(IUSTI-Europe Congress 2023)
Mag. Dr. Ursula Fürnkranz, Mag.rer.nat. Maria Haller, Bsc Katharina Schwarz, MD Claudia Heller-Vitouch, MD Gudrun Heidler, MD Tamara Gagic, Angelika Stary
Gonococcal strains resistant to recommended antibiotics are an increasing global problem. In the current study we monitored the drug susceptibilities of Neisseria gonorrhoeae to ceftriaxone, cefixime, azithromycin, benzylpenicillin, tetracycline and ciprofloxacin as well as co-infections with other sexually transmitted diseases from 2015 to 2022.
Methods
Resistance of gonococcal isolates collected from cervix, urethra, pharynx, and rectum were tested using the Etest®; minimal inhibitory concentrations (MICs) were interpreted according to the EUCAST guidelines. Co-infections were documented as they were detected using the appropriate diagnostic methods.
Results
2848 isolates of N. gonorrhoeae (2500 from men, 348 from women; 41 pharyngeal, 149 rectal, 2658 genital isolates, respectively) were investigated. No ceftriaxone resistant isolate was detected. Cefixime resistance peaked in 2016/2017 (12%) and declined afterwards with zero resistant isolates in 2020, but rising again thereafter. Resistance to azithromycin increased from 1% in 2015 to 15% in 2022. Less than 1% of the isolates showed concurrent resistances to cefixime and azithromycin.
Isolates susceptible to all included drugs decreased from 29% in 2015 to 0.03% in 2022. Most frequently observed co-infections were Chlamydia trachomatis (14%) and Mycoplasma genitalium (3.1%).
Conclusion
A high fluctuation in resistance rates to the azithromycin and cefixime was observed, especially during the first two years of the COVID-19 pandemic (2020 and 2021). C. trachomatis was the most frequent co-infection.
