I Putu Yuda Hananta1, Alje P van Dam, Sylvia Maria Bruisten, Maarten Franciscus Schim van der Loeff, Hardyanto Soebono, Henry John Christiaan de Vries. 1. From the *Department of Dermatology and Venereology, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia; †Department of Dermatology, Academic Medical Center, University of Amsterdam; ‡Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam; §Center for Infections and Immunology Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam; and ¶Onze Lieve Vrouwe Gasthuis (OLVG) Hospital, Amsterdam, the Netherlands.
Abstract
BACKGROUND: Little is known about the epidemiology of asymptomatic urogenital gonorrhea and antimicrobial susceptibility of Neisseria gonorrhoeae (NG) strains circulating in Indonesia. We studied these issues in 3 large Indonesian cities. METHODS: In 2014, participants were recruited from sexually transmitted infection clinics and through outreach in Jakarta, Yogyakarta, and Denpasar. Neisseria gonorrhoeae detection in genital specimens was performed with NG-qPCR at the Public Health Service in Amsterdam. Antimicrobial susceptibility was investigated using the Etest. RESULTS: Among 992 participants, 781 were asymptomatic and included in the risk factors analysis: 439 (56.2%) men, 258 (33.0%) women, and 84 (10.8%) transwomen. They differed significantly in age and were mostly men who have sex with men (35.2%) and female sex workers (29.3%).Overall, 175 (22.4%) asymptomatic participants had a positive NG-qPCR result. Factors positively associated with asymptomatic urogenital gonorrhea were being recruited through outreach (vs clinic-based), inconsistent condom use, and being divorced/widowed (vs single).Among 79 urogenital cultured isolates derived from 27 symptomatic and 52 asymptomatic participants, all isolates were susceptible to ceftriaxone and cefixime, and 98.7% of isolates were susceptible to azithromycin. In contrast, resistance to doxycycline (98.7%) and ciprofloxacin (97.4%) was common. CONCLUSIONS: Prevalence of asymptomatic urogenital gonorrhea among Indonesian key populations is very high. Little to no resistance against extended spectrum cephalosporins and azithromycin was observed. However, almost all isolates were resistant to doxycycline and ciprofloxacin. Strengthening outreach sexually transmitted infections services, composing guidelines to screen asymptomatic individuals, and implementing periodical antimicrobial resistance surveillance are recommended.
BACKGROUND: Little is known about the epidemiology of asymptomatic urogenital gonorrhea and antimicrobial susceptibility of Neisseria gonorrhoeae (NG) strains circulating in Indonesia. We studied these issues in 3 large Indonesian cities. METHODS: In 2014, participants were recruited from sexually transmitted infection clinics and through outreach in Jakarta, Yogyakarta, and Denpasar. Neisseria gonorrhoeae detection in genital specimens was performed with NG-qPCR at the Public Health Service in Amsterdam. Antimicrobial susceptibility was investigated using the Etest. RESULTS: Among 992 participants, 781 were asymptomatic and included in the risk factors analysis: 439 (56.2%) men, 258 (33.0%) women, and 84 (10.8%) transwomen. They differed significantly in age and were mostly men who have sex with men (35.2%) and female sex workers (29.3%).Overall, 175 (22.4%) asymptomatic participants had a positive NG-qPCR result. Factors positively associated with asymptomatic urogenital gonorrhea were being recruited through outreach (vs clinic-based), inconsistent condom use, and being divorced/widowed (vs single).Among 79 urogenital cultured isolates derived from 27 symptomatic and 52 asymptomatic participants, all isolates were susceptible to ceftriaxone and cefixime, and 98.7% of isolates were susceptible to azithromycin. In contrast, resistance to doxycycline (98.7%) and ciprofloxacin (97.4%) was common. CONCLUSIONS: Prevalence of asymptomatic urogenital gonorrhea among Indonesian key populations is very high. Little to no resistance against extended spectrum cephalosporins and azithromycin was observed. However, almost all isolates were resistant to doxycycline and ciprofloxacin. Strengthening outreach sexually transmitted infections services, composing guidelines to screen asymptomatic individuals, and implementing periodical antimicrobial resistance surveillance are recommended.
Authors: Liang-Chun Wang; Jacob Wagner; Annabelle Capino; Elizabeth Nesbit; Wenxia Song; Daniel C Stein Journal: J Vis Exp Date: 2019-02-08 Impact factor: 1.355
Authors: I Putu Yuda Hananta; Alje P van Dam; Sylvia Maria Bruisten; Maarten Franciscus Schim van der Loeff; Hardyanto Soebono; Henry John Christiaan de Vries Journal: BMJ Open Date: 2017-08-11 Impact factor: 2.692
Authors: I Putu Yuda Hananta; Alje Pieter van Dam; Maarten Franciscus Schim van der Loeff; Mirjam Dierdorp; Carolien Marleen Wind; Hardyanto Soebono; Henry John Christiaan de Vries; Sylvia Maria Bruisten Journal: BMC Infect Dis Date: 2018-01-05 Impact factor: 3.090
Authors: C R Robert George; Rodney P Enriquez; Barrie J Gatus; David M Whiley; Ying-Ru Lo; Naoko Ishikawa; Teodora Wi; Monica M Lahra Journal: PLoS One Date: 2019-04-03 Impact factor: 3.240