Background Emergence and development of resistance in Neisseria gonorrhoeae (NG) to antibiotics has become a major public health problem worldwide. The aim of our study was to determine the antimicrobial susceptibility, especially ceftriaxone and azithromycin, and molecular epidemiological typing of NG isolates in Shenzhen, China.

Methods A total of 1,282 NG isolates were collected from Shenzhen, between 2010 and 2017. The minimum inhibitory concentrations (MICs) of NG isolates were determined by the agar dilution method. Resistance to azithromycin (AZM-R) was defined as MIC ≥1.0 mg/L, and decreased susceptibility to ceftriaxone (CRO^D) was defined as MIC ≥0.125 mg/L. Isolates were genotyped using Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST).

Results Among the isolates, 5.0% showed CRO^D, 17.3% was AZM-R and 1.3% was both CRO^D and AZM-R. Increasing ceftriaxone MICs was found from 2010–2014 to 2015–2017 [ridit value: 0.585; 95% confidence interval (95%CI): 0.559–0.611], but not for CRO^D and AZM-R. The proportions of isolates resistant to ciprofloxacin (97.4%, increasing from 96.6% in 2010–2014 to 98.8% in 2015–2017) and penicillin (68.2%, increasing from 60.6% in 2013–2014 to 73.5% in 2015–2017) were increasing, but PPNG was decreased. All isolates were susceptible to spectinomycin. Genogroup 5308 was inversely association associated with AZM-R; the corresponding odds ratio (95%CI) was: 0.098 (0.013–0.747).

Conclusion The founding of increasing ceftriaxone MICs over the time and high proportions of AZM-R in Shenzhen region calls for reevaluation dual therapy. Timely and efficient surveillance with isolates characterization and changes of susceptibility over time is essential.

Disclosure No significant relationships.