CDC Grand Rounds: the growing threat of multidrug-resistant gonorrhea

Abstract

Although gonorrhea has afflicted humans for centuries, and the causative bacterium, Neisseria gonorrhoeae, was identified more than a century ago, gonorrhea remains a public health problem in the United States. Gonorrhea is the second most commonly reported notifiable infection in the United States; >300,000 cases were reported in 2011. In the United States, health inequities persist; the incidence of reported gonorrhea among blacks is 17 times the rate among whites, likely because of structural socioeconomic factors.

FIGURE 1

Prevalence of ciprofloxacin resistance* in urethral Neisseria gonorrhoeae isolates collected from men in the United States, by location — Gonococcal Isolate Surveillance Project, 1990–2007 * Defined as minimum inhibitory concentrations ≥1 μg/mL.

FIGURE 2

Prevalence of ciprofloxacin resistance* in urethral Neisseria gonorrhoeae isolates collected from men in the United States, by gender of sex partner — Gonococcal Isolate Surveillance Project, 1999–2007 Abbreviations: MSM = men who have sex with men; MSW = men who have sex exclusively with women. * Defined as minimum inhibitory concentrations ≥1 μg/mL.

FIGURE 3

Percentage of urethral Neisseria gonorrhoeae isolates with elevated cefixime minimum inhibitory concentrations (MICs) and elevated ceftriaxone MICs* — Gonococcal Isolate Surveillance Project, 2006–2011^† * Elevated cefixime MICs defined as ≥0.25 μg/mL; elevated ceftriaxone MICs defined as ≥0.125 μg/mL. ^† Isolates not tested for cefixime susceptibility in 2007 and 2008.