Antimicrobial-Resistant Neisseria gonorrhoeae Infections in Men Using Doxycycline Postexposure Prophylaxis: A Substudy of the ANRS 174 DOXYVAC Trial

作者：Béatrice Berçot, Lambert Assoumou, François Caméléna, Chloé Voitichouk, Manel Mérimèche, Moussa Ouattara, Geoffroy Liégeon, A. Kaba, Victoria Manda, Mary Mainardis, Aymeric Braille, Gilles Pialoux, Christine Katlama, Laure Surgers, Laurence Slama, Cécile Bébéar, Manon Ollivier, Jade Ghosn, Dominique Costagliola, Jean‐Michel Molina, the ANRS 174 DOXYVAC Study Group, E Rubenstein, I Bichard, A Aslan, C Pintado, B Loze, C Delaugerre, D Ponscarme, L Niedbalski, E Dalle, G Liegeon, V Manda, J M Molina, J Chas, M Siguier, C Palacios, S Mebarki, S Ould Younes, G Pialoux, R Palich, L Schneider, A Chermak, N Ktorza, S Seang, M A Valantin, T Orrière, B Sellem, N Qatib, N Hamani, C Katlama, Y Yazdanpanah, A Bachelard, B Phung, C Rioux, C Proux, O Da Conceicao, D Larkeche, Y Bouaraba, A N’diaye, S Le Gac, A Deprez, J Ghosn, K Lacombe, T Chiabarini, R Feliho, L Surgers, L Slama, M Kalambay, S Bouain, J P Viard, J Lourenco, C Lousin, C Duvivier, A Rachline, P Otmesguine, P Buisson, M L Lucas, M Ptack, J Pavie, S Landowski, P De Truchis, R Mahrez, M Diemer, L Azemar, C Boucheraine, M Resche-Rigon, L Cotte, O Chosidow, H Pollard, C Alauzet, J M Molina, D Costagliola, J Ghosn, L Assoumou, M Algarté-Génin, C Delaugerre, D Rojas-Castro, B Berçot, C Bébéar, O Peuchant, L Goldwirt, M Olivier, V Petrov-Sanchez, S Gibowski, A Diallo, S Le Mestre, M Ben Mechlia, D Rojas Castro, M Taha, N Dupin, L Surgers, C Pintado, J Zeggagh, S Fouéré, F Eberlé, L Assoumou, M Algarté-Génin, S Rodrigues, Y Tobbal, A Kaba, A Paucard, C Averlant, I Maraghni, M Vilmin, N Boumghar, W Salah, B Berçot, F Caméléna, J Brousseau, C Voitichouk, A Braille, M Mainardis, F Meunier, M Mérimèche, M Garros, C Moreau, P Fernandes, C Sevin, P Lawson-Body, M Mathar, S Gilot, C Bébéar, O Peuchant, J Guiraud, C Balcon, A Touati, P Grange, N Dupin · 发表于：Clinical Infectious Diseases · 年份：2025 · DOI：10.1093/cid/ciaf591 · 被引用次数：10 · 研究领域：Reproductive tract infections research、Bacterial Infections and Vaccines、Neonatal and Maternal Infections

BACKGROUND: Prevention of bacterial sexually transmitted infections prevention by doxycycline postexposure prophylaxis (DoxyPEP) in men who have sex with men has raised concerns about antimicrobial resistance (AMR). We studied the impact of DoxyPEP on Neisseria gonorrhoeae (gonococcus [GC]) AMR in the ANRS 174 DOXYVAC trial. METHODS: Men who have sex with men and were on human immunodeficiency virus preexposure prophylaxis randomized to DoxyPEP (n = 362) or no-postexposure prophylaxis (PEP) (n = 183) arms were tested for GC at baseline and every 3 months thereafter, by culture and nucleic acid amplification test (NAAT). Minimum inhibitory concentrations (MICs) were determined with Etest (bioMérieux) and interpreted according to European Committee on Antimicrobial Susceptibility Testing guidelines. We performed whole-genome sequencing and/or polymerase chain reaction sequencing on GC isolates and NAAT-positive samples, using Fisher exact tests for comparisons. RESULTS: From January 2021 to February 2023, MICs were determined for 78 GC isolates, and 233 NAAT-only GC-positive samples were analyzed to identify the molecular determinants of resistance. All GC isolates were resistant to tetracycline with a significant increase in the rate of high-level tetracycline resistance mediated by the tetM gene in the DoxyPEP arm compared with the no-PEP arm (35.5 vs 12.5%, respectively; P = .043). The MICs of ceftriaxone, fluoroquinolones, and azithromycin were similarly distributed in the ...