Background The emergence and international spread of antimicrobial resistance (AMR) in Neisseria gonorrhoeae has compromised the treatment and public health management of gonococcal infections. Appropriate diagnostics and surveillance of AMR are critical for controlling infections and in guiding international and national treatment guidelines to ensure appropriate patient management.

Methods A questionnaire-based survey regarding the diagnostics and AMR surveillance of N. gonorrhoeae in Latvia was conducted by the Centre for Disease Prevention and Control and Infectology of Latvia. Telephone interviews were carried out among the 73 biggest medical laboratories in Latvia.

Results In 2011, a total of 550 cases of gonorrhoea were reported giving a rate of 26.7 per 100 000 population. In 2012 – 602 cases and an incidence of 29.5. In total, the incidence of gonorrhoea increased by 73.5% from 2010 to 2012. For detection of N. gonorrhoeae, currently three laboratories are using nucleic acid amplification tests (NAATs), 10 - RNA probe hybridization tests, four laboratories culture, and 17 - Gram staining of specimen smears only. Monitoring of AMR in N. gonorrhoeae was initiated in 2010, however, during 2010 and 2012 in total only 35 isolates were tested. All 35 isolates were fully susceptible to cefixime, ceftriaxone, azithromycin, and spectinomycin, and the minimum inhibitory concentrations (MICs) of gentamicin were low. Resistance to ciprofloxacin was displayed by 43% of isolates, to penicillin by 31%, and to tetracycline by 23%.

Conclusion The gonorrhoea incidence has significantly increased in Latvia during the recent years, which cannot only be explained by introduction of more sensitive diagnostics such as NAATs in a few laboratories. It is imperative to substantially strengthen the diagnostics and AMR surveillance in Latvia.