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The European response to control and manage multi- and extensively drug-resistant Neisseria gonorrhoeae
Open accessAbstract
Because cefixime and ceftriaxone resistance in Neisseria gonorrhoeae and gonorrhoea treatment failures were increasing, a response plan to control and manage multidrug-resistant N. gonorrhoeae (MDR-NG) in Europe was published in 2012. The three main areas of the plan were to: (i) strengthen surveillance of antimicrobial resistance (AMR), (ii) implement monitoring of treatment failures and (iii) establish a communication strategy to increase awareness and disseminate AMR results. Since 2012, several additional extensively drug-resistant N. gonorrhoeae (XDR-NG) strains have emerged, and strains with high-level ceftriaxone resistance spread internationally. This prompted an evaluation and review of the 2012 European Centre for Disease Prevention and Control (ECDC) response plan, revealing an overall improvement in many aspects of monitoring AMR in N. gonorrhoeae; however, treatment failure monitoring was a weakness. Accordingly, the plan was updated in 2019 to further support European Union/European Economic Area (EU/EEA) countries in controlling and managing the threat of MDR/XDR-NG in Europe through further strengthening of AMR surveillance and clinical management including treatment failure monitoring. The plan will be assessed biennially to ensure its effectiveness and its value. Along with prevention, diagnostic, treatment and epidemiological surveillance strategies, AMR surveillance is essential for effective control of gonorrhoea.
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Data from systematic reviews of the literature and from the WHO Gonococcal Antimicrobial Surveillance Programme found that ceftriaxone resistance is increasing in most countries, except in Europe, where introducing a ceftriaxone 500 mg dose in 2013 and subsequently increasing to ceftriaxone 1 g was associated with a decrease in reported ceftriaxone resistance.
“Data from systematic reviews of the literature and from the WHO Gonococcal Antimicrobial Surveillance Programme (GASP) found that ceftriaxone resistance is increasing in most countries, except in Europe, where introducing a ceftriaxone 500 mg dose in 2013 and subsequently increasing to ceftriaxone 1 g was associated with a decrease in reported ceftriaxone resistance (6, 9, 12, 32).”
From Updated recommendations for the treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum (syphilis) and new recommendations on syphilis testing and partner services (2024) · cites this paper as [32]
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- Cole, 2019, The European gonococcal antimicrobial surveillance programme (Euro-GASP) appropriately reflects the antimicrobial resistance situation for Neisseria gonorrhoeae in the European Union/European Economic Area., BMC Infect Dis, 19, 1040, 10.1186/s12879-019-4631-x · DOI
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Metadata
- Authors
- Cole, M. J., Day, M., Jacobsson, S., Amato-Gauci, A. J., Spiteri, G., Unemo, M., & T. E. G. R. P. G.
- Affiliations
- UK Health Security Agency (GB)
- Örebro University (SE)
- European Centre for Disease Prevention and Control (SE)
- ORCID
- Unemo, Magnus
- Venue
- Eurosurveillance
- Published
- 2022-05-05
- Volume
- 27
- Issue
- 18
- ISSN
- 1025-496X (ISSN-L)
- 1560-7917
- PMC
- PMC9074391
- OpenAlex
- W4229030692
- Cited by
- 17
- References
- 0
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 6 · 2022: 2
- FWCI
- 2.34
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Eurosurveillance (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, cc-by)
- Funders
- European Centre for Disease Prevention and Control (ECDC/2013/015)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
- Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
- Keywords
- Neisseria gonorrhoeae, antimicrobial resistance surveillance, ceftriaxone resistance, cefixime resistance
- MeSH terms
- Anti-Bacterial Agents, Ceftriaxone, Gonorrhea, Humans, Microbial Sensitivity Tests, Neisseria gonorrhoeae, Drug Resistance, Bacterial
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