First antimicrobial resistance data and genetic characteristics of Neisseria gonorrhoeae isolates from Estonia, 2009-2013.

D Golparian,M Unemo,M Domeika,E Viktorova,T Brilene,E Johansson,Y Laaring

doi:10.1002/nmi2.57

Abstract

Gonorrhoea is a sexually transmitted infection with major public health implications and Neisseria gonorrhoeae has developed resistance to all antimicrobials introduced for treatment. Enhanced surveillance of antimicrobial resistance in N. gonorrhoeae is crucial globally. This is the first internationally reported antimicrobial resistance data for N. gonorrhoeae from Estonia (44 isolates cultured in 2009–2013). A high prevalence of resistance was observed for azithromycin, ciprofloxacin and tetracycline. One and two isolates with resistance and decreased susceptibility to the last remaining first-line treatment option ceftriaxone, respectively, were identified. It is crucial to implement surveillance of gonococcal antimicrobial resistance (ideally also treatment failures) in Estonia.

Highlights

Gonorrhoea is a sexually transmitted infection with major public health implications
The emergence of treatment failures to the last remaining option for treatment, i.e. ceftriaxone, [4,5,6,7,8,9] and extensively drug resistant Neisseria gonorrhoeae strains [9,10,11] has placed antimicrobial resistance (AMR) surveillance as an essential key priority nationally and internationally; no AMR data for N. gonorrhoeae has ever been internationally reported from Estonia
We investigated the AMR to previously and currently recommended treatment options and genotypic characteristics of N. gonorrhoeae isolates in 2009–2013 in Estonia

Summary

Introduction

Gonorrhoea is a sexually transmitted infection with major public health implications. We investigated the AMR to previously and currently recommended treatment options and genotypic characteristics of N. gonorrhoeae isolates in 2009–2013 in Estonia. The MICs (mg/L) of ceftriaxone, cefixime, azithromycin, spectinomycin, ciprofloxacin, tetracycline and gentamicin were analysed using the Etest method, according to the instructions from the manufacturer (BioMerieux AB, Solna, Sweden).

Results

Conclusion