Estimating the prevalence of gonococcal resistance to antimicrobials in England and Wales

Abstract

Although over-representing MSM and under-representing women and heterosexual men, GRASP has provided reliable estimates of resistance prevalence in England and Wales. However, weighting for the national distribution of patient characteristics should be considered in future. As resistance usually emerges in MSM, enhanced surveillance of high-risk populations could enable development of more tailored (and therefore optimal) treatment strategies.

Risk Factors of HIV Co-Infection and Sexual Behaviours in Patients with Gonococcal Infection in a STI′s Clinic in Madrid

“…In our study, the most frequent localizations of the gonococcal infection was urethral followed by rectal, oropharyngeal, and cervical; these findings may be influenced by the characteristics of our sample, patients presenting with active symptoms of infection, but are consistent with the results of an investigation conducted in eight western European countries for the detection of antibiotic resistance [21].…”

Frequency and correlates of culture-positive infection withNeisseria gonorrhoeaein England: a review of sentinel surveillance data

“…A previous study11 has shown that, relative to other clinics in England and Wales, GRASP clinics may over-represent MSM, although weighted analyses correcting this bias had minimal impact on estimates of resistance prevalence. Here we show that, within GRASP clinics, patients whose gonococcal isolates are included in GRASP may not be representative of all gonorrhoea cases.…”

Risk Factors for Antimicrobial-Resistant Neisseria gonorrhoeae in Europe

“…26 The differences in the number of countries participating, isolates, and reporting of patient variables suggest that weighting of the data might be needed to provide better estimates of resistance levels. 27 However, the high level of heterogeneity in the European STI surveillance systems, case definitions, 1,25 and laboratory diagnostics, 28 along with the heavy influence of data submitted from the United Kingdom (59% of all EU/EEA gonorrhea cases in 2011), 1 emphasizes that the European STI surveillance system needs to be more complete and comprehensive to underpin weighting for Euro-GASP. A more complete European picture from both surveillance systems would allow us to determine resistance levels across the EU/EEA region more accurately to then inform the European treatment guidelines.…”