Background Increased resistance of Neisseria gonorrhoeae to antimicrobials has been reported worldwide, jeopardising the treatment of gonorrhoea. In order to provide guidance in treatment guidelines a national gonococcal antimicrobial surveillance programme has been installed in Belgium. We present here the data collected from 2006 till 2011.

Methods All Belgian laboratories are asked to send N. gonorrhoeae strains isolated in their laboratories to the national reference laboratory where Minimal Inhibitory Concentrations (MIC) are determined using the agar dilution assay according to the Clinical and Laboratory Standard Institute (CLSI). The MICs for ceftriaxone (cef), spectinomycin (spe), ciprofloxacin (cip), azithromycin (azi), penicillin (pen), and tetracycline (tet) are determined. The MIC breakpoints recommended by CLSI are applied, except for azithromycin for which the breakpoints recommend by the Centers for Disease Control and prevention are used.

Results The following table summarises the antimicrobial resistance per year

Conclusions The current Belgian guidelines recommend ceftriaxone as first- and spectinomycin as second line treatment for gonorrhoea. Although a decreased susceptibility or resistance was not observed, shifts in MIC are closely followed up. In addition, alternatives for treatment have to be sought in the event of emerging resistance.