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
. 2021 Dec 1;48(12S Suppl 2):S111-S117.
doi: 10.1097/OLQ.0000000000001548.

Antimicrobial Susceptibility of Urogenital and Extragenital Neisseria gonorrhoeae Isolates Among Men Who Have Sex With Men: Strengthening the US Response to Resistant Gonorrhea and Enhanced Gonococcal Isolate Surveillance Project, 2018 to 2019

Laura A S Quilter, Sancta B St Cyr  1 , Jaeyoung Hong  1 , Lenore Asbel  2 , Ilene Bautista  3 , Bonnie Carter  4 , Yanick Casimir  5 , Michael Denny  6 , Melissa Ervin  7 , Raquel Gomez  8 , Alesia Harvey  1 , Justin L Holderman, Kimberly Johnson  9 , Robert P Kohn  10 , Emily R Learner  1 , Kerry Mauk  1 , Timothy Menza  11 , Christie Mettenbrink  12 , William D Nettleton, Karen R Nicosia  13 , Cau D Pham  1 , Christopher Ried  14 , Karen Schlanger  1 , Annah Schneider  15 , Olusegun O Soge  16 , Irina Tabidze  17 , Stephanie N Taylor  18 , Winston Tilghman  19 , Cindy Toler  20 , Hillard Weinstock  1 , Elizabeth A Torrone  1
Affiliations

Antimicrobial Susceptibility of Urogenital and Extragenital Neisseria gonorrhoeae Isolates Among Men Who Have Sex With Men: Strengthening the US Response to Resistant Gonorrhea and Enhanced Gonococcal Isolate Surveillance Project, 2018 to 2019

Laura A S Quilter et al. Sex Transm Dis. .

Abstract

Background: We investigated differences in gonococcal antimicrobial susceptibility by anatomic site among cisgender men who have sex with men (MSM) using specimens collected through the Centers for Disease Control and Prevention's enhanced Gonococcal Isolate Surveillance Project and Strengthening the US Response to Resistant Gonorrhea.

Methods: During the period January 1, 2018-December 31, 2019, 12 enhanced Gonococcal Isolate Surveillance Project and 8 Strengthening the US Response to Resistant Gonorrhea sites collected urogenital, pharyngeal, and rectal isolates from cisgender MSM in sexually transmitted disease clinics. Gonococcal isolates were sent to regional laboratories for antimicrobial susceptibility testing by agar dilution. To account for correlated observations, linear mixed-effects models were used to calculate geometric mean minimum inhibitory concentrations (MICs), and mixed-effects logistic regression models were used to calculate the proportion of isolates with elevated or resistant MICs; comparisons were made across anatomic sites.

Results: Participating clinics collected 3974 urethral, 1553 rectal, and 1049 pharyngeal isolates from 5456 unique cisgender MSM. There were no significant differences in the geometric mean MICs for azithromycin, ciprofloxacin, penicillin, and tetracycline by anatomic site. For cefixime and ceftriaxone, geometric mean MICs for pharyngeal isolates were higher compared with anogenital isolates (P < 0.05). The proportion of isolates with elevated ceftriaxone MICs (≥0.125 μg/mL) at the pharynx (0.67%) was higher than at rectal (0.13%) and urethral (0.18%) sites (P < 0.05).

Conclusions: Based on data collected from multijurisdictional sentinel surveillance projects, antimicrobial susceptibility patterns of Neisseria gonorrhoeae isolates may differ among MSM at extragenital sites, particularly at the pharynx. Continued investigation into gonococcal susceptibility patterns by anatomic site may be an important strategy to monitor and detect the emergence of antimicrobial resistant gonorrhea over time.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest and Sources of Funding: None declared.

Figures

Figure 1.
Figure 1.
Minimum inhibitory concentration distribution by antimicrobial and anatomic site of gonococcal infection among men who have sex with men: eGISP and SURRG, 2018 to 2019. The MIC distributions (percentage of isolates by MICs) by each antimicrobial (azithromycin, cefixime, ceftriaxone, ciprofloxacin, tetracycline, and penicillin) were calculated for pharyngeal, rectal, and urethral isolates.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States, 2019. Atlanta, GA: CDC, 2019. Available at: https://www.cdc.gov/drugresistance/pdf/threats-report/2019-ar-threats-re.... Accessed February 21, 2021.
    1. Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States, 2013. Atlanta, GA: CDC, 2013. Available at: https://www.cdc.gov/drugresistance/threat-report-2013/pdf/ar-threats-201.... Accessed February 21, 2021.
    1. Bolan GA, Sparling PF, Wasserheit JN. The emerging threat of untreatable gonococcal infection. N Engl J Med 2012; 366:485–487. - PubMed
    1. Unemo M, Golparian D, Eyre DW. Antimicrobial resistance in Neisseria gonorrhoeae and treatment of gonorrhea. Methods Mol Biol 1997; 2019:37–58. - PubMed
    1. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2018. Available at: https://www.cdc.gov/std/stats18/STDSurveillance2018-full-report.pdf. Accessed February 21, 2021.

Publication types