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National surveillance of Neisseria gonorrhoeae antimicrobial susceptibility and epidemiological data of gonorrhoea patients across Brazil, 2018–20

2022; Oxford University Press; Volume: 4; Issue: 4 Linguagem: Inglês

10.1093/jacamr/dlac076

2632-1823

Hanalydia de Melo Machado, Jéssica Motta Martins, Marcos André Schörner, Pâmela Cristina Gaspar, Álisson Bigolin, Mauro Cunha Ramos, Willian Antunes Ferreira, Gérson Fernando Mendes Pereira, Angélica Espinosa Miranda, Magnus Unemo, Maria Luíza Bazzo, Simone Veloso Faria de Carvalho, Maria Rita Rabelo Costa, Luciane Guimarães Dias, Elly Rodrigo Porto, Lidiane da Fonseca Andrade, Glaura Regina de Castro e Caldo Lima, Viviane Furlan Lozano, Maria Luíza Bazzo, Felipe de Rocco, Fernando Hartmann Barazzetti, Guilherme Kerber, Hanalydia de Melo Machado, Jéssica Motta Martins, Ketlyn Buss, Mara Cristina Scheffer, Marcos André Schörner, Ronaldo Zonta, Mauro Cunha Ramos, Maria Rita Castilhos Nicola, Maria Cristina Cecconi, Barbara Suely Souza de Noronha, Cleiby Andrade dos Santos, Francinete Motta Lopes, Jairo de Souza Gomes, Jamile Izan Lopes Palhesta Júnior Paulo Tadeu Cavalcante Saif, Willian Antunes Ferreira, Miralba Freire, André Ramos, Felipe Nogueira M. Carvalho, Aida Politano, Roberto José Carvalho da Silva, Sandra de Araújo Claudio Campos do Porto, Roberta Alessandra Lima Bocalon, Ursula de Oliveira Machado de Souza, Rafael Mialski, Keite da Silva Nogueira, Mônica Baumgardt Bay, Manoella do Monte Alves, Juliana Cintra Campos, Luíz Fernando Aires, Larissa de Oliveira Camargo, Lis Aparecida de Souza Neves, Ana Paula Luchetta Paes, Felipe Barufaldi, Henrique Dib Oliveira Reis, Luiz Sérgio D’Oliveira Rocha, Marta Inês Cazentini Ribeiro, Paulo da Silva, Fabiana Amaral, François José de Figueiroa, Anesia Maria Siqueira Barbosa, Ana Albertina de Araújo, Maria Goretti Varejão, Fernanda Garnier de França Mendes, Valdelúcia Oliveira Cavalcanti, Paulo Gabriel Lima Ribeiro, Bruno Ishigami, Lucas Caheté, Cássia Maria Zoccoli,

Adolescent Sexual and Reproductive Health

To (i) describe the nationwide antimicrobial susceptibility of Neisseria gonorrhoeae (NG) isolates cultured across Brazil in 2018-20 and compare it with NG antimicrobial resistance data from 2015-16, and (ii) present epidemiological data of the corresponding gonorrhoea patients in 2018-20.Twelve representative sentinel sites cultured NG isolates from men with urethral discharge. Susceptibility to eight antimicrobials was examined using agar dilution method, according to WHO standards. The consenting participants were invited to provide epidemiological data.In total, 633 NG isolates (one isolate per participant) were analysed, and 449 (70.9%) questionnaires were answered. Heterosexual (68.2%) and homosexual (23.1%) sexual orientations were common, and most prevalent types of unprotected sexual intercourse were vaginal insertive (69.9%), oral giving (56.6%) and anal insertive (47.4%). The levels of in vitro NG resistance to ciprofloxacin, tetracycline, benzylpenicillin, azithromycin, cefixime, gentamicin, spectinomycin and ceftriaxone were 67.3%, 40.0%, 25.7%, 10.6%, 0.3%, 0%, 0% and 0%, respectively. Compliance with the recommended first-line ceftriaxone 500 mg plus azithromycin 1 g therapy was high (90.9%).Compared with 2015-16, ciprofloxacin resistance has remained high and azithromycin and cefixime resistance rates have increased in Brazil. Resistance remained lacking to ceftriaxone, gentamicin and spectinomycin, which all are gonorrhoea treatment options. The increasing azithromycin resistance in Brazil and internationally may threaten the future use of azithromycin in dual regimens for treatment of gonorrhoea. Consequently, continued and enhanced quality-assured surveillance of gonococcal AMR, and ideally also treatment failures and including WGS, is imperative in Brazil and worldwide.