Introduction: Neisseria gonorrhoeae (NG), initially highly susceptible to many antimicrobials, was recently assigned as a superbug due to its ability to develop resistance to all antimicrobials introduced for treatment during the last years. This study aimed to determine the prevalence and trends of NG antimicrobial resistance (AMR) during 2008–2016 in Grande Florianópolis, Santa Catarina, Brazil.
Methods A total of 152 gonococcal isolates from urogenital specimens were submitted to Santa Luzia Medical Laboratory, Florianópolis, Brazil. All isolates were identified to the species level using MALDI-TOF. The minimum inhibitory concentration (MIC) was determined using agar dilution method to penicillin, tetracycline, ciprofloxacin, ceftriaxone, cefixime and azithromycin. Quality control was performed using NG WHO reference strains and ATCC 49226.
Results All isolates were sensitive to ceftriaxone (MIC 0.001–0.06 µg/ml) and cefixime (MIC: 0.0005–0.125 µg/ml). Resistance to penicilin, tetracycline, ciprofloxacin and azithromycin were 26.3%, 40.8%, 52.0% and 5.2% respectively.
Conclusion The study showed increased resistance to penicillin, tetracycline, ciprofloxacin and azithromycin. No resistance to ceftriaxone and cefixime was detected. Due to the high level ciprofloxacin resistance, the dual therapy currently recommended in Brazil for gonococcal infections (ciprofloxacin plus azithromycin) is no more an effective treatment option in Grande Florianópolis. Thus, ceftriaxone constitute the treatment option for gonococcal infections, as well as in the states of Rio de Janeiro, São Paulo and Minas Gerais, where regional studies have already detected high level ciprofloxacin resistance. AMR testing needs to be frequently performed to ensure the treatment effectiveness.
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