title: Neisseria gonorrhoeae antimicrobial resistance among men who have sex with men and men who have sex exclusively with women: the Gonococcal Isolate Surveillance Project, 2005-2010.
abstract: BACKGROUND
  Gonorrhea treatment has been complicated by antimicrobial resistance in Neisseria gonorrhoeae. Gonococcal fluoroquinolone resistance emerged more rapidly among men who have sex with men (MSM) than men who have sex exclusively with women (MSW).
  
  
  OBJECTIVE
  To determine whether N. gonorrhoeae urethral isolates from MSM were more likely than isolates from MSW to exhibit resistance to or elevated minimum inhibitory concentrations (MICs) of antimicrobials used to treat gonorrhea.
  
  
  METHODS
  6 years of surveillance data from the Gonococcal Isolate Surveillance Project.
  
  
  METHODS
  Publicly funded sexually transmitted disease clinics in 30 U.S. cities.
  
  
  METHODS
  Men with a total of 34 600 episodes of symptomatic urethral gonorrhea.
  
  
  METHODS
  Percentage of isolates exhibiting resistance or elevated MICs and adjusted odds ratios for resistance or elevated MICs among isolates from MSM compared with isolates from MSW.
  
  
  RESULTS
  In all U.S. regions except the West, isolates from MSM were significantly more likely to exhibit elevated MICs of ceftriaxone and azithromycin than isolates from MSW (P < 0.050). Isolates from MSM had a high prevalence of resistance to ciprofloxacin, penicillin, and tetracycline and were significantly more likely to exhibit antimicrobial resistance than isolates from MSW (P < 0.001).
  
  
  CONCLUSIONS
  Sentinel surveillance may not be representative of all patients with gonorrhea. HIV status, travel history, and antimicrobial use data were missing for some patients.
  
  
  CONCLUSIONS
  Men who have sex with men are vulnerable to the emerging threat of antimicrobial-resistant N. gonorrhoeae. Because antimicrobial susceptibility testing is not routinely done in clinical practice, clinicians should monitor for treatment failures among MSM diagnosed with gonorrhea. Strengthened prevention strategies for MSM and new antimicrobial treatment options are needed.
authors: Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-02, Atlanta, GA 30333, USA. rkirkcaldy@cdc.gov
authors: Robert D
authors: RD
authors: Kirkcaldy
authors: Akbar
authors: A
authors: Zaidi
authors: Edward W
authors: EW
authors: Hook
authors: King K
authors: KK
authors: Holmes
authors: King H
authors: KH
authors: Holmes
authors: Olusegun
authors: O
authors: Soge
authors: Carlos
authors: C
authors: del Rio
authors: Geraldine
authors: G
authors: Hall
authors: John
authors: J
authors: Papp
authors: Gail
authors: G
authors: Bolan
authors: Hillard S
authors: HS
authors: Weinstock
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D004318:Doxycycline / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy* / Q000382:microbiology*; D020010:Heterosexuality; D006716:Homosexuality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects*; D010406:Penicillins / Q000627:therapeutic use; D012680:Sensitivity and Specificity; D018571:Sentinel Surveillance; D013752:Tetracycline / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins; D002939:Ciprofloxacin; D002443:Ceftriaxone; D017963:Azithromycin; D013752:Tetracycline; D004318:Doxycycline