Antimicrobial resistance, genetic resistance determinants for ceftriaxone and molecular epidemiology of Neisseria gonorrhoeae isolates in Nanjing, China

Chen, Shaochun; Yin, Yue-Ping; Dai, Xiu-Qin; Unemo, Magnus; Chen, Xiang-Sheng

doi:10.1093/jac/dku245

Cited by 38 publications

(33 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the present study, we found that the proportion of N. gonorrhoeae isolates with CRO MICs ≥ 0.125 mg/L in Shanghai (1996–2013) greatly varied from year to year, ranging from 0% (1995) to 19.72% in 2008, and 13.76% in 2013. Our findings were consistent with those of a survey of CRO susceptibility in Nanjing, China [ 24 ],[ 25 ]. The proportion of CRO less susceptible N. gonorrhoeae isolates (CRO MIC ≥ 0.06 mg/L) was 17.86–50.5% during the period from 1999 to 2006 in Nanjing [ 24 ].…”

Section: Discussionsupporting

confidence: 92%

“…The proportion of CRO less susceptible N. gonorrhoeae isolates (CRO MIC ≥ 0.06 mg/L) was 17.86–50.5% during the period from 1999 to 2006 in Nanjing [ 24 ]. Chen et al reported that the proportion of isolates with a CRO MIC = 0.125 mg/L was 39.4% in 2007 and 11.3% in 2012 [ 25 ]. The proportion of CRO nonsusceptible isolates (MIC ≥ 0.125 mg/L) ranged from 22% to over 48% in Nanning in 2000–2012 [ 26 ], much higher than that detected in Shanghai.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Twenty-five-year changing pattern of gonococcal antimicrobial susceptibility in Shanghai: surveillance and its impact on treatment guidelines

Chen

Yang

et al. 2014

BMC Infect Dis

View full text Add to dashboard Cite

BackgroundAntimicrobial resistance of Neisseria gonorrhoeae is a serious health problem in China. Gonococcal antimicrobial susceptibility has been monitored in Shanghai since 1988. In this study, we examined the changing pattern of gonococcal antimicrobial susceptibility based on data from N. gonorrhoeae isolates collected over the past 25 years.MethodsApproximately 100–200 isolates each year (1988–2013) were tested for their susceptibility to penicillin (PEN), tetracycline (TET), ciprofloxacin (CIP), ceftriaxone (CRO) and spectinomycin (SPT), using the agar dilution method. Plasmid-mediated N. gonorrhoeae antimicrobial resistance, comprising penicillinase-producing N. gonorrhoeae (presumed PPNG) and high-level tetracycline resistance N. gonorrhoeae (presumed TRNG), were also determined. Breakpoints for susceptibilities followed those described by the Clinical and Laboratory Standard Institute and the European Committee on Antimicrobial Susceptibility Testing.ResultsA high proportion of isolates were resistant to PEN, TET and CIP, ranging from less than 20% at the beginning of the survey, increasing in the late 1990s and reaching over 90% in recent years. The proportion of isolates exhibiting plasmid-mediated resistance exceeded 38% for presumed PPNG and 20% for presumed TRNG in recent years. The proportion of CRO nonsusceptible isolates (MIC ≥ 0.125 mg/L) ranged from 7% to 13% in most of the study years. Almost all isolates were susceptible to SPT. The SPT MIC90 was 16–32 mg/L for 2008–2013. The proportion of CRO nonsusceptible-associated multiple-drug-resistant (MDR) isolates was over 5% in most of the study years.ConclusionsN. gonorrhoeae isolates in Shanghai were resistant to PEN, TET and CIP. Furthermore, CRO nonsusceptible and MDR isolates were prevalent. N. gonorrhoeae isolates were also found to be susceptible to SPT. It is recommended that the CRO dose be increased from currently recommended 250 mg to 500 mg and that SPT be an alternative in treating urogenital gonorrhea. Our findings highlight the importance of both regional and national surveillance programs for the prompt modification of treatment guidelines, vital in responding to the changing pattern of gonococcal antimicrobial susceptibility.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0731-9) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Twenty-five-year changing pattern of gonococcal antimicrobial susceptibility in Shanghai: surveillance and its impact on treatment guidelines

Chen

Yang

et al. 2014

BMC Infect Dis

View full text Add to dashboard Cite

show abstract

“…The programme documented a statistically significant increase in cefixime resistance from 2009 (5.1 %) to 2010 (8.7 %), however after 2010 the cefixime resistance levels started to decrease to a low of 3.9 % in 2012 [ 29 , 30 ]. Similar decreases in the resistance to ESCs have also been documented in other regions [ 15 , 16 , 31 – 36 ].…”

