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JAC Advance Access published online on July 1, 2006
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkl265
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Received April 5, 2006
Revised May 31, 2006
Accepted June 1, 2006

Original article

European Surveillance of Sexually Transmitted Infections (ESSTI): the first combined antimicrobial susceptibility data for Neisseria gonorrhoeae in Western Europe

I. M. C. Martin 1 *, S. Hoffmann 2, and C. A. Ison 1, on behalf of the European Surveillance of Sexually Transmitted Infections (ESSTI) Network {dagger}

1 Sexually Transmitted Bacteria Reference Laboratory, Health Protection Agency Centre for Infections, 61 Colindale Avenue, London, UK
2 Neisseria and Streptococcus Reference Laboratory, Statens Serum Institut, Copenhagen, Denmark

* To whom correspondence should be addressed.
I. M. C. Martin, E-mail: iona.martin{at}hpa.org.uk


  Abstract

Objectives: To conduct a sentinel surveillance study for antimicrobial resistance in Neisseria gonorrhoeae in Western Europe in 2004 as part of the European Surveillance of Sexually Transmitted Infections (ESSTI) Programme.

Methods: Gonococcal isolates were collected from centres in 12 countries and transferred to two reference centres for testing. The same methodology of agar dilution was used to determine susceptibility to a range of antimicrobials used for the treatment of gonorrhoea including azithromycin, ceftriaxone, ciprofloxacin, penicillin and tetracycline. Quality control between the two laboratories was assessed during the testing.

Results: A total of 1055 gonococcal isolates were collected, of which 965 (91.5%) were retrievable for susceptibility testing. Resistance was found to be high to ciprofloxacin (30.9%), but also present to penicillin (21.3%) and tetracycline (59.8%). Azithromycin resistance was above 5%, the first time this has been documented in Europe. Three isolates had a low level of resistance to ceftriaxone. With regard to quality control between the two reference laboratories, 92% of MIC results were within two dilutions.

Conclusions: These are the first sentinel surveillance data for Western Europe for N. gonorrhoeae and they have implications for choice of antimicrobial for treatment of gonorrhoea on a European and a local level. This is the start of the formation of a European gonococcal antimicrobial surveillance programme (EURO-GASP).

Keywords: GASP; gonococci; antimicrobial resistance; antimicrobial surveillance; ciprofloxacin.
{dagger}Members are listed in the Acknowledgements section.
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