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Sandoval MM, Bardach A, Rojas-Roque C, Alconada T, Gomez JA, Pinto T, Palermo C, Ciapponi A. Antimicrobial resistance of Neisseria gonorrhoeae in Latin American countries: a systematic review. J Antimicrob Chemother 2023; 78:1322-1336. [PMID: 37192385 PMCID: PMC10232280 DOI: 10.1093/jac/dkad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/23/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Detailed information is needed on the dynamic pattern of antimicrobial resistance (AMR) in Neisseria gonorrhoeae in Latin America and the Caribbean (LAC). OBJECTIVES To conduct a systematic review of AMR in N. gonorrhoeae in LAC. METHODS Electronic searches without language restrictions were conducted in PubMed, Embase, Cochrane Library, EconLIT, Cumulative Index of Nursing and Allied Health Literature, Centre for Reviews and Dissemination, and Latin American and Caribbean Literature in Health Sciences. Studies were eligible if published between 1 January 2011 and 13 February 2021, conducted in any LAC country (regardless of age, sex and population) and measured frequency and/or patterns of AMR to any antimicrobial in N. gonorrhoeae. The WHO Global Gonococcal Antimicrobial Surveillance Programme (WHO-GASP) for LAC countries and Latin American AMR SurveillanceNetwork databases were searched. AMR study quality was evaluated according to WHO recommendations. RESULTS AMR data for 38, 417 isolates collected in 1990-2018 were included from 31 publications, reporting data from Argentina, Brazil, Colombia, Peru, Uruguay, Venezuela and WHO-GASP. Resistance to extended-spectrum cephalosporins was infrequent (0.09%-8.5%). Resistance to azithromycin was up to 32% in the published studies and up to 61% in WHO-GASP. Resistance to penicillin, tetracycline and ciprofloxacin was high (17.6%-98%, 20.7%-90% and 5.9%-89%, respectively). Resistance to gentamicin was not reported, and resistance to spectinomycin was reported in one study. CONCLUSIONS This review provides data on resistance to azithromycin, potentially important given its use as first-line empirical treatment, and indicates the need for improved surveillance of gonococcal AMR in LAC. Trial registration: Registered in PROSPERO, CRD42021253342.
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Affiliation(s)
| | - Ariel Bardach
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
- Centro de Investigaciones Epidemiológicas y Salud Pública (CIESP-IECS), CONICET, Buenos Aires, Argentina
| | - Carlos Rojas-Roque
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Tomás Alconada
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | | | | | - Carolina Palermo
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Agustin Ciapponi
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
- Centro de Investigaciones Epidemiológicas y Salud Pública (CIESP-IECS), CONICET, Buenos Aires, Argentina
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Lu Z, Tadi DA, Fu J, Azizian K, Kouhsari E. Global status of Azithromycin and Erythromycin Resistance Rates in Neisseria gonorrhoeae: A Systematic Review and Meta-analysis. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2022; 95:465-478. [PMID: 36568835 PMCID: PMC9765340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background: The widespread development of antibiotic resistance or decreased susceptibility in Neisseria gonorrhoeae (NG) infection is a global and significant human public health issue. Objectives: Therefore, this meta-analysis aimed to estimate worldwide resistance rates of NG to the azithromycin and erythromycin according to years, regions, and antimicrobial susceptibility testing (AST). Methods: We systematically searched the published studies in PubMed, Scopus, and Embase from 1988 to 2021. All analyses were conducted using Stata software. Results: The 134 reports included in the meta-analysis were performed in 51 countries and examined 165,172 NG isolates. Most of the included studies were from Asia (50 studies) and Europe (46 studies). In the metadata, the global prevalence over the past 30 years were 6% for azithromycin and 48% for erythromycin. There was substantial change in the prevalence of macrolides NG resistance over time (P <0.01). In this metadata, among 58 countries reporting resistance data for azithromycin, 17 (29.3%) countries reported that >5% of specimens had azithromycin resistance. Conclusions: The implications of this study emphasize the rigorous or improved antimicrobial stewardship, early diagnosis, contact tracing, and enhanced intensive global surveillance system are crucial for control of further spreading of gonococcal emergence of antimicrobial resistance (AMR).
