimum inhibitory concentrations for cefixime and azithromycin, but not ceftriaxone when using change in city geometric mean N. gonorrhoeae MIC between 2005 and 2013.
Highlights
In the United States (USA) the prevalence of antimicrobial resistance in Neisseria gonorrhoeae has typically been higher in men who have sex with men (MSM) than men who have sex with women (MSW) and women[1,2]
The proportion testing for bacterial sexually transmitted infection (STI) was associated with an increase of minimum inhibitory concentration (MIC) for cefixime and azithromycin but not ceftriaxone over the time period 2005 to 2013
The correlations between percent screening in 2011 and MIC in the following year were different in that the only significant association was for ceftriaxone
Summary
In the United States (USA) the prevalence of antimicrobial resistance in Neisseria gonorrhoeae has typically been higher in men who have sex with men (MSM) than men who have sex with women (MSW) and women[1,2]. Resistance has characteristically emerged in the West Coast and Hawaii and spread eastward[1,2,3]. This patterning of spread has led to the view that a primary driver of resistance is the import of resistant gonococci from eastern Asia and other world regions[3]. In support of this theory, a number of studies have documented travel as a means of import of resistance in the USA4,5. An analysis of data from the Gonococcal Isolate Surveillance Project (GISP) 2002 to 2007, for example, found a pronounced increase in ciprofloxacin-resistance in MSM and a smaller and later increase in MSW; the association with recent travel was negative in MSM and borderline positive in MSW7
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