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Poster Presentations
PS02 – POSTER VIEWING SESSION – TUESDAY
Tuesday, July 16, 2019 5:45 PM – 7:00 PM
P658 Did minimum inhibitory concentrations in N. gonorrhoeae isolates change in germany since 2014?
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  1. Thalea Tamminga1,
  2. Susanne Buder2,
  3. Sandra Dudareva3,
  4. Gabriele Zuelsdorf4,
  5. Sebastian Banhart5,
  6. Tanja Pilz5,
  7. Kerstin Dehmel4,
  8. Eva Guhl2,
  9. Ingeborg Graeber2,
  10. Peter Kohl2,
  11. Viviane Bremer6,
  12. Dagmar Heuer7,
  13. Klaus Jansen3
  1. 1Robert-Koch-Institute, Unit 34: HIV/AIDS, STI and Blood-borne Infections, Berlin, Germany
  2. 2German Conciliar Laboratory for Gonococci, Department of Dermatology and Venerology, Vivantes Hospital, Berlin, Germany
  3. 3Robert Koch Institute, Infectious Disease Epidemiology, Berlin, Germany
  4. 4Robert Koch Institute, Unit for HIV/AIDS, STI and Blood-borne Infections, Berlin, Germany
  5. 5Robert Koch Institute, Unit for Sexually Transmitted Bacterial Infections, Berlin, Germany
  6. 6Robert Koch Institute, Berlin, Germany
  7. 7Robert Koch Institute, Sexually Transmitted Bacterial Pathogens, Berlin, Germany

Abstract

Background German national guidelines recommend ceftriaxone combined with azithromycin for Neisseria gonorrhoeae (NG) treatment since 2014. The Gonococcal-Resistance-Network (GORENET) monitors gonococcal antimicrobial resistance (AMR) in Germany. The aim is to assess whether national guidelines are still effective in Germany and which factors affect higher minimum inhibitory concentrations (MICs).

Methods GORENET laboratories sent NG isolates to the conciliar laboratory for centralized retesting of AMR using E-test. We included infection year, sex, age, infection site and clinical service type in the analysis. Geometric means were calculated for MICs for infection year. The effects of infection year, sex, age, infection site and clinical service type on MICs for ceftriaxone, cefixime, and azithromycin were investigated by multiple linear regression.

Results

Overall, 278 (2014), 303 (2015), 438 (2016) and 409 (2017) isolates were analysed. Of these, 90% of isolates came from men. Median age was 33 years (IQR: 25–44). Cumulative geometric means of MICs 2014–2017 were 0.006 µg/ml for ceftriaxone, 0.022 µg/ml for cefixime, and 0.185 µg/ml for azithromycin. In adjusted analysis, MICs decreased for ceftriaxone, cefixime and azithromycin by 0.74 (CI-95% 0.70–0.79), 0.89 (CI-95% 0.87–0.92) and 0.79 (CI-95% 0.75–0.83) per year, respectively. For ceftriaxone, isolates from urology (1.40; 95%-CI 1.15–1.69) and other service types (1.39; 95%-CI 1.10–1.77) compared to internal medicine, and from women (1.58; 95%-CI 1.14–2.18) were associated with increased MICs. Regarding cefixime isolates collected from urology (1.14; 95%-CI 1.02–1.28) compared to internal medicine, and from women (1.41; 95%-CI 1.18–1.69) were associated with increased MICs. For azithromycin, isolates from urology (0.82; 95%-CI 0.70–0.97) compared to internal medicine, and from women (0.77; 95%-CI 0.59–1.00) were associated with decreased MICs.

Conclusion Treatment options as recommended by German national guidelines are still applicable. The lower MICs after 2014 may be due to the change of national treatment guidelines in 2014. Differences in MICs regarding service types and sex need to be further investigated.

Disclosure No significant relationships.

  • surveillance
  • Neisseria gonorrhoeae
  • antimicrobial resistance

https://doi.org/10.1136/sextrans-2019-sti.726

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