Chris Kenyon1,2, Jozefien Buyze3, G Spiteri4, M J Cole5, M Unemo6. 1. HIV/STI Unit. 2. Division of Infectious Diseases and HIV Medicine, University of Cape Town, South Africa. 3. Clinical Trials Unit, Institute of Tropical Medicine, Antwerp, Belgium. 4. European Centre for Disease Prevention and Control, Stockholm. 5. National Infection Service, Public Health England, London, United Kingdom. 6. WHO Collaborating Centre for Gonorrhea and Other Sexually Transmitted Infections, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Abstract
OBJECTIVES: There are substantial variations between different populations in the susceptibility of Neisseria gonorrhoeae to antimicrobials, and the reasons for this are largely unexplored. We aimed to assess whether the population-level consumption of antimicrobials is a contributory factor. METHODS: Using antimicrobial susceptibility data from 24 countries in the European Gonococcal Antimicrobial Surveillance Programme and antimicrobial consumption data from the IQVIA MIDAS database, we built mixed-effects linear/logistic regression models with country-level cephalosporin, fluoroquinolone, and macrolide consumption (standard doses/1000 population/year) as the explanatory variables (from 2009 to 2015) and 1-year-lagged ceftriaxone, cefixime, azithromycin, and ciprofloxacin geometric mean minimum inhibitory concentrations (MICs) as the outcome variables (from 2010 to 2016). RESULTS: Positive correlations were found between the consumption of cephalosporins and the geometric mean MICs of ceftriaxone and cefixime (P < .05 for both comparisons). Fluoroquinolone consumption was positively associated with the prevalence of resistance to ciprofloxacin (P < .05). CONCLUSIONS: Differences in the population-level consumption of particular antimicrobials may contribute to variations in the level of antimicrobial resistance in N. gonorrhoeae in different settings. Further interventions to reduce misuse and overuse of antimicrobials in high-consumption populations and core groups are required.
OBJECTIVES: There are substantial variations between different populations in the susceptibility of Neisseria gonorrhoeae to antimicrobials, and the reasons for this are largely unexplored. We aimed to assess whether the population-level consumption of antimicrobials is a contributory factor. METHODS: Using antimicrobial susceptibility data from 24 countries in the European Gonococcal Antimicrobial Surveillance Programme and antimicrobial consumption data from the IQVIA MIDAS database, we built mixed-effects linear/logistic regression models with country-level cephalosporin, fluoroquinolone, and macrolide consumption (standard doses/1000 population/year) as the explanatory variables (from 2009 to 2015) and 1-year-lagged ceftriaxone, cefixime, azithromycin, and ciprofloxacin geometric mean minimum inhibitory concentrations (MICs) as the outcome variables (from 2010 to 2016). RESULTS: Positive correlations were found between the consumption of cephalosporins and the geometric mean MICs of ceftriaxone and cefixime (P < .05 for both comparisons). Fluoroquinolone consumption was positively associated with the prevalence of resistance to ciprofloxacin (P < .05). CONCLUSIONS: Differences in the population-level consumption of particular antimicrobials may contribute to variations in the level of antimicrobial resistance in N. gonorrhoeae in different settings. Further interventions to reduce misuse and overuse of antimicrobials in high-consumption populations and core groups are required.
Authors: Sami L Gottlieb; Francis Ndowa; Edward W Hook; Carolyn Deal; Laura Bachmann; Laith Abu-Raddad; Xiang-Sheng Chen; Ann Jerse; Nicola Low; Calman A MacLennan; Helen Petousis-Harris; Kate L Seib; Magnus Unemo; Leah Vincent; Birgitte K Giersing Journal: Vaccine Date: 2020-04-28 Impact factor: 3.641
Authors: Tessa de Block; Jolein Gyonne Elise Laumen; Christophe Van Dijck; Said Abdellati; Irith De Baetselier; Sheeba Santhini Manoharan-Basil; Dorien Van den Bossche; Chris Kenyon Journal: Pathogens Date: 2021-03-23