High Prevalence of Azithromycin-Resistant Neisseria gonorrhoeae Isolates With a Multidrug Resistance Phenotype in Fukuoka, Japan

Abstract

Over the previous 4 years, an increasing prevalence of azithromycin-resistant N. gonorrhoeae isolates with a multidrug-resistant phenotype was observed. Furthermore, the azithromycin-resistant isolates seemed to belong to 2 predominant STs. As a result, continued surveillance of gonococci resistant to antimicrobial agents, including azithromycin in Fukuoka, Japan, is necessary.

Evaluation of the Microbiological Efficacy of a Single 2-Gram Dose of Extended-Release Azithromycin by Population Pharmacokinetics and Simulation in Japanese Patients with Gonococcal Urethritis

“…Taken together with the findings described in previous reports (22,23), our results suggest that adequate therapeutic effects cannot be obtained, even upon AZM-SR administration. Although descriptions of the effectiveness of AZM for the treatment of gonococcal urethritis have been added to the guidelines revised in 2016 (4), the decreasing susceptibility of N. gonorrhoeae to AZM has been reported in Japan (22,24). In our current study, the microbiological efficacy of a single 2-g dose of AZM-SR was 83.3%, which was lower than that previously reported (93.8%) (14).…”

Gonococcal infections in Austria: a long‐term observation of prevalence and resistance profiles from 1999 to 2014

“…However, in countries where azithromycin is preferentially used, such as in Latin America and also Europe, the percentage of resistant isolates has rapidly risen . Internationally, azithromycin resistance has been observed to varying degrees, depending on its varying use in the treatment of gonococcal infection . In the present resistance study, the values for azithromycin resistance were very low (between 0 and 0.5 %) in the 15‐year observation period.…”

Conjunctivitis Caused by a Strain of <i>Neisseria gonorrhoeae</i> That Was Less Susceptible to Ceftriaxone

“…Similarly a recent review recommended combined treatment with ceftriaxone and azithromycin or cefixime and azithromycin (13). However, the prevalence of azithromycin-resistant N. gonorrhoeae has been reported to be high in Fukuoka, Japan (14). The report showed that 22.6% of N. gonorrhoeae strains were azithromycin-resistant.…”