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P3.146 First brazilian national antimicrobial susceptibility surveillance for neisseria gonorrhoeae
  1. Maria Luiza Bazzo1,
  2. Lisléia Golfetto1,
  3. Miriam Franchini2,
  4. Pâmela Cristina Gaspar2,
  5. Ana Flávia Pires3,
  6. Ligia Maria Bedeschi Costa4,
  7. Mauro Cunha Ramos5,
  8. Loeci Natalina Timm6,
  9. William Antunes Ferreira7,
  10. Purificação Pereira da Silva Maria Da8,
  11. Carvalho da Silva Roberto José9,
  12. Fonseca Andrade Lidiane da10,
  13. Fátima Mendes Pereira Lúcia de11,
  14. Felipe de Rocco1,
  15. Jéssica Martins1,
  16. Hanalydia Machado1,
  17. Marcos André Schörner1,
  18. Thaís Mattos Santos1,
  19. Faria de Carvalho Simone Veloso4,
  20. Luciane Guimarães Dias4,
  21. Letícia Eidt6,
  22. de Oliveira Arnhold Guilherme Henrique6,
  23. Souza Coelho Muniz Chayane Ariel6,
  24. Waldemara de Souza Vasconcelos7,
  25. Jairo de Souza Gomes7,
  26. Pinto Da Silva Maria De Fátima7,
  27. Rosan Barboza de Matos8,
  28. Cláudio Campos do,
  29. Leonor Henriette de Lannoy12,
  30. Adele Schwartz Benzaken2
  1. 1Federal University of Santa Catarina, Florianópolis – SC, Brazil
  2. 2Department of Surveillance, Prevention and Control of STI, HIV/AIDS and Viral Hepatitis, Brasília – DF, Brazil
  3. 3Postgraduate Program In Collective Health Of University of Brasília, Brasília – DF, Brazil
  4. 4Municipal Secretary of Health Belo Horizonte, Belo Horizonte – MG, Brazil
  5. 5Brazilian Society of STD, Porto Alegre – RS, Brazil
  6. 6State Department of Health of Rio Grande do Sul, Porto Alegre – RS, Brazil
  7. 7Alfredo da Mata Foundation, Manaus – AM, Brazil
  8. 8State Centre Specialised in Diagnosis, Assistance And Research, Salvador – BA, Brazil
  9. 9STD Reference and Training Centre of São Paulo, São Paulo – SP, Brazil
  10. 10Testing and Counselling Centre of Distrito Federal, Brasília – DF, Brazil
  11. 11Central Public Health Laboratory of Distrito Federal, Brasília – DF, Brazil
  12. 12Day Hospital of Brasília, Brasília – DF, Brazil

Abstract

Introduction The threat of multidrug resistant Neisseria gonorrhoeae (NG) is a concern worldwide, especially in settings with emerging resistance to the extended spectrum cephalosporins. Since 2009 WHO recommendation to the countries to perform Antimicrobial Surveillance has been reinforced. Brazilian’s sexually transmitted infection guideline recommends dual therapy to treat gonococcal infection (ciprofloxacin plus azithromycin). However, regional studies performed in three Brazilian states demonstrated quinolone resistance. For these states it was recommended to replace the quinolones by third generation cephalosporin. The aim of this study was to perform a Brazilian national gonococcal antimicrobial surveillance.

Methods The surveillance study included seven collection sites representing five geographic regions of Brazil. A total of 550 NG isolates from male urethral discharge was sent to the gonococcal national reference laboratory for analysis. The minimum inhibitory concentration (MIC) with the agar dilution method was performed for penicillin, tetracycline, ciprofloxacin, ceftriaxone, cefixime and azithromycin.

Results The sensitivity profile of the NG isolates was performed in 131 isolates from the Southeast, 104 from the Northeast, 100 from the North, 68 from the Center-West and 147 from the South. In addition to penicillin and tetracycline, a high level of resistance for ciprofloxacin (47% to 78% of isolates) was observed in the isolates of all the regions. All the isolates were sensitive to ceftriaxone and cefixime, although one isolate was found with elevated MIC. Regarding azithromycin sensitivity, the majority of the isolates were sensitive, but the emergence of an intermediate (5% to 15%) or resistant (4% to 10%) profile needs to be monitored.

Conclusion The national survey confirmed the high level of ciprofloxacin resistance already described worldwide. These results indicate the need to urgently change Brazilian recommendation for gonorrhoeae treatment and the importance of systematic gonococcal resistance surveillance.

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