Surveillance for Antimicrobial Resistance in Gonorrhea: The Alberta Model, 2012–2016
Abstract
1. Introduction
2. Materials and Methods
3. Results
3.1. Culture Representativeness
3.2. Antimicrobial Resistance Patterns
3.3. Sequence Types
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristics | Categories | Test Type | Total (N = 13,132) | |
---|---|---|---|---|
Culture (n = 2891) | NAAT-Only (n = 10,241) | |||
Year (p < 0.001) | 2012 | 487 (16.8%) | 1594 (15.6%) | 2081 (15.8%) |
2013 | 506 (17.5%) | 1491 (14.6%) | 1997 (15.2%) | |
2014 | 465 (16.1%) | 1426 (13.9%) | 1891 (14.4%) | |
2015 | 729 (25.2%) | 2682 (26.2%) | 3411 (26.0%) | |
2016 | 704 (24.4%) | 3048 (29.7%) | 3752 (28.6%) | |
Gender (p < 0.0001) | Male | 2285 (79.0%) | 5017 (49.0%) | 7302 (55.6%) |
Female | 606 (21.0%) | 5224 (51.0%) | 5830 (44.4%) | |
Age (in year) (p < 0.001) | 0–14 | 10 (0.3%) | 75 (0.7%) | 85 (0.7%) |
15–19 | 256 (8.9%) | 1723 (16.8%) | 1979 (15.1%) | |
20–24 | 648 (22.4%) | 2818 (27.5%) | 3466 (26.4%) | |
25–29 | 780 (27.0%) | 2226 (21.7%) | 3006 (22.9%) | |
30–34 | 520 (18.0%) | 1532 (15.0%) | 2052 (15.6%) | |
35–39 | 242 (8.4%) | 839 (8.2%) | 1081 (8.2%) | |
40 and older | 435 (15.0%) | 1028 (10.1%) | 1463 (11.1%) | |
Ethnicity (p < 0.001) | First Nation | 373 (12.9%) | 3439 (33.6%) | 3812 (29.0%) |
Inuit | 2 (0.1%) | 13 (0.1%) | 15 (0.1%) | |
Métis | 148 (5.1%) | 546 (5.3%) | 694 (5.3%) | |
Asian | 206 (7.1%) | 332 (3.3%) | 538 (4.1%) | |
Black | 215 (7.4%) | 448 (4.4%) | 663 (5.0%) | |
Caucasian | 1761 (60.9%) | 3699 (36.1%) | 5460 (41.6%) | |
Other | 95 (3.3%) | 155 (1.5%) | 250 (1.9%) | |
Unknown | 91 (3.2%) | 1609 (15.7%) | 1700 (13.0%) | |
Sexual Partner (p < 0.001) | Opposite sex | 1434 (49.6%) | 7144 (69.8%) | 8578 (65.3%) |
Same sex | 1196 (41.4%) | 801 (7.8%) | 1997 (15.2%) | |
Bisexual | 187 (6.5%) | 290 (2.8%) | 477 (3.6%) | |
Case < 12 years | 7 (0.2%) | 6 (0.1%) | 13 (0.1%) | |
Unknown | 67 (2.3%) | 2000 (19.5%) | 2067 (15.8%) | |
Geographic Area (p < 0.001) | South | 33 (1.1%) | 246 (2.4%) | 279 (2.1%) |
Calgary | 1150 (39.8%) | 1924 (18.8%) | 3074 (23.4%) | |
Central | 15 (0.5%) | 902 (8.8%) | 917 (6.9%) | |
Edmonton | 1624 (56.2%) | 4627 (45.2%) | 6251 (47.6%) | |
North | 69 (2.4%) | 2542 (24.8%) | 2611 (20.0%) | |
Testing Agency (p < 0.001) | Calgary STI Clinic | 1114 (38.5%) | 281 (2.7%) | 1395 (10.6%) |
Edmonton STI Clinic | 1468 (50.8%) | 878 (8.6%) | 2346 (17.9%) | |
Fort McMurray STI Clinic | 46 (1.6%) | 118 (1.2%) | 164 (1.2%) | |
Other Providers | 263 (9.1%) | 8964 (87.5%) | 9227 (70.3%) |
Sequence Group | Cases/Isolates (n) | Predominant ST (n) | Differ ≤1% for porB ST (n) | Differ ≤1% for tbpB ST (n) |
---|---|---|---|---|
SG-7638 | 367 | ST-7638 (328) | ST-10815 (12), ST-12095 (1), ST-12863 (17), ST-13828 (1), ST-14537 (1), ST-14878 (1), ST-14984 (1) | ST-13826 (5) |
SG-5985 | 145 | ST-5985 (133) | ST-6968 (3), ST-11348 (1), ST-11471 (1), ST-11544 (1), ST-11841 (1), ST-14865 (3) | ST-10131 (2) |
SG-11299 | 127 | ST-11299 (116) | ST-8695 (4), ST-11837 (1), ST-12389 (5), ST-15200 (1) | -- |
Characteristics | Categories | NG-MAST Group n (%) | ||
---|---|---|---|---|
SG-7638 (n = 367) | SG-5985 (n = 145) | SG-11299 (n = 127) | ||
