Document Detail


Neisseria gonorrhoeae antimicrobial resistance among men who have sex with men and men who have sex exclusively with women: the Gonococcal Isolate Surveillance Project, 2005-2010.
MedLine Citation:
PMID:  23460055     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Gonorrhea treatment has been complicated by antimicrobial resistance in Neisseria gonorrhoeae. Gonococcal fluoroquinolone resistance emerged more rapidly among men who have sex with men (MSM) than men who have sex exclusively with women (MSW).
OBJECTIVE: To determine whether N. gonorrhoeae urethral isolates from MSM were more likely than isolates from MSW to exhibit resistance to or elevated minimum inhibitory concentrations (MICs) of antimicrobials used to treat gonorrhea.
DESIGN: 6 years of surveillance data from the Gonococcal Isolate Surveillance Project.
SETTING: Publicly funded sexually transmitted disease clinics in 30 U.S. cities.
PATIENTS: Men with a total of 34 600 episodes of symptomatic urethral gonorrhea.
MEASUREMENTS: Percentage of isolates exhibiting resistance or elevated MICs and adjusted odds ratios for resistance or elevated MICs among isolates from MSM compared with isolates from MSW.
RESULTS: In all U.S. regions except the West, isolates from MSM were significantly more likely to exhibit elevated MICs of ceftriaxone and azithromycin than isolates from MSW (P < 0.050). Isolates from MSM had a high prevalence of resistance to ciprofloxacin, penicillin, and tetracycline and were significantly more likely to exhibit antimicrobial resistance than isolates from MSW (P < 0.001).
LIMITATIONS: Sentinel surveillance may not be representative of all patients with gonorrhea. HIV status, travel history, and antimicrobial use data were missing for some patients.
CONCLUSION: Men who have sex with men are vulnerable to the emerging threat of antimicrobial-resistant N. gonorrhoeae. Because antimicrobial susceptibility testing is not routinely done in clinical practice, clinicians should monitor for treatment failures among MSM diagnosed with gonorrhea. Strengthened prevention strategies for MSM and new antimicrobial treatment options are needed.
Authors:
Robert D Kirkcaldy; Akbar Zaidi; Edward W Hook; King K Holmes; King H Holmes; Olusegun Soge; Carlos del Rio; Geraldine Hall; John Papp; Gail Bolan; Hillard S Weinstock
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of internal medicine     Volume:  158     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-05     Completed Date:  2013-05-06     Revised Date:  2013-10-29    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  321-8     Citation Subset:  AIM; IM    
Affiliation:
Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-02, Atlanta, GA 30333, USA. rkirkcaldy@cdc.gov
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Bacterial Agents / therapeutic use*
Azithromycin / therapeutic use
Ceftriaxone / therapeutic use
Ciprofloxacin / therapeutic use
Doxycycline / therapeutic use
Drug Resistance, Bacterial*
Female
Gonorrhea / drug therapy*,  microbiology*
Heterosexuality*
Homosexuality*
Humans
Logistic Models
Male
Microbial Sensitivity Tests
Neisseria gonorrhoeae / drug effects*
Penicillins / therapeutic use
Sensitivity and Specificity
Sentinel Surveillance
Tetracycline / therapeutic use
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Penicillins; 564-25-0/Doxycycline; 60-54-8/Tetracycline; 73384-59-5/Ceftriaxone; 83905-01-5/Azithromycin; 85721-33-1/Ciprofloxacin
Comments/Corrections
Erratum In:
Ann Intern Med. 2013 Sep 3;159(5):372
Note: Holmes, King H [corrected to Holmes, King K]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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