Journal Article
Epidemiology and antimicrobial resistance profile of Neisseria gonorrhoeae in Catalonia, Spain, 2016–2019
Mercè Herrero; Sonia Broner; Adrià Cruells; Silvia Esteve; Lourdes Ferré; Jacobo Mendioroz; Mireia Jané; Pilar Ciruela; Miguel Ángel Benítez; Jordi Bosch; Cristina Pitart; Frederic Ballester; Ana Calderón; Teresa Falgueras; Carmina Martí; Mª Àngeles Pulido; Margarida Curriu; Ester Sanfeliu; Percy Juan Ayala; Carme Gallés; Elisenda Capdevila; Pilar Hernández; Paula Gassiot; Carme Mora; Frederic Gómez; Araceli González; Màrius Juanpere Aixalà; Eduardo Padilla; Amadeu Gené; Ferran Navarro; Alba Rivera; Ferran Sánchez; Gloria Trujillo; Joan López; Montserrat Olsina; Pepa Pérez; Mar Olga Pérez; Joan Manel Ramírez; Xavier Raga; Judith Lucena; Jesús Aramburu; Esther Sanfeliu Riera; Goretti Sauca; Inés Valle; Anna Vilamala; Yannick Hoyos; Jordi Cámara; Jordi Niubó; Graciela Rodríguez; Fe Tubau; Maria Dolores Quesada; Nuria Torrellas; Natàlia Claver; Teresa Bastida; Rosalia Santos; Olga González-Moreno
European Journal of Clinical Microbiology & Infectious Diseases · Vol. 42, Issue 7 · pp. 883-893 · 2023
Abstract
Antimicrobial resistance data for Neisseria gonorrhoeae is globally sparse and resistant strains are emerging in Catalonia. We aim to describe epidemiological and antimicrobial resistance in all patients infected with N. gonorrhoeae during the period from 2016 to 2019, using available antimicrobial susceptibility data. We retrospectively analysed confirmed N. gonorrhoeae cases notified to Catalonia’s microbiological reporting system. Antibiotic susceptibility testing (azithromycin, cefixime, ceftriaxone, ciprofloxacin, penicillin, spectinomycin, and tetracycline) was assessed using clinical breakpoints published by the European Committee on Antimicrobial Susceptibility Testing. Incidence rates were calculated and proportions were compared using the χ 2 test or Fisher’s exact test, and analysed using the Statistical Package for Social Sciences (SPSS 18.0). A total of 14,251 confirmed cases of N. gonorrhoeae were notified. Incidence increased from 30.7 cases/100,000 person-years ( p < 0.001) in 2016 to 64.7 in 2019. Culture was available in 6,292 isolates (44.2%), of which 5,377 (85.5%) were resistant to at least one of the antibiotics tested. Azithromycin resistance rose from 6.1% in 2016 to 16% in 2019 ( p < 0.001). Only 1.0% (45 cases) were resistant to ceftriaxone. Multidrug-resistant N. gonorrhoeae increased from 0.25% in 2016 to 0.42% in 2019 ( p = 0.521). One case presented extensively drug-resistant N. gonorrhoeae . In Catalonia, 10% of the N. gonorrhoeae isolates were resistant to azithromycin in the 2016–2019 period. According to World Health Organization guidelines, resistance above 5% indicates an alert to review treatment guidelines. Antimicrobial susceptibility testing in clinical practice followed by surveillance and interventions are essential to monitor trends and prevent the spread of antimicrobial resistance.