Gonococcal antimicrobial resistance in the Western Pacific Region.

Abstract

OBJECTIVE:

To outline the current situation of gonococcal antimicrobial resistance (AMR) in the Western Pacific region and factors that impact on this.

BACKGROUND:

The Western Pacific region is densely populated with many living in poverty. There are high rates of infectious diseases, and a disproportionate burden of gonococcal disease. In many countries there is uncontrolled antimicrobial use: these are ideal conditions for the emergence of AMR.

METHODS:

Gonococcal AMR in this region has been monitored for more than 20 years. Clinical isolates, predominantly from unselected patients attending sexually transmitted diseases clinics, are tested against a panel of antibiotics. Quality assurance and control strategies are in place.

RESULTS:

There is widespread, high level resistance to penicillin and ciprofloxacin. Decreased susceptibility to ceftriaxone (MIC ≥ 0.06 mg/L) is reported in high levels from some countries in the region. Low numbers of isolates tested in some countries reflect capacity for testing, and are suboptimal for surveillance.

CONCLUSION:

The raised MIC values to ceftriaxone, and the emergence and spread of ceftriaxone resistant strains regionally is alarming. Sustaining and enhancing surveillance is critical; however obtaining an adequate sample size is a long-standing issue. The implementation of molecular surveillance strategies could provide broader information on the spread and threat of AMR.

• Authors: Monica M Lahra, Ying-Ru Lo, David M Whiley
• Journal: Sexually transmitted infections (Sex Transm Infect) Vol. 89 Suppl 4 Pg. iv19-23 (Dec 2013) ISSN: 1472-3263 [Electronic] England
• PMID: 24243875 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Anti-Bacterial Agents

Topics

• Anti-Bacterial Agents (pharmacology)
• Australasia (epidemiology)
• Drug Resistance, Bacterial
• Gonorrhea (epidemiology)
• Humans
• International Cooperation
• Microbial Sensitivity Tests
• Neisseria gonorrhoeae (drug effects, isolation & purification)
• Sentinel Surveillance