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Antimicrobial susceptibility in Neisseria gonorrhoeae isolates from five sentinel surveillance sites in Zimbabwe, 2015-2016
Public Health Consultant, Brisbane, Australia.
Department of Medical Laboratory Sciences, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
STI, HIV/AIDS and TB Programmes, Ministry of Health and Child Care, Harare, Zimbabwe.
STI, HIV/AIDS and TB Programmes, Ministry of Health and Child Care, Harare, Zimbabwe.
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2018 (English)In: Sexually Transmitted Infections, ISSN 1368-4973, E-ISSN 1472-3263, Vol. 94, no 1, p. 62-66Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Gonorrhoea and antimicrobial resistance (AMR) in Neisseria gonorrhoeae are major public health concerns worldwide. Enhanced AMR surveillance for gonococci is essential globally. In Zimbabwe, very limited gonococcal AMR data were reported. Our aims were to (i) implement quality-assured gonococcal AMR surveillance in Zimbabwe and (ii) investigate gonococcal AMR at five health centres in 2015-2016.

METHODS: Gonococcal isolates from 104 men with urethral discharge were tested for susceptibility to kanamycin, ceftriaxone, cefixime, ciprofloxacin and azithromycin using Etest.

RESULTS: All isolates (102 possible to test) were susceptible to ceftriaxone and cefixime. The level of resistance (intermediate resistance) to kanamycin and ciprofloxacin was 2.0% (2.0%) and 18.6% (27.5%), respectively. The two kanamycin-resistant isolates (R≥128 mg/L) had a kanamycin minimum inhibitory concentration (MIC) of >256 mg/L. The ciprofloxacin resistance ranged from 9.5% to 30.8% in the five sentinel sites. Only 10 (9.6%) of the isolates were tested for susceptibility to azithromycin and 1 (10.0%) was resistant (MIC=4 mg/L).

CONCLUSIONS: The emergence of multidrug-resistant gonorrhoea internationally is a major public health concern and gonococcal AMR surveillance is crucial globally. In Zimbabwe, gonococcal AMR surveillance has now been implemented and quality assured according to WHO standards. The results of this first surveillance will be used to directly inform revisions of the national treatment guidelines. It is imperative to further strengthen the surveillance of gonococcal AMR, and ideally also treatment failures, in Zimbabwe and most countries in the WHO African region, which requires continuous national and international support, including technical support, and political and financial commitment.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018. Vol. 94, no 1, p. 62-66
Keywords [en]
Africa, antimicrobial resistance, gonorrhoea, neisseria gonorrhoea, treatment
National Category
Dermatology and Venereal Diseases Infectious Medicine
Identifiers
URN: urn:nbn:se:oru:diva-60894DOI: 10.1136/sextrans-2016-053090ISI: 000424010500015PubMedID: 28476914OAI: oai:DiVA.org:oru-60894DiVA, id: diva2:1142525
Note

Funding agency:

The Department of Reproductive Health and Research, WHO, Geneva

Available from: 2017-09-19 Created: 2017-09-19 Last updated: 2018-02-16Bibliographically approved

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