ObjectivesInternational spread has contributed substantially to the high prevalence of antimicrobial resistant (AMR) Neisseria gonorrhoeae infections worldwide. We compared the prevalence of AMR gonococcal isolates among native persons to foreign-born (reporting country different from country of birth) persons, and describe the epidemiological and clinical characteristics of foreign-born patients and their associations to AMR.MethodsWe analysed isolates and patient data reported to the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) 2010–2014 (n=9529).ResultsForty-three per cent of isolates had known country of birth and 17.2% of these were from persons born abroad. Almost 50% of foreign-born were from the WHO European Region (13.1% from non-European Union [EU] and the European Economic Area [EEA] countries). Compared with isolates from natives, isolates from foreign-born had a similar level (p>0.05) of azithromycin resistance (7.5% vs 7.2%), ciprofloxacin resistance (50.0% vs 46.3%) and of decreased susceptibility to ceftriaxone (1.9% vs 2.8%); a lower rate of cefixime resistance (5.7% vs 3.6%, p=0.02), and a higher proportion of isolates producing penicillinase (8.4% vs 11.7%, p=0.02). Among isolates from persons born outside EU/EEA, the level of decreased susceptibility to ceftriaxone was higher (1.8% vs 3.5%, p=0.02), particularly in those from the WHO Eastern Mediterranean Region and non-EU/EEA WHO European countries (1.9% vs 9.6% and 8.7%, respectively, p<0.01). In multivariable analysis, foreign-born patients with AMR isolates were more likely to be from non-EU/EEA WHO European countries (adjusted OR [aOR]: 3.2, 95% CI 1.8 to 5.8), WHO Eastern Mediterranean countries (aOR: 1.8, 95% CI 1.1 to 3.3) and heterosexual males (aOR: 1.8, 95% CI 1.2 to 2.7).ConclusionsImportation of AMR strains remains an important threat in the EU/EEA. Research to improve understanding of sexual networks within foreign born and sexual tourism populations could help to inform effective tailor-made interventions. The Euro-GASP demonstrates the public health value of quality-assured surveillance of gonococcal AMR and the need for strengthened AMR surveillance, particularly in the non-EU/EEA WHO European Region.

RESUMENFundamentos: Los flujos migratorios tienen la capacidad de dispersar agentes infecciosos y alterar las epidemiologías locales. El objetivo del estudio es describir las características socio-epidemiológicas, clínicas y de microbiología/epidemiología molecular de la infección VIH/Sida en la población inmigrada.. Métodos:Revisión de la literatura científica mediante la metodología de Scoping Review. Se realizó una búsqueda bibliográfica en las bases de datos Medline y MEDES. Se seleccionaron artículos originales realizados en España y publicados entre 1998-2012, en los que participara población procedente de América Latina, África subsahariana, Norte de África, Asia y Europa del Este.Resultados: Se seleccionaron 41 artículos. La población más estudiada fue la de América Latina (48,8%). Se observaron prevalencias mayores de VIH que en autóctonos en los hombres que tienen sexo con hombresde América Latina (18,1%), travestis y transexuales trabajadores del sexo de América Latina (23,3%), mujeres gestantes (0,9%) y hombres y mujeres de África Subsahariana (9,1% y 7,5%). Las conductas de riesgo fueron diferentes en función del país de origen y del sexo. El retraso diagnóstico llegó al 43% de las infecciones VIH, hallándose mayor prevalencia en inmigrantes de África subsahariana, que mostraron retraso diagnóstico en el 41% y resistencias al tratamiento anti-retroviral en el 13%. Las mujeres inmigrantes presentaron más pérdidas de seguimiento, peor respuesta inmunológica al TARV y menor tiempo de fracaso terapéutico.Conclusiones: La mayor prevalencia de VIH la presentan los sujetos procedentes de África subsahariana y los hombres que tienen sexo con hombres y travestis y transexuales trabajadores del sexo de América Latina. También las mujeres gestantes. El retraso diagnóstico y las resistencias al tratamiento son más frecuentes en sujetos de África Subsahariana. Las mujeres inmigrantes respondieron peor al tratamiento antiretroviral. Background: Migration flows have the ability to disperse infectious agents and alter local epidemiologies. The aim of the study is to describe the socio-epidemiological, clinical and microbiology / molecular epidemiology of HIV / AIDS infection in the immigrant population.

Interacting frequently with the community, using different recruitment strategies simultaneously, incorporating researchers from the same geographical origin as participants, minimising language barriers and offering flexibility in conducting data collection facilitated the participation of the migrant families. The Chinese families presented greater difficulties. The study findings will facilitate the implementation of future cohort studies with similar characteristics.