Gender | Female | 147 (40.1%) | 17 (11.7%) | 15 (11.8%) |
Male | 220 (59.9%) | 128 (88.3%) | 112 (88.2%) | |
Age (in years) | 0–14 | 1 (0.3%) | 1 (0.7%) | 0 |
15–19 | 35 (9.5%) | 9 (6.2%) | 6 (4.7%) | |
20–24 | 93 (25.3%) | 43 (29.7%) | 25 (19.7%) | |
25–29 | 103 (28.1%) | 45 (31.0%) | 31 (24.4%) | |
30–34 | 59 (16.1%) | 23 (15.9%) | 22 (17.3%) | |
35–39 | 38 (10.4%) | 5 (3.4%) | 20 (15.8%) | |
40+ | 38 (10.4%) | 19 (13.1%) | 23 (18.1%) | |
Ethnicity | Asian | 13 (3.5%) | 8 (5.5%) | 14 (11.0%) |
Black | 19 (5.2% | 6 (4.1%) | 4 (3.2%) | |
Caucasian | 118 (32.2%) | 109 (75.2%) | 90 (70.9%) | |
First Nation | 134 (36.5%) | 7 (4.8%) | 4 (3.2%) | |
Metis | 44 (12.0%) | 3 (2.1%) | 5 (3.9%) | |
Other | 6 (1.6%) | 5 (3.5%) | 4 (3.2%) | |
Unknown | 33 (9.0%) | 7 (4.8%) | 6 (4.7%) | |
Sexual Partners | Opposite Sex | 302 (82.3%) | 42 (29.0%) | 35 (27.6%) |
Same Sex | 16 (4.3%) | 93 (64.1%) | 69 (54.3%) | |
Bisexual | 15 (4.1%) | 5 (3.4%) | 17 (13.4%) | |
Case < 12 years | 1 (0.3%) | 1 (0.7%) | 0 | |
Unknown | 33 (9.0%) | 4 (2.8%) | 6 (4.7%) | |
Year | 2012 | 0 | 3 (2.1%) | 0 |
2013 | 1 (0.3%) | 22 (15.2%) | 4 (3.2%) | |
2014 | 8 (2.2%) | 47 (32.4%) | 22 (17.3%) | |
2015 | 229 (62.4%) | 45 (31.0%) | 52 (40.9%) | |
2016 | 129 (35.1%) | 28 (19.3%) | 49 (38.6%) | |
Geographic Area | South | 2 (0.5%) | 1 (0.7%) | 1 (0.8%) |
Calgary | 29 (8.0%) | 82 (56.5%) | 48 (37.8%) | |
Central | 2 (0.5%) | 1 (0.7%) | 0 | |
Edmonton | 153 (41.7%) | 42 (29.0%) | 64 (50.4%) | |
North | 181 (49.3%) | 19 (13.1%) | 14 (11.0%) | |
Testing Agency | Calgary STI Clinic | 28 (7.6%) | 81 (55.9%) | 45 (35.4%) |
Edmonton STI Clinic | 131 (35.7%) | 36 (24.8%) | 60 (47.2%) | |
Fort McMurray STI Clinic | 13 (3.5%) | 5 (3.4%) | 1 (0.8%) | |
Other providers | 195 (53.1%) | 23 (15.9%) | 21 (16.5%) | |
Antibiotic Resistance or Decreased Susceptibility (MIC Value; µg/mL) 1 | Culture-positive Isolates | 192 (52.3%) | 131 (90.3%) | 114 (89.8%) |
Cefixime (>0.25) | 0 | 0 | 0 | |
Ceftriaxone (>0.25) | 0 | 0 | 0 | |
Azithromycin (>2) | 1 (0.5%) | 0 | 0 | |
Ciprofloxacin (≥1) | 6 (3.1%) | 1 (0.8%) | 108 (94.7%) | |
Penicillin (≥2.0) | 0 | 0 | 21 (18.4%) | |
Tetracycline (≥2.0) | 3 (1.6%) | 128 (97.7%) | 8 (7.0%) |
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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. https://doi.org/10.3390/antibiotics7030063
Gratrix J, Kamruzzaman A, Martin I, Smyczek P, Read R, Bertholet L, Naidu P, Singh AE. Surveillance for Antimicrobial Resistance in Gonorrhea: The Alberta Model, 2012–2016. Antibiotics. 2018; 7(3):63. https://doi.org/10.3390/antibiotics7030063
Chicago/Turabian StyleGratrix, Jennifer, Anmmd Kamruzzaman, Irene Martin, Petra Smyczek, Ron Read, Lindsay Bertholet, Prenilla Naidu, and Ameeta E. Singh. 2018. "Surveillance for Antimicrobial Resistance in Gonorrhea: The Alberta Model, 2012–2016" Antibiotics 7, no. 3: 63. https://doi.org/10.3390/antibiotics7030063
APA StyleGratrix, J., Kamruzzaman, A., Martin, I., Smyczek, P., Read, R., Bertholet, L., Naidu, P., & Singh, A. E. (2018). Surveillance for Antimicrobial Resistance in Gonorrhea: The Alberta Model, 2012–2016. Antibiotics, 7(3), 63. https://doi.org/10.3390/antibiotics7030063