Trends in Antimicrobial Resistance Patterns in Neisseria Gonorrhoeae in Australia and New Zealand: A Meta-analysis and Systematic Review

Abstract

1) Background: The widespread development of resistance among Neisseria gonorrhoeae (NG) clinical isolates has been reported by surveillance systems around the world. This meta-analysis estimated the changes in susceptibility patterns among antibiotics under surveillance in Australia and New Zealand. (2) Methods: Articles published in English from 1980-2018, from Australia or New Zealand, that met the selection criteria were included. The meta-analysis was carried out using the R statistical software. (3) Results: In Australia, there has been decreasing susceptibility of gonococcal isolates to selected antimicrobials over time. Azithromycin (Odds Ratio (OR): 0.73; 95% Confidence Interval (CI) 0.64-0.82) and ceftriaxone (OR: 0.69; 95% CI 0.59-0.80) showed decreasing levels of susceptibility each year. Western Australia (OR: 0.76; 95% CI 0.60-0.96) and Victoria (OR: 0.74; 95% CI 0.60-0.90) also had decreasing levels of susceptibility to ceftriaxone over time compared with other states and territories. (4) Conclusions: The results highlight the need for the development of new approaches for managing cases of gonorrhoea. Improved antimicrobial stewardship, enhanced surveillance and contact tracing are needed to identify and respond to changes in antibiotic resistance in a timely manner. Increasing awareness and public health follow-up of cases can help to interrupt the cycle of infection and limit transmission.

Antibacterial Activity of Propolis Extracts from the Central Region of Romania against Neisseria gonorrhoeae

“…The continually increasing resistance to ciprofloxacin, a drug not used in the routine treatment of gonococcal infections, highlights the ongoing selective pressure generated by the use of antibiotics. There is an urgent need for new approaches, including collaborative efforts to determine how culture-based tests and NAAT may be combined or complemented to strengthen antimicrobial resistance surveillance [41].…”

“…According to the Centers for Disease Control and Prevention (CDC) and to the Clinical and Laboratory Standards Institute (CLSI) on interpretive criteria for NG susceptibility testing [41], NG strains can be considered sensitive to ciprofloxacin if the diameter of the inhibition zone is at least 41 mm and resistant if it is less than 27 mm, with the strains being considered intermediate resistant between the two limits. Of the strains we isolated, one (NGI) was sensitive to ciprofloxacin, the diameter of the inhibition zone being 41 mm; another one (NGII) was intermediate-resistant, while the NGIII strain, with a diameter of 20 mm, can be considered resistant to ciprofloxacin.…”

Antimicrobial resistance of Neisseria gonorrhoeae in Latin American countries: a systematic review

“…The quality of AMR studies was evaluated according to WHO recommendations. 39 , 40 Studies were scored on whether they specified the location at which the isolates were collected and the collection period, described the method of identifying the isolates and the population from which the isolates were obtained, included at least 100 tested isolates, utilized or implied utilization of control strains recommended by WHO to identify MIC, and described the method for determining the antimicrobial susceptibility of isolates or the MIC values for susceptibility, reduced susceptibility and resistance isolates.…”

Comprehensive observational study evaluating the enduring effectiveness of 4CMenB, the meningococcal B vaccine against gonococcal infections in the Northern Territory and South Australia, Australia: study protocol

“…The effectiveness of antibiotics against Neisseria gonorrhoeae has been compromised due to accelerating antibiotic resistance. A systematic review reveals a progressive decline in the susceptibility of gonococcal isolates to azithromycin and ceftriaxone over time 6. Moreover, the development of an effective gonococcal vaccine has been challenging 7.…”