title: Local outbreak of quinolone-resistant but ceftriaxone-susceptible gonorrhoea in a region of Denmark.
abstract: BACKGROUND
  During the past decade, gonorrhoea has been on the rise in several European countries, and along with a decreasing susceptibility to currently used antimicrobial agents, there are worldwide concerns about future case management. The objective of the present study was to describe the antibiotic resistance of gonococci and physicians' adherence to national Danish guidelines in the Region of Northern Jutland (RNJ) from 2000 to 2010.
  
  
  METHODS
  All incident episodes of microbiologically confirmed Neisseria gonorrhoeae infections from 2000 to 2010 were included. Data were retrieved from the Laboratory Information System at the Department of Clinical Microbiology, Aalborg University Hospital. Clinical data on hospital-treated patients were retrieved from medical records. General practitioners and patients were not contacted.
  
  
  RESULTS
  A total of 296 incident episodes in 285 patients were included. The majority of infections were observed in men (71%). The annual incidence increased five-fold during the study period and peaked in 2009. Most infections were acquired in Denmark. 13 per cent had swabs performed according to guidelines from the Danish National Board of Health