2023-05-25 13:12:44
The constant increase in the resistance of Neisseria gonorrhoeae antibiotics is a global concern. Cultures are an essential tool for monitoring resistance. In 2014, after noticing a decrease in the use of culture, a reflection took place regarding the establishment of a Sentinel Surveillance Network. Better knowledge of the epidemiological characteristics of cases infected with susceptible or resistant strains appeared necessary. The data collected by the Sentinel network for surveillance of gonococcal infection, antibiotic resistance and treatment failures in Quebec from September 2015 to December 2019 allow the following messages to emerge:
- The proportion of episodes for which at least one sample for culture was taken decreased significantly, from 68% in 2015-2017 to 61% in 2018-2019. Promoting detection by culture when indicated must remain a priority.
- Azithromycin resistance affects particularly, but not exclusively, people reporting a history of sexually transmitted and blood-borne infections (STBBIs) and men who have sex with men (MSM).
- High minimum inhibitory concentrations (MICs) for cefixime and ceftriaxone are associated with a high number of sexual partners and being MSM.
- More than 85% of the first-line treatments prescribed by clinicians followed current recommendations.
- An increase in control tests was observed, from 56% in 2015-2017 to 62% in 2018-2019.
- Eighteen treatment failures were documented. Only one case showed resistance to one of the antibiotics used for the treatment. Other potential causes commonly seen include pharyngeal infection as well as suboptimal treatment for that anatomical site.
- The promotion of membership of the person to the treatment, to the respect of the post-treatment abstinence period, to the follow-up appointment for the control test and to the adequate use of the condom is important in reducing the transmission of antibiotic resistant strains.
- THE strains not susceptible to ceftriaxone, in particular, represent a health threat, because ceftriaxone is the last effective treatment option in certain situations such as pelvic inflammatory disease and pharyngeal infection.
The results of the Sentinel Network contribute to the adjustment of the recommendations made at the national level, for the Quebec guide to screening for STBBIs of the MSSS and the guides for optimal use (GUO) or guides to pharmacological treatment of STBBIs of the Institut d’ excellence in health and social services (INESSS).
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