Antimicrobial resistance in Neisseria gonorrhoeae isolates from foreign-born population in the European Gonococcal Antimicrobial Surveillance Programme
Hernando Rovirola, Cristina (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Spiteri, Gianfranco (European Centre for Disease Prevention and Control)
Sabidó Espin, Meritxell (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Montoliu, Alexandra (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Gonzalez Soler, Victoria (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Casabona-Barbarà, Jordi (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Cole, Michelle Jayne (Public Health England)
Noori, Teymur (European Centre for Disease Prevention and Control)
Unemo, Magnus (Örebro University)

Date:	2020
Abstract:	International 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. We analysed isolates and patient data reported to the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) 2010-2014 (n=9529). Forty-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). Importation 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.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Gonorrhoea ; Treatment ; Ceftriaxone ; Antimicrobial resistance ; Surveillance ; Euro-GASP ; Europe ; Migrants
Published in:	Sexually Transmitted Infections, Vol. 96 (february 2020) , p. 204-210, ISSN 1472-3263

DOI: 10.1136/sextrans-2018-053912
PMID: 32019895

7 p, 291.0 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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