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Establishment of a Gonococcal Antimicrobial Surveillance Programme, in Accordance With World Health Organization Standards, in Côte d'Ivoire, Western Africa, 2014-2017
Département de Bactériologie-Virologie, Institut Pasteur de Côte, République de Côte d'Ivoire; Unité des Agents du Tractus Génital, Centre National de Référence des IST, Abidjan, République Côte d'Ivoire.
Département de Bactériologie-Virologie, Institut Pasteur de Côte, République de Côte d'Ivoire.
Département de Bactériologie-Virologie, Institut Pasteur de Côte, République de Côte d'Ivoire; Unité des Agents du Tractus Génital, Centre National de Référence des IST, Abidjan, République Côte d'Ivoire.
Département de Bactériologie-Virologie, Institut Pasteur de Côte, République de Côte d'Ivoire; Unité des Agents du Tractus Génital, Centre National de Référence des IST, Abidjan, République Côte d'Ivoire.
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2019 (English)In: Sexually Transmitted Diseases, ISSN 0148-5717, E-ISSN 1537-4521, Vol. 46, no 3, p. 179-184Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is compromising the treatment of gonorrhea globally. Recent AMR data are extremely limited in Africa, and mainly totally lacking in Western Africa, including Côte d'Ivoire. This study (i) established a quality-assured gonococcal antimicrobial surveillance program, according to World Health Organization quality criteria, (ii) investigated the AMR to 8 therapeutic antimicrobials in gonococcal isolates from 2014 to 2017, and (iii) provided evidence for updating the National Sexually Transmitted Disease Syndromic Management Guidelines in Côte d'Ivoire.

METHODS: During 2014 to 2017, gonococcal isolates were obtained from sexually active symptomatic or asymptomatic males and females in 14 sites in Côte d'Ivoire. It was a special focus on symptomatic males, and their sexual partners, due to the higher culture positivity rates in symptomatic males. Patient metadata were collected, including age, gender, sexual orientation, and symptoms. Minimum inhibitory concentrations of 8 antimicrobials were determined by Etest and interpreted using European Committee on Antimicrobial Susceptibility Testing breakpoints. β-lactamase production was detected using cefinase disks.

RESULTS: The level of resistance, examining 212 gonococcal isolates, was as follows: 84.9% to tetracycline, 68.9% to benzylpenicillin, 62.7% to ciprofloxacin, 6.1% to azithromycin, and 1.4% to gentamicin. All isolates were susceptible to ceftriaxone, cefixime and spectinomycin.

CONCLUSIONS: We provide the first gonococcal AMR data, quality assured according to World Health Organization standards, from Côte d'Ivoire since more than 20 years. The high ciprofloxacin resistance, which informed a revision of the national syndromic management guideline during study, and relatively high resistance to azithromycin demand an improved gonococcal antimicrobial surveillance program and increased awareness when prescribing treatment in Côte d'Ivoire.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019. Vol. 46, no 3, p. 179-184
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:oru:diva-72899DOI: 10.1097/OLQ.0000000000000943ISI: 000459593600010PubMedID: 30461598Scopus ID: 2-s2.0-85061281997OAI: oai:DiVA.org:oru-72899DiVA, id: diva2:1293206
Note

Funding Agencies:

Institut Pasteur de Cote d'Ivoire, Abidjan, Cote d'Ivoire  

Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland 

Available from: 2019-03-04 Created: 2019-03-04 Last updated: 2019-06-19Bibliographically approved

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