title: Factors related to increasing prevalence of resistance to ciprofloxacin and other antimicrobial drugs in Neisseria gonorrhoeae, United States.
abstract: Using data from the Gonococcal Isolate Surveillance Project, we studied changes in ciprofloxacin resistance in Neisseria gonorrhoeae isolates in the United States during 2002-2007. Compared with prevalence in heterosexual men, prevalence of ciprofloxacin-resistant N. gonorrhoeae infections showed a more pronounced increase in men who have sex with men (MSM), particularly through an increase in prevalence of strains also resistant to tetracycline and penicillin. Moreover, that multidrug resistance profile among MSM was negatively associated with recent travel. Across the surveillance project sites, first appearance of ciprofloxacin resistance in heterosexual men was positively correlated with such resistance for MSM. The increase in prevalence of ciprofloxacin resistance may have been facilitated by use of fluoroquinolones for treating gonorrhea and other conditions. The prominence of multidrug resistance suggests that using other classes of antimicrobial drugs for purposes other than treating gonorrhea helped increase the prevalence of ciprofloxacin-resistant strains that are also resistant to those drugs.
authors: Harvard School of Public Health, Boston, Massachusetts 02115, USA. egoldste@hsph.harvard.edu
authors: Edward
authors: E
authors: Goldstein
authors: Robert D
authors: RD
authors: Kirkcaldy
authors: David
authors: D
authors: Reshef
authors: Stuart
authors: S
authors: Berman
authors: Hillard
authors: H
authors: Weinstock
authors: Pardis
authors: P
authors: Sabeti
authors: Carlos
authors: C
authors: Del Rio
authors: Geraldine
authors: G
authors: Hall
authors: Edward W
authors: EW
authors: Hook
authors: Marc
authors: M
authors: Lipsitch
mesh_terms: D000890:Anti-Infective Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000494:pharmacology* / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy / Q000453:epidemiology*; D020010:Heterosexuality; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000302:isolation & purification; D015995:Prevalence; D012307:Risk Factors; D018571:Sentinel Surveillance; D014195:Travel; D014481:United States / Q000453:epidemiology
chemical_list: D000890:Anti-Infective Agents; D002939:Ciprofloxacin