Prevalence of cefixime-resistant Neisseria gonorrhoeae in Melbourne, Australia, 2021-2022

Eric P F Chow; Kerrie Stevens; Vesna De Petra; Marcus Y Chen; Catriona S Bradshaw; Norelle L Sherry; Lindley A Barbee; Lenka A Vodstrcil; Ivette Aguirre; Kate L Seib; Kate Maddaford; Deborah A Williamson; Benjamin P Howden; Christopher K Fairley

doi:10.1093/infdis/jiae313

Prevalence of cefixime-resistant Neisseria gonorrhoeae in Melbourne, Australia, 2021-2022

Eric P F Chow^*, Kerrie Stevens, Vesna De Petra, Marcus Y Chen, Catriona S Bradshaw, Norelle L Sherry, Lindley A Barbee, Lenka A Vodstrcil, Ivette Aguirre, Kate L Seib, Kate Maddaford, Deborah A Williamson, Benjamin P Howden, Christopher K Fairley

^*Corresponding author for this work

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

While ceftriaxone remains the first-line treatment for gonorrhea, the US Centers for Disease Control and Prevention recommended cefixime as a second-line treatment in 2021. We tested 1176 Neisseria gonorrhoeae isolates among clients attending the Melbourne Sexual Health Centre in 2021 and 2022. The prevalence of cefixime resistance was 6.3% (74/1176), azithromycin resistance was 4.9% (58/1176), and ceftriaxone resistance was 0% (0/1176). Cefixime resistance was highest among women (16.4%, 10/61), followed by men who have sex with women (6.4%, 7/109) and men who have sex with men (5.8%, 57/982). The prevalence of cefixime-resistant N gonorrhoeae exceeds the threshold of the 5% resistance level recommended by the World Health Organization; thus, cefixime treatment would have limited benefits in Australia.

Original language	English
Pages (from-to)	e1121-e1125
Journal	Journal of Infectious Diseases
Volume	230
Issue number	5
Early online date	15 Jun 2024
DOIs	https://doi.org/10.1093/infdis/jiae313
Publication status	Published - 15 Nov 2024

Keywords

Humans
Neisseria gonorrhoeae/drug effects
Cefixime/pharmacology
Male
Gonorrhea/epidemiology
Female
Anti-bacterial agents/pharmacology
Prevalence
Australia/epidemiology
Adult
Microbial sensitivity tests
Ceftriaxone/pharmacology
Young adult
Drug resistance, bacterial - drug effects
Adolescent
Azithromycin/pharmacology

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10.1093/infdis/jiae313Licence: CC BY

Chow-2024-Prevalence of cefixime-resistant-JID-230-e1121-CCBY
Copyright © The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Final published version, 435 KBLicence: CC BY

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Chow, E. P. F., Stevens, K., De Petra, V., Chen, M. Y., Bradshaw, C. S., Sherry, N. L., Barbee, L. A., Vodstrcil, L. A., Aguirre, I., Seib, K. L., Maddaford, K., Williamson, D. A., Howden, B. P., & Fairley, C. K. (2024). Prevalence of cefixime-resistant Neisseria gonorrhoeae in Melbourne, Australia, 2021-2022. Journal of Infectious Diseases, 230(5), e1121-e1125. https://doi.org/10.1093/infdis/jiae313

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title = "Prevalence of cefixime-resistant Neisseria gonorrhoeae in Melbourne, Australia, 2021-2022",

abstract = "While ceftriaxone remains the first-line treatment for gonorrhea, the US Centers for Disease Control and Prevention recommended cefixime as a second-line treatment in 2021. We tested 1176 Neisseria gonorrhoeae isolates among clients attending the Melbourne Sexual Health Centre in 2021 and 2022. The prevalence of cefixime resistance was 6.3% (74/1176), azithromycin resistance was 4.9% (58/1176), and ceftriaxone resistance was 0% (0/1176). Cefixime resistance was highest among women (16.4%, 10/61), followed by men who have sex with women (6.4%, 7/109) and men who have sex with men (5.8%, 57/982). The prevalence of cefixime-resistant N gonorrhoeae exceeds the threshold of the 5% resistance level recommended by the World Health Organization; thus, cefixime treatment would have limited benefits in Australia.",

keywords = "Humans, Neisseria gonorrhoeae/drug effects, Cefixime/pharmacology, Male, Gonorrhea/epidemiology, Female, Anti-bacterial agents/pharmacology, Prevalence, Australia/epidemiology, Adult, Microbial sensitivity tests, Ceftriaxone/pharmacology, Young adult, Drug resistance, bacterial - drug effects, Adolescent, Azithromycin/pharmacology",

author = "Chow, {Eric P F} and Kerrie Stevens and {De Petra}, Vesna and Chen, {Marcus Y} and Bradshaw, {Catriona S} and Sherry, {Norelle L} and Barbee, {Lindley A} and Vodstrcil, {Lenka A} and Ivette Aguirre and Seib, {Kate L} and Kate Maddaford and Williamson, {Deborah A} and Howden, {Benjamin P} and Fairley, {Christopher K}",

note = "Funding: This work was supported by an National Health and Medical Research Council Emerging Leadership Investigator Grant (GNT1172873 to E. P. F. C. and GNT1174555 to D. A. W.); and an National Health and Medical Research Council Leadership Investigator.",

year = "2024",

month = nov,

day = "15",

doi = "10.1093/infdis/jiae313",

language = "English",

volume = "230",

pages = "e1121--e1125",

journal = "Journal of Infectious Diseases",

issn = "0022-1899",

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Chow, EPF, Stevens, K, De Petra, V, Chen, MY, Bradshaw, CS, Sherry, NL, Barbee, LA, Vodstrcil, LA, Aguirre, I, Seib, KL, Maddaford, K, Williamson, DA, Howden, BP & Fairley, CK 2024, 'Prevalence of cefixime-resistant Neisseria gonorrhoeae in Melbourne, Australia, 2021-2022', Journal of Infectious Diseases, vol. 230, no. 5, pp. e1121-e1125. https://doi.org/10.1093/infdis/jiae313

TY - JOUR

T1 - Prevalence of cefixime-resistant Neisseria gonorrhoeae in Melbourne, Australia, 2021-2022

AU - Chow, Eric P F

AU - Stevens, Kerrie

AU - De Petra, Vesna

AU - Chen, Marcus Y

AU - Bradshaw, Catriona S

AU - Sherry, Norelle L

AU - Barbee, Lindley A

AU - Vodstrcil, Lenka A

AU - Aguirre, Ivette

AU - Seib, Kate L

AU - Maddaford, Kate

AU - Williamson, Deborah A

AU - Howden, Benjamin P

AU - Fairley, Christopher K

N1 - Funding: This work was supported by an National Health and Medical Research Council Emerging Leadership Investigator Grant (GNT1172873 to E. P. F. C. and GNT1174555 to D. A. W.); and an National Health and Medical Research Council Leadership Investigator.

PY - 2024/11/15

Y1 - 2024/11/15

N2 - While ceftriaxone remains the first-line treatment for gonorrhea, the US Centers for Disease Control and Prevention recommended cefixime as a second-line treatment in 2021. We tested 1176 Neisseria gonorrhoeae isolates among clients attending the Melbourne Sexual Health Centre in 2021 and 2022. The prevalence of cefixime resistance was 6.3% (74/1176), azithromycin resistance was 4.9% (58/1176), and ceftriaxone resistance was 0% (0/1176). Cefixime resistance was highest among women (16.4%, 10/61), followed by men who have sex with women (6.4%, 7/109) and men who have sex with men (5.8%, 57/982). The prevalence of cefixime-resistant N gonorrhoeae exceeds the threshold of the 5% resistance level recommended by the World Health Organization; thus, cefixime treatment would have limited benefits in Australia.

AB - While ceftriaxone remains the first-line treatment for gonorrhea, the US Centers for Disease Control and Prevention recommended cefixime as a second-line treatment in 2021. We tested 1176 Neisseria gonorrhoeae isolates among clients attending the Melbourne Sexual Health Centre in 2021 and 2022. The prevalence of cefixime resistance was 6.3% (74/1176), azithromycin resistance was 4.9% (58/1176), and ceftriaxone resistance was 0% (0/1176). Cefixime resistance was highest among women (16.4%, 10/61), followed by men who have sex with women (6.4%, 7/109) and men who have sex with men (5.8%, 57/982). The prevalence of cefixime-resistant N gonorrhoeae exceeds the threshold of the 5% resistance level recommended by the World Health Organization; thus, cefixime treatment would have limited benefits in Australia.

KW - Humans

KW - Neisseria gonorrhoeae/drug effects

KW - Cefixime/pharmacology

KW - Male

KW - Gonorrhea/epidemiology

KW - Female

KW - Anti-bacterial agents/pharmacology

KW - Prevalence

KW - Australia/epidemiology

KW - Adult

KW - Microbial sensitivity tests

KW - Ceftriaxone/pharmacology

KW - Young adult

KW - Drug resistance, bacterial - drug effects

KW - Adolescent

KW - Azithromycin/pharmacology

U2 - 10.1093/infdis/jiae313

DO - 10.1093/infdis/jiae313

M3 - Article

C2 - 38877763

SN - 0022-1899

VL - 230

SP - e1121-e1125

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

IS - 5

ER -

Prevalence of cefixime-resistant Neisseria gonorrhoeae in Melbourne, Australia, 2021-2022

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Keywords

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