Section: Introductionsupporting

confidence: 81%

“…As well as decreases in the level of resistance to ESCs in the EU/EEA from 2010 to 2012, decreases have also been observed in other regions with well-developed surveillance programmes globally [ 15 , 16 , 31 , 33 – 36 ]. Furthermore, despite some rare ESC treatment failures verified in recent years [ 3 – 14 ], the anticipated number of reported gonorrhoea treatment failures has not yet materialised, which could also be partly due to a lack of identification and under-reporting of treatment failures.…”

Section: Discussionmentioning

confidence: 93%

Is the tide turning again for cephalosporin resistance in Neisseria gonorrhoeae in Europe? Results from the 2013 European surveillance

et al. 2015

Self Cite

View full text Add to dashboard Cite

BackgroundThe emerging resistance to the extended-spectrum cephalosporins (ESCs) in Neisseria gonorrhoeae together with increasing incidence of gonorrhoea cases in many countries have been global public health concerns. However, in recent years the levels of ESC resistance have decreased in several regions worldwide. We describe the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) data from 2013, and compare them to corresponding data from 2009–2012.MethodsDuring 2013, N. gonorrhoeae isolates from 21 participating countries were examined. Antimicrobial susceptibility testing (Etest or agar dilution) was performed for cefixime, ceftriaxone, ciprofloxacin, azithromycin, spectinomycin and gentamicin. Statistical analyses were performed to identify significant changes in resistance between years and to investigate associations between patients with resistant gonococcal isolates and collected epidemiological variables.ResultsIn total, 93 (4.7 %) of 1994 isolates displayed resistance to cefixime, representing an increase compared to the 3.9 % detected in 2012 (p = 0.23). Cefixime resistance was detected in 13 (61.9 %) of the 21 countries. Cefixime resistance among men who have sex with men was only 1.2 %, compared to 5.6 % and 6.1 % in females and male heterosexuals, respectively. The univariate analysis confirmed that isolates resistant to cefixime were more likely to be from females (OR 4.87, p < 0.01) or male heterosexuals (OR 5.32, p < 0.01). Seven (0.4 %) isolates displayed ceftriaxone resistance (in addition to cefixime resistance) compared to three and 10 isolates in 2012 and 2011, respectively. All 93 isolates with cefixime resistance were additionally resistant to ciprofloxacin and 16 (17.2 %) were also resistant to azithromycin. Among all tested isolates (n = 1994), the ciprofloxacin resistance level (52.9 %) was higher than in 2012 (50.1 %; p = 0.08), and azithromycin resistance (5.4 %) increased since 2012 (4.5 %; p = 0.16).ConclusionsIn 2013, the ESC resistance was again slightly increasing in Europe. This emphasises the importance of implementing the actions outlined in the European and additional response plans, particularly activities strengthening the surveillance of antimicrobial resistance. Ceftriaxone combined with azithromycin remains a satisfactory option for the first-line treatment of gonorrhoea. However novel antimicrobials (new derivatives of previously developed antimicrobials or newly developed antimicrobials) for effective monotherapy or at least inclusion in new dual antimicrobial therapy regimens (combined with previously developed antimicrobials or novel antimicrobials) will likely be required.

show abstract

“…In jüngster Zeit wurden in Japan, Australien, Kanada, Südafrika und in einigen europäischen Ländern wie England, Frankreich, Spanien, Österreich und Schweden zunehmende Resistenzentwicklungen gegen Cefixim beobachtet [11,[16][17][18][19][20][21][22][23]. Auch bei der GO-Behandlung mit Ceftriaxon fanden sich in den letzten Jahren vermehrt Einzelfallberichte über ein Therapieversagen, wie beispielsweise in Australien, Japan, Slowenien und Schweden [23][24][25][26][27]. Studien des Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) aus England zeigen zusätzlich, dass sich die Verbreitungen von Antibiotikaresistenzen bei NG-Infektionen je nach Risikogruppe unterscheiden [28].…”

unclassified

Die deutsche Laborlandschaft zu Diagnostik und Antibiotikaresistenztestung bei Neisseria gonorrhoeae

Loenenbach

Dudareva

Buder

et al. 2015

Bundesgesundheitsbl.

View full text Add to dashboard Cite

Antimicrobial resistance, genetic resistance determinants for ceftriaxone and molecular epidemiology of Neisseria gonorrhoeae isolates in Nanjing, China

Cited by 38 publications

References 34 publications

Twenty-five-year changing pattern of gonococcal antimicrobial susceptibility in Shanghai: surveillance and its impact on treatment guidelines

Twenty-five-year changing pattern of gonococcal antimicrobial susceptibility in Shanghai: surveillance and its impact on treatment guidelines

Is the tide turning again for cephalosporin resistance in Neisseria gonorrhoeae in Europe? Results from the 2013 European surveillance

Die deutsche Laborlandschaft zu Diagnostik und Antibiotikaresistenztestung bei Neisseria gonorrhoeae

Contact Info

Product

Resources

About