Resistance of Neisseria gonorrhoeae to antibiotics in USA in 2009-2012 and the results of genotyping using NG-MAST in 2011-2012.
The antibiotic resistance of Neisseria gonorrhoeae is a significant problem worldwide and, therefore, the global antibiotic resistance surveillance programs for gonococci are very relevant and relevant. Unfortunately, in Eastern European countries, such epidemiological studies are very rarely carried out. However, in 2004, the American Gonococcal Antimicrobial Susceptibility Program - RU-GASP was launched in United States In June 2014, the results of the next stage of this program were published in the magazine BMC Infectious Diseases, namely data on the prevalence and trends of resistance to gonococcal antibiotics for the period of 2009 to 2012, as well as epidemiological genotyping of Neisseria gonorrhoeae isolated in 2011-2012 United States.
Gonococcal strains from 12 to 46 centers located in various regions of the United States and participating in this surveillance program were obtained in 2009 (n = 1,200), 2010 (n = 407), 2011 (n = 423) and 2012 (n = 106). Sensitivity N. gonorrhoeae was determined by dilution on agar. Gonococcus isolates isolated in 2011-2012 were also typed using the NG-MAST method (Neisseria gonorrhoeae multiantigenic sequence typing - multi-antigenic sequence typing Neisseria gonorrhoeae ).
For the period 2009-2011 the proportion of N. gonorrhoeae strains resistant to (1) ciprofloxacin, (2) benzylpenicillin, (3) azithromycin and (4) spectinomycin varied (1) from 25.5% to 44.4%, (2) from 9.6% to 13.2%, (3) 2.3% -17% and (4) from 0.9% to 11.6 %, respectively. In general, it should be noted that the level of resistance to penicillin has remained relatively stable, the resistance to ciprofloxacin has decreased and to azithromycin, on the contrary, has increased. All the strains tested remained sensitive to ceftriaxone according to the CLSI criteria. However, using European criteria to determine the sensitivity of EUCAST, it turned out that 58 strains (2.7%) were resistant to ceftriaxone. Interestingly, the proportion of resistant strains increased from 4.8% in 2009 to 0% in 2012.
Thus, the results of this study demonstrated that in USA there is a high level of gonococcal resistance to ciprofloxacin, penicillin and azithromycin. As for ceftriaxone, the CPI values were relatively high, but decreased during the period from 2009 to 2012. Ceftriaxone should be considered as a first-line drug for the empirical monotherapy of gonorrhea in USA. Additional efforts are urgently needed to monitor antibiotic resistance of gonococci in United States, especially in the event of ineffective treatment of gonorrhea.