The European Centre for Disease Prevention and Control (ECDC) has published its gonococcal antimicrobial (AMR) susceptibility surveillance for 2019. The European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) followed an annual decentralised and centralised testing model, requesting participating laboratories to collect gonococcal isolates during the period September to November 2019. Susceptibility testing was performed on all isolates, where available, for ceftriaxone, cefixime, azithromycin, ciprofloxacin, spectinomycin, and gentamicin, as well as testing for β-lactamase production for detection of high-level penicillin resistance.
In 2019, 26 EU or EEA member states participated in Euro-GASP, 19 via decentralised testing. In total, 4,166 isolates were tested, with 83% of specimens from male patients, and a median patient age of 30 years. Among cases with known sexual orientation and sex, 54.4% were heterosexual men or women, and 45.6% were men who have sex with men (MSM). Among all cases, 14.1% were HIV-positive, and 84.9% of those were MSM.
The ECDC report that decreasing azithromycin susceptibility, combined with the continued detection of ceftriaxone resistance, is a major concern and threatens the effectiveness of the currently effective dual-therapy regimen of ceftriaxone plus azithromycin, and high-dose ceftriaxone monotherapy recently adopted by some European countries. Even though the level of resistance to cefixime has significantly decreased, the ECDC report that cefixime resistance needs to be monitored closely, particularly because gonococcal strains with resistance to both cefixime and ceftriaxone continue to spread internationally.
Source: ECDC, 15 November 2021