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Volume 30, Supplement—October 2024
SUPPLEMENT ISSUE
Articles

Common Patterns and Unique Threats in Antimicrobial Resistance as Demonstrated by Global Gonococcal Surveillance

Adriana Le VanComments to Author , Nazia Rahman, Reuel Sandy, Nelson Dozier, Hunter J. Smith, Melissa J. Martin, Katelyn V. Bartlett, Krit Harncharoenkul, Anna Nanava, Tamar Akhvlediani, Paul Rios, Supriya D. Mehta, Walter Agingu, Denis K. Byarugaba, Fred Wabwire-Mangen, Hannah Kibuuka, Bernard Erima, Hope O. Kabatasi, Naiki Attram, Dutsadee Peerapongpaisarn, Wilawan Oransathit, Wirote Oransathit, Umaporn Suksawad, Woradee Lurchachaiwong, Somchai Sriplienchan, Nonlawat Boonyalai, Maneerat Somsri, Nithinart Chaitaveep, Ann Jerse, and Eric Garges
Author affiliation: Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA (A. Le Van, R. Sandy); Uniformed Services University, Bethesda (A. Le Van, R. Sandy, N. Dozier, A. Jerse, E. Garges); Cherokee Nation Strategic Programs, Tulsa, Oklahoma, USA (N. Rahman); Global Emerging Infections Surveillance Branch, Armed Forces Health Surveillance Division, Silver Spring, Maryland, USA (N. Rahman, H.J. Smith); Multidrug Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring (M.J. Martin, K.V. Bartlett); Walter Reed Army Institute of Research, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand (K. Harncharoenkul, D. Peerapongpaisarn, Wilawan Oransathit, Wirote Oransathit, U. Suksawad, W. Lurchachaiwong, S. Sriplienchan, N. Boonyalai, M. Somsri, N. Chaitaveep); Walter Reed Army Institute of Research Europe-Middle East, Tbilisi, Georgia (A. Nanava, T. Akhvlediani); US Naval Medical Research Unit SOUTH, Lima, Peru (P. Rios); Rush University College of Medicine, Chicago, Illinois, USA (S.D. Mehta); Walter Reed Army Institute of Research-Africa, Kisumu, Kenya (W. Agingu); Makerere University Walter Reed Project, Kampala, Uganda (D.K. Byarugaba); Makerere University College of Veterinary Medicine, Kampala (D.K. Byarugaba, F. Wabwire-Mangen, H. Kibuuka, B. Erima, H.O. Kabatasi); US Naval Medical Research Unit EURAFCENT, Accra, Ghana (N. Attram); Walter Reed Army Institute of Research-Africa, Nairobi, Kenya (E. Garges)

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Table 1

Summary of phenotypic antimicrobial resistance in study of common patterns and unique threats in antimicrobial resistance as demonstrated by global gonococcal surveillance*

Region Isolates with reduced susceptibility or resistance, no. (%)
Tetracycline Benzylpenicillin Ciprofloxacin Azithromycin Cefixime Ceftriaxone Gentamicin
Thailand, n = 516 500 (96.9) 502 (97.3) 500 (97) 4 (0.77) 2 (0.4) 16 (3.1) 31 (6.0)
Ghana, n = 19 19 (100) 19 (100) 17 (89.5) 0 1 (5.3) 0 7 (36.8)
Peru, n = 208 195 (93.7) 205 (98.5) 186 (89.4) 2 (0.96) 7 (3.4) 3 (1.4) 63 (30.3)
Nairobi, Kenya, n = 27 27 (100) 26 (96.3) 23 (85.1) 0 0 0 1 (3.7)
Kisumu, Kenya, n = 110 108 (98.2) 105 (95.5) 106 (96.4) 2 (1.8) 3 (2.72) 4 (3.63) 26 (23.6)
Uganda, n = 10 9 (90) 10 (100) 9 (90) 0 0 0 2 (20)
Georgia, n = 72 44 (61.1) 50 (69.4) 41 (56.9) 2 (2.8) 11 (15.2) 11 (15.2) 16 (22.2)
Total, N = 962 902 (93.7) 917 (95.3) 882 (91.7) 10 (1.02) 24 (2.5) 34 (3.6) 146 (15.2)

*MICs interpreted according to Clinical and Laboratory Standards Institute criteria when available (22). CLSI resistance breakpoints used for penicillin (I>0.06; R>2.0 μg/mL), tetracycline (I>0.25; R>2.0 μg/mL), and ciprofloxacin (I>0.06; R>1.0 μg/mL) (22). Gonococcal Isolate Surveillance Project breakpoints used for azithromycin (I>1; R>2.0 μg/mL), cefixime (I>0.06; R>0.25 μg/mL), and ceftriaxone (I>0.06; R>0.125 μg/mL) (23,24), because CLSI has not established criteria for resistance to those antimicrobial drugs. Gentamicin breakpoints (I≥8–16 μg/mL; R I>32.0 μg/mL) were determined according to research published by the Centers for Disease Control and Prevention (25).

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