Introduction Antimicrobial resistant Neisseria gonorrhoea (NG) is a global public health threat, and it is critical to monitor patterns of resistance and risk factors. The Thailand Ministry of Public Health, the Centres for Disease Control and Prevention and World Health Organisation began the Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) in November 2015. Thailand is the first EGASP country to systematically monitor trends in NG antimicrobial susceptibilities.
Methods Surveillance occurs in 2 sites: Bangrak Hospital (BH) and Silom Community Clinic at Tropical Medicine (SCC). Men receiving HIV voluntary counselling and testing were routinely asked about urethral symptoms. Symptomatic men had demographic and clinical data collected and a urethral swab for Gram stain and NG culture. All positive cultures had antimicrobial susceptibility testing (AST) to determine minimum inhibition concentrations (MICs) for Cefixime (CFM), Ceftriaxone (CRO), Azithromycin (AZI), Gentamicin (GEN), and Ciprofloxacin (CIP) using E-test.
Results From November 2015-August 2016, 900 specimens were collected; 713 (79.2%) specimens were from BH and 187 (20.8%) were from SCC. Among the 900 specimens, 479 (53.3%) had NG growth; 478 (99.8%) NG isolates had AST performed. Seventeen men had repeat NG infections. Among the 461 men with at least one infection, 291 (63.1%) had sex with women only, 138 (29.9%) had antibiotic use in the last 2 weeks, and all received treatment for gonorrhoea. The median age of men with NG infection was 29 years (range 14–76 years). All NG isolates were susceptible by Clinical and Laboratory Standards Institute standards to CFM, CRO, AZI and GEN; 438 of 478 (91.6%) isolates were resistant to CIP.
Conclusion We report the first 10 months of data from EGASP Thailand. Most isolates were found to be susceptible to all tested antibiotics except CIP. Surveillance is critical to assess trends and risk factors for NG, and to monitor for emergence of resistance.
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