Background The World Health Organization (WHO) issued an international action plan in 2012 to mitigate the health impact of antimicrobial resistant Neisseria gonorrhoeae isolates. A key strategy is to strengthen international surveillance of gonococcal antimicrobial susceptibility. The Gonococcal Antimicrobial Surveillance Program (GASP) in Latin America and Caribbean (LAC) has reported on AMR trends from 1990. The present study presents regional trends in antimicrobial susceptibility between 2010 and 2011.
Methods Seven countries reported using either agar dilution (CLSI), Etest or disc diffusion assays to determine antimicrobial susceptibility. Countries were asked to report MIC data and categories of susceptibility.
Results Seven countries tested 1019 isolates of N. gonorrhoeae in 2010 and 1216 isolates in 2011 to ceftriaxone, penicillin, tetracycline and ciprofloxacin (n = 7); azithromycin (n = 4) and spectinomycin (n = 3). Several countries reported a 2-fold increase in MIC50 to ceftriaxone (from 0.004 to 0.008 µg/mL) between 2010 and 2011 and 12 isolates with ceftriaxone MICs 0.125- ≥ 0.25 µg/ml were reported in 2011. All isolates were susceptible to spectinomycin. Resistance to azithromycin increased slightly from 1. 0% (6/612) to 1.7% (20/1169) while resistance to ciprofloxacin decreased from 42.1% (429/1019) to 36.2% (439/1214) of isolates tested between 2010 and 2011. Resistance to penicillin increased from 31% (310/1016) in 2010 to 35% (428/1216) in 2011 while the percentage of isolates resistant to tetracycline was stable (2010 – 21.8%, 187/858; 2011 – 22.6%, 275/1216).
Conclusions Third generation cephalosporins and spectinomycin continue to be viable options for the treatment of gonorrhoea in the countries reporting. Low percentages of resistance to azithromycin continue to be reported. There has been a steady decline in capacity for N. gonorrhoeae diagnosis and antimicrobial susceptibility testing in the region. The implementation of the WHO action plan to control the spread and impact of antimicrobial resistance in N. gonorrhoeae is an urgent priority.
- antimicrobial susceptibility
- Neisseria gonorrhoeae