Monitoring antimicrobial resistance in Neisseria gonorrhoeae in selected countries of the WHO South-East Asia Region between 2009 and 2012: a retrospective analysis
Monitoring antimicrobial resistance in Neisseria gonorrhoeae in selected countries of the WHO South-East Asia Region between 2009 and 2012: a retrospective analysis
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DOI：
10.1136/sextrans-2012-050904
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发表时间：
2013-12-01
影响因子：
3.6
通讯作者：
Ramesh, V.
中科院分区：
文献类型：
--
作者：
Bala, Manju;Kakran, Monika;Ramesh, V.
本研究的目的是回顾性分析2009年至2012年世卫组织全球淋球菌抗菌素监测计划（GASP）恢复后，东南亚地区6个国家淋球菌抗菌素耐药性（AMR）报告的数据。方法采用校正后的二分敏感性（CDS）方法，对18个重点实验室的4675株临床分离菌进行7种抗生素的AMR数据分析或临床和实验室标准化研究所（CLSI）的方法和Etest在一些中心的最小抑菌浓度测试。结果进行解释使用的断点recommended.ResultsHigh-Level耐药传统抗生素，青霉素（25%至100%）和四环素（10%至100%）和以前推荐的环丙沙星（38%至100%），观察在所有的国家。总体而言，从15个实验室中鉴定出> 90%的对青霉素和环丙沙星敏感性较低和耐药的分离株。分别有9个和8个中心报告了对头孢曲松和头孢泊肟的敏感性降低。仅3个中心报告了对壮观霉素（0.6%至10.5%）和阿奇霉素（< 5%）的耐药。在不丹、印度、斯里兰卡和泰国，对青霉素、四环素和环丙沙星的耐药性呈上升趋势，国家间差异不大。对ceftriaxone的敏感性下降的无意义的趋势reported.ConclusionsExpansion的世卫组织GASP促进增强AMR监测，以满足淋球菌AMR控制的持续挑战。结果强调，头孢曲松敏感性降低和壮观霉素和阿奇霉素耐药性的出现将必然导致治疗选择的丧失，需要开始寻找新的有效药物来应对耐药菌株的出现。
ObjectiveThe aim of the present study was to retrospectively analyse the data reported on antimicrobial resistance (AMR) in Neisseria gonorrhoeae in six South-East Asia Region countries from 2009 to 2012 following the revitalisation of the WHO global Gonococcal Antimicrobial Surveillance Program (GASP).MethodsAMR data were generated for 7 antibiotics of 4675 isolates in 18 focal point laboratories using the calibrated dichotomous sensitivity (CDS) or Clinical and Laboratory Standards Institute (CLSI) methods and minimal inhibitory concentration testing by Etest in some of the centres. The results were interpreted using the breakpoints recommended.ResultsHigh-level resistance to traditional antibiotics, penicillin (25% to 100%) and tetracycline (10% to 100%) and the previously recommended ciprofloxacin (38% to 100%) was observed in all the countries. Overall, > 90% of less susceptible and resistant isolates to penicillin and ciprofloxacin were identified from 15 laboratories. Decreased susceptibility to ceftriaxone and cefpodoxime was reported by nine and eight centres, respectively. Resistance to spectinomycin (0.6% to 10.5%) and azithromycin (< 5%) was reported only by three centres. The increasing trends of resistance towards penicillin, tetracycline and ciprofloxacin were demonstrated in Bhutan, India, Sri Lanka and Thailand, and no large intercountry variations were evident. Insignificant trends in decreased susceptibility towards ceftriaxone were reported.ConclusionsExpansion of the WHO GASP facilitated enhanced AMR surveillance to meet the ongoing challenges of control of gonococcal AMR. The results highlight that the emergence of decreased susceptibility to ceftriaxone and resistance to spectinomycin and azithromycin will unavoidably lead to loss of therapeutic options, and a search for new effective agents needs to be initiated to respond to the emergence of resistant isolates.