Decreased Azithromycin Susceptibility of Neisseria gonorrhoeae Isolates in Patients Recently Treated with Azithromycin

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Carolien M WindHenry J C de Vries

Abstract

Increasing azithromycin usage and resistance in Neisseria gonorrhoeae threatens current dual treatment. Because antimicrobial exposure influences resistance, we analyzed the association between azithromycin exposure and decreased susceptibility of N. gonorrhoeae. We included N. gonorrhoeae isolates of patients who visited the Amsterdam STI Clinic between 1999 and 2013 (t0), with another clinic visit in the previous 60 days (t-1). Exposure was defined as the prescription of azithromycin at t-1. Using multivariable linear regression, we assessed the association between exposure and azithromycin minimum inhibitory concentration (MIC). Whole genome sequencing (WGS) was performed to produce a phylogeny and identify multilocus sequence types (MLST), N. gonorrhoeae multiantigen sequence types (NG-MAST), and molecular markers of azithromycin resistance. We included 323 isolates; 212 were unexposed to azithromycin, 14 were exposed ≤30 days, and 97 were exposed between 31 and 60 days before isolation. Mean azithromycin MIC was 0.28 mg/L (range, <0.016-24 mg/L). Linear regression adjusted for age, ethnicity, infection site, and calendar year showed a significant association between azithromycin exposure ≤30 days and MIC (β, 1.00; 95% conf...Continue Reading

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Citations

Oct 19, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Lindley A BarbeeMatthew R Golden
Jun 8, 2018·Annals of the New York Academy of Sciences·Tatum D Mortimer, Yonatan H Grad
Sep 22, 2018·The Journal of Infectious Diseases·Scott W OlesenYonatan H Grad
Jun 18, 2019·Sexual Health·Sarah Mensforth, Jonathan D C Ross
Dec 25, 2019·Antimicrobial Agents and Chemotherapy·Walter DemczukMichael R Mulvey
Aug 20, 2020·Antimicrobial Resistance and Infection Control·Awoke DerbieTamrat Abebe
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Dec 19, 2018·Proceedings of the National Academy of Sciences of the United States of America·David A Relman, Marc Lipsitch
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Apr 9, 2019·The Journal of Infectious Diseases·Scott W Olesen, Yonatan H Grad
Apr 14, 2020·JAC-antimicrobial Resistance·Sukhyun RyuYonatan H Grad
Feb 6, 2020·International Journal of STD & AIDS·David Taylor-RobinsonAnna Pallecaros
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