Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov 5;20(1):809.
doi: 10.1186/s12879-020-05532-3.

Trends in antimicrobial resistance in Neisseria gonorrhoeae in Hanoi, Vietnam, 2017-2019

Paul C Adamson  1 , Hung Van Le  2   3 , Hai Ha Long Le  2   3 , Giang Minh Le  3 , Trung Vu Nguyen  3   4 , Jeffrey D Klausner  5   6
Affiliations

Trends in antimicrobial resistance in Neisseria gonorrhoeae in Hanoi, Vietnam, 2017-2019

Paul C Adamson et al. BMC Infect Dis. .

Abstract

Background: Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is an emerging global health threat. Surveillance of AMR in N. gonorrhoeae in the Western Pacific Region is important, as resistant strains have typically emerged from this region. There are sparse data regarding antibiotic susceptibility of N. gonorrhoeae from Vietnam. This study aimed to provide updated data on antibiotic susceptibilities in N. gonorrhoeae isolates from Hanoi, Vietnam.

Methods: From 2017 to 2019, 409 N. gonorrhoeae clinical isolates were collected at the National Hospital for Venereology and Dermatology in Hanoi, Vietnam. Antibiotic susceptibility testing was performed by disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) protocol. The zone diameters of inhibition were recorded and interpreted according to standard CLSI criteria, except for azithromycin, due to the absence of CLSI interpretation. Categorical variables were analyzed by Chi-square and Fisher's exact tests. Linear regression was used to evaluate zones of inhibition by year.

Results: Among the 409 isolates, no isolates were susceptible to penicillin, 98.3% were resistant to ciprofloxacin, and all isolates were susceptible to spectinomycin. There were 122/407 (30.0%) isolates resistant to azithromycin and there was an association between resistance and year (p < 0.01), ranging from 15.3% of isolates in 2017 to 46.7% of the isolates in 2018. Resistance to cefixime was found in 13/406 (3.2%) of isolates and there was no association by year (p = 0.30). Resistance to ceftriaxone occurred in 3/408 (0.7%) of isolates. Linear regression indicated the zone of inhibition diameters decreased by 0.83 mm each year for ceftriaxone (95% CI: - 1.3, - 0.4; p < 0.01) and decreased by 0.83 mm each year (95% CI: - 1.33, - 0.33; p < 0.01) for azithromycin; the association was not significant for cefixime (p = 0.07).

Conclusions: We found decreasing susceptibility of N. gonorrhoeae to ceftriaxone and azithromycin, as well as a high prevalence of resistance to azithromycin, among isolates in Hanoi, Vietnam from 2017 to 2019. The trends of decreasing susceptibility to first-line treatments are concerning and highlight the urgency of addressing antimicrobial resistance in N. gonorrhoeae. Expanded surveillance efforts within the Western Pacific Region are critical to monitoring trends and informing treatment guidelines.

Keywords: Anti-bacterial agents; Azithromycin; Ceftriaxone; Drug resistance, bacterial; Gonorrhea; Neisseria gonorrhoeae.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Scatter plot of disk diffusion data for N. gonorrhoeae isolates in Vietnam from 2017 to 2019. Zone diameters of inhibition in mm are shown, along with the fitted slope line and corresponding 95% confidence intervals (shaded gray), from the linear regression model. Panel a displays data for ceftriaxone and Panel b shows data for azithromycin
See this image and copyright information in PMC

References

    1. Williamson DA, Chen MY. Emerging and reemerging sexually transmitted infections. N Engl J Med. 2020;382(21):2023–2032. doi: 10.1056/nejmra1907194. - DOI - PubMed
    1. Tacconelli E, Carrara E, Savoldi A, Harbarth S, Mendelson M, Monnet DL, Pulcini C, Kahlmeter G, Kluytmans J, Carmeli Y, et al. Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis. Lancet Infect Dis. 2018;18(3):318–327. doi: 10.1016/s1473-3099(17)30753-3. - DOI - PubMed
    1. Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2019. Atlanta; 2019. 10.15620/cdc:82532.
    1. Unemo M, Shafer WM. Antimicrobial resistance in Neisseria gonorrhoeae in the 21st century: past, evolution, and future. Clin Microbiol Rev. 2014;27(3):587–613. doi: 10.1128/cmr.00010-14. - DOI - PMC - PubMed
    1. Centers for Disease Control and Prevention Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(RR-03):1–137. - PMC - PubMed

MeSH terms