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Affiliation(s)
- Zhiwei Lu
- Graduate School, Zhejiang Chinese Medical University,
Hangzhou, Zhejiang, China,Hangzhou Heyunjia Hospital, Hangzhou, Zhejiang,
China
| | - Danyal Abbasi Tadi
- Department of Veterinary, Azad University of Shahr-e
Kord, Shahr-e Kord, Iran
| | - Jinchao Fu
- Department of General Practice, Shulan (Hangzhou)
Hospital Affiliated to Zhejiang Shuren University Shulan International Medical
College, Hangzhou, Zhejiang, China,To whom all correspondence should be addressed:
Jinchao Fu, ; Ebrahim Kouhsari,
; ORCID:
https://www.orcid.org/0000-0001-5893-6483
| | - Khalil Azizian
- Department of Microbiology, Faculty of Medicine,
Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ebrahim Kouhsari
- Laboratory Sciences Research Center, Golestan
University of Medical Sciences, Gorgan, Iran,Department of Laboratory Sciences, Faculty of
Paramedicine, Golestan University of Medical Sciences, Gorgan, Iran,To whom all correspondence should be addressed:
Jinchao Fu, ; Ebrahim Kouhsari,
; ORCID:
https://www.orcid.org/0000-0001-5893-6483
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Martins RA, Cassu-Corsi D, Nodari CS, Cayô R, Natsumeda L, Streling AP, Doi AM, da Silva RJC, Bocalon RAL, Gales AC, Pignatari ACC. Temporal evolution of antimicrobial resistance among Neisseria gonorrhoeae clinical isolates in the most populated South American Metropolitan Region. Mem Inst Oswaldo Cruz 2019; 114:e190079. [PMID: 31411309 PMCID: PMC6690644 DOI: 10.1590/0074-02760190079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 07/17/2019] [Indexed: 11/21/2022] Open
Abstract
A total of 124 Neisseria gonorrhoeae isolates recovered during a
12-year period (2003-2015) from outpatients assisted at Centro de Referência e
Treinamento DST/AIDS-CRT of São Paulo city, Brazil, were analysed. The following
resistance rates were observed: penicillin-59.6%, ciprofloxacin-15.3%, and
azithromycin-6.7%. Although reduced susceptibility to these drugs was observed
since 2003, no ceftriaxone-resistant isolates were detected. Ciprofloxacin- and
azithromycin non-susceptible isolates were grouped in 11 clusters. Mutations
were detected in GyrA and ParC of isolates 124 and 260, and a C2611T
substitution on 23S rRNA alleles was also observed in isolate 260. Both isolates
belonged to ST1901/ST6210 (MSLT/NG-MAST schemes).
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Affiliation(s)
- Rafael Affini Martins
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório ALERTA, São Paulo, SP, Brasil
| | - Dandara Cassu-Corsi
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório ALERTA, São Paulo, SP, Brasil
| | - Carolina Silva Nodari
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório ALERTA, São Paulo, SP, Brasil
| | - Rodrigo Cayô
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório ALERTA, São Paulo, SP, Brasil.,Universidade Federal de São Paulo, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Departamento de Ciências Biológicas, Laboratório de Bacteriologia e Imunologia, Diadema, SP, Brasil
| | - Larissa Natsumeda
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório ALERTA, São Paulo, SP, Brasil
| | - Ana Paula Streling
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório ALERTA, São Paulo, SP, Brasil
| | - André Mario Doi
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório Especial de Microbiologia Clínica, São Paulo, SP, Brasil
| | | | | | - Ana Cristina Gales
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório ALERTA, São Paulo, SP, Brasil.,Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório Especial de Microbiologia Clínica, São Paulo, SP, Brasil
| | - Antonio Carlos Campos Pignatari
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório ALERTA, São Paulo, SP, Brasil.,Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório Especial de Microbiologia Clínica, São Paulo, SP, Brasil
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