P658 Did minimum inhibitory concentrations in N. gonorrhoeae isolates change in germany since 2014?. (14th July 2019)

• Record Type: Journal Article
• Authors: Tamminga, Thalea; Buder, Susanne; Dudareva, Sandra; Zuelsdorf, Gabriele; Banhart, Sebastian; Pilz, Tanja; Dehmel, Kerstin; Guhl, Eva; Graeber, Ingeborg; Kohl, Peter; Bremer, Viviane; Heuer, Dagmar; Jansen, Klaus
• Is Part Of: Sexually transmitted infections. Volume 95(2019)Supplement 1
• Page Start: A290
• Page End: A290
• Publication Date: 2019-07-14
• Subjects: surveillance -- Neisseria gonorrhoeae -- antimicrobial resistance; Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sextrans-2019-sti.726
• Languages: English
• ISSNs: 1368-4973

Abstract

Abstract : Background: German national guidelines recommend ceftriaxone combined with azithromycin for Neisseria gonorrhoeae (NG) treatment since 2014. The Gonococcal-Resistance-Network (GORENET) monitors gonococcal antimicrobial resistance (AMR) in Germany. The aim is to assess whether national guidelines are still effective in Germany and which factors affect higher minimum inhibitory concentrations (MICs). Methods: GORENET laboratories sent NG isolates to the conciliar laboratory for centralized retesting of AMR using E-test. We included infection year, sex, age, infection site and clinical service type in the analysis. Geometric means were calculated for MICs for infection year. The effects of infection year, sex, age, infection site and clinical service type on MICs for ceftriaxone, cefixime, and azithromycin were investigated by multiple linear regression. Results Overall, 278 (2014), 303 (2015), 438 (2016) and 409 (2017) isolates were analysed. Of these, 90% of isolates came from men. Median age was 33 years (IQR: 25–44). Cumulative geometric means of MICs 2014–2017 were 0.006 µg/ml for ceftriaxone, 0.022 µg/ml for cefixime, and 0.185 µg/ml for azithromycin. In adjusted analysis, MICs decreased for ceftriaxone, cefixime and azithromycin by 0.74 (CI-95% 0.70–0.79), 0.89 (CI-95% 0.87–0.92) and 0.79 (CI-95% 0.75–0.83) per year, respectively. For ceftriaxone, isolates from urology (1.40; 95%-CI 1.15–1.69) and other service types (1.39; 95%-CI 1.10–1.77) compared to internal medicine, and from women (1.58; 95%-CI 1.14–2.18) were associated with increased MICs. Regarding cefixime isolates collected from urology (1.14; 95%-CI 1.02–1.28) compared to internal medicine, and from women (1.41; 95%-CI 1.18–1.69) were associated with increased MICs. For azithromycin, isolates from urology (0.82; 95%-CI 0.70–0.97) compared to internal medicine, and from women (0.77; 95%-CI 0.59–1.00) were associated with decreased MICs. Conclusion: Treatment options as recommended by German national guidelines are still applicable. The lower MICs after 2014 may be due to the change of national treatment guidelines in 2014. Differences in MICs regarding service types and sex need to be further investigated. Disclosure: No significant relationships.