WHO global gonococcal antimicrobial surveillance programmes, 2019–22: a retrospective observational study

作者：Magnus Unemo, Monica M Lahra, Michelle Cole, Daniel Marcano, Susanne Jacobsson, Patricia Galarza, Irene Martín, Kristen Kreisel, Marcelo Galas, Silvia Bertagnolio, Pilar Ramón-Pardo, Ismaël Maatouk, Teodora Wi · 发表于：The Lancet Microbe · 年份：2025 · DOI：10.1016/j.lanmic.2025.101181 · 被引用次数：27 · 研究领域：Reproductive tract infections research、Bacterial Identification and Susceptibility Testing、Neonatal and Maternal Infections

BACKGROUND: Gonorrhoea and gonococcal antimicrobial resistance (AMR) remain global public health concerns, and enhanced quality-assured global surveillance of gonococcal AMR is imperative to inform management guidelines and public health policies. We aimed to describe the results of surveillance of gonococcal AMR conducted globally by WHO and discuss the actions needed to retain our ability to treat gonorrhoea. METHODS: In this retrospective observational study, we present gonococcal AMR data reported to WHO by 77 countries between Jan 1, 2019, and Dec 31, 2022. Gonococcal isolates were tested for minimum inhibitory concentrations of one to four key antimicrobials (ceftriaxone, cefixime, azithromycin, and ciprofloxacin) in each country. We used breakpoints for resistance and decreased susceptibility to antimicrobials from the European Committee on Antimicrobial Susceptibility Testing or Clinical Laboratory and Standards Institute. FINDINGS: 29 (39%) of 75 participating countries reported at least one isolate with resistance or decreased susceptibility to ceftriaxone, 28 (50%) of 56 reported resistance or decreased susceptibility to cefixime, 58 (88%) of 66 reported resistance to azithromycin, and 74 (99%) of 75 reported resistance to ciprofloxacin. Globally, azithromycin resistance is increasing, as is resistance or decreased susceptibility to ceftriaxone and cefixime, especially in the WHO Western Pacific region. Resistance to ciprofloxacin remained very high globally. Since...