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Antibiotics 2018, 7(3), 63; https://doi.org/10.3390/antibiotics7030063

Surveillance for Antimicrobial Resistance in Gonorrhea: The Alberta Model, 2012–2016

1
STI Centralized Services, Population, Public and Indigenous Health, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
2
Surveillance and Reporting, Population, Public and Indigenous Health, Alberta Health Services, Calgary, AB T2W 3N2, Canada
3
National Microbiology Laboratory, Winnipeg, MB R3E 3R2, Canada
4
Department of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
5
Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB T6G 3E1, Canada
6
Department of Medicine, University of Alberta, Edmonton, AB T6G 2G3, Canada
*
Author to whom correspondence should be addressed.
Received: 14 June 2018 / Revised: 17 July 2018 / Accepted: 18 July 2018 / Published: 20 July 2018
(This article belongs to the Special Issue Multi-Drug Resistant Neisseria gonorrhoeae)
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Abstract

Alberta established a surveillance system in 2001 to monitor resistance to antibiotics used for the treatment of gonorrhea. A retrospective review of gonorrhea cases during the last five years was conducted. All cases of gonorrhea were reportable to public health by testing laboratories and clinicians. Specimens were primarily submitted for nucleic acid amplification testing (NAAT); three sentinel sites obtained specimens for culture and NAAT. The Provincial Laboratory for Public Health conducted E-tests on isolates for multiple antibiotics. A proportion of isolates and NAAT specimens were submitted to the National Microbiology Laboratory for sequence typing (ST). Data were combined and analyzed using SAS version 9.4. Between 2012 and 2016, 13,132 gonorrhea cases were reported; 22.0% (n = 2891) had isolates available for susceptibility testing. All culture positive isolates were susceptible to ceftriaxone. Decreased susceptibility (0.5 ug/mL) to cefixime was reported in four cases in 2014. Resistance to azithromycin (≥2 ug/mL) ranged between 0.4% and 1.8%. Many (n = 509) unique STs were identified; the most prevalent sequence groups (SG) were SG-7638 (n = 367), SG-5985 (n = 145), and SG-11299 (n = 127). The Alberta model for maintaining surveillance for antimicrobial resistance in gonorrhea employs culture and NAAT specimens, providing information crucial to informing provincial treatment guidelines. View Full-Text
Keywords: gonorrhea; antimicrobial resistance; surveillance; sexually transmitted infections gonorrhea; antimicrobial resistance; surveillance; sexually transmitted infections
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Gratrix, J.; Kamruzzaman, A.; Martin, I.; Smyczek, P.; Read, R.; Bertholet, L.; Naidu, P.; Singh, A.E. Surveillance for Antimicrobial Resistance in Gonorrhea: The Alberta Model, 2012–2016. Antibiotics 2018, 7, 63.

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