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Gonococcal resistance can be viewed productively as part of a syndemic of antimicrobial resistance: an ecological analysis of 30 European countries.
Antimicrob Resist Infect Control. 2020 Jun 30; 9(1):97.AR

Abstract

BACKGROUND

It is unclear how important bystander selection is in the genesis of antimicrobial resistance (AMR) in Neisseria gonorrhoeae.

METHODS

We assessed bystander selection in a novel way. Mixed-effects linear regression was used to assess if country-level prevalence of gonococcal AMR in 30 European countries predicts homologous AMR in other bacteria. The data used was from the European Antimicrobial Resistance Surveillance Network.

RESULTS

The prevalence of gonococcal ciprofloxacin resistance was found to be positively associated with AMR prevalence in E. coli (coef. 0.52; P = 0.007), Acinetobacter spp. (coef. 0.13; P = 0.044) and Pseudomonas aeruginosa (coef. 0.36; P = 0.020) but not Klebsiella pneumoniae. Azithromycin resistance in N. gonorrhoeae was positively associated with macrolide resistance in Streptococcus pneumoniae (coef. 0.01; P = 0.018). No association was found for cephalosporins.

CONCLUSIONS

Gonococcal AMR is linked to that in other bacteria. This finding is likely explained by high antimicrobial consumption in affected populations and provides additional motivation for strengthening antimicrobial stewardship programs.

Authors+Show Affiliations

HIV/STI Unit, Institute of Tropical Medicine, 2000, Antwerp, Belgium. ckenyon@itg.be. Division of Infectious Diseases and HIV Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, 7700, South Africa. ckenyon@itg.be.HIV/STI Unit, Institute of Tropical Medicine, 2000, Antwerp, Belgium.HIV/STI Unit, Institute of Tropical Medicine, 2000, Antwerp, Belgium.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32605597

Citation

Kenyon, Chris, et al. "Gonococcal Resistance Can Be Viewed Productively as Part of a Syndemic of Antimicrobial Resistance: an Ecological Analysis of 30 European Countries." Antimicrobial Resistance and Infection Control, vol. 9, no. 1, 2020, p. 97.
Kenyon C, Manoharan-Basil SS, Van Dijck C. Gonococcal resistance can be viewed productively as part of a syndemic of antimicrobial resistance: an ecological analysis of 30 European countries. Antimicrob Resist Infect Control. 2020;9(1):97.
Kenyon, C., Manoharan-Basil, S. S., & Van Dijck, C. (2020). Gonococcal resistance can be viewed productively as part of a syndemic of antimicrobial resistance: an ecological analysis of 30 European countries. Antimicrobial Resistance and Infection Control, 9(1), 97. https://doi.org/10.1186/s13756-020-00764-z
Kenyon C, Manoharan-Basil SS, Van Dijck C. Gonococcal Resistance Can Be Viewed Productively as Part of a Syndemic of Antimicrobial Resistance: an Ecological Analysis of 30 European Countries. Antimicrob Resist Infect Control. 2020 Jun 30;9(1):97. PubMed PMID: 32605597.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gonococcal resistance can be viewed productively as part of a syndemic of antimicrobial resistance: an ecological analysis of 30 European countries. AU - Kenyon,Chris, AU - Manoharan-Basil,Sheeba S, AU - Van Dijck,Christophe, Y1 - 2020/06/30/ PY - 2020/03/04/received PY - 2020/06/23/accepted PY - 2020/7/2/entrez PY - 2020/7/2/pubmed PY - 2020/7/2/medline KW - Antibiotic consumption KW - Antimicrobial resistance KW - Bystander selection KW - Fluoroquinolones KW - Gonorrhoea KW - Macrolides KW - Neisseria gonorrhoeae KW - Stewardship SP - 97 EP - 97 JF - Antimicrobial resistance and infection control JO - Antimicrob Resist Infect Control VL - 9 IS - 1 N2 - BACKGROUND: It is unclear how important bystander selection is in the genesis of antimicrobial resistance (AMR) in Neisseria gonorrhoeae. METHODS: We assessed bystander selection in a novel way. Mixed-effects linear regression was used to assess if country-level prevalence of gonococcal AMR in 30 European countries predicts homologous AMR in other bacteria. The data used was from the European Antimicrobial Resistance Surveillance Network. RESULTS: The prevalence of gonococcal ciprofloxacin resistance was found to be positively associated with AMR prevalence in E. coli (coef. 0.52; P = 0.007), Acinetobacter spp. (coef. 0.13; P = 0.044) and Pseudomonas aeruginosa (coef. 0.36; P = 0.020) but not Klebsiella pneumoniae. Azithromycin resistance in N. gonorrhoeae was positively associated with macrolide resistance in Streptococcus pneumoniae (coef. 0.01; P = 0.018). No association was found for cephalosporins. CONCLUSIONS: Gonococcal AMR is linked to that in other bacteria. This finding is likely explained by high antimicrobial consumption in affected populations and provides additional motivation for strengthening antimicrobial stewardship programs. SN - 2047-2994 UR - https://www.unboundmedicine.com/medline/citation/32605597/Gonococcal_resistance_can_be_viewed_productively_as_part_of_a_syndemic_of_antimicrobial_resistance:_an_ecological_analysis_of_30_European_countries L2 - https://aricjournal.biomedcentral.com/articles/10.1186/s13756-020-00764-z DB - PRIME DP - Unbound Medicine ER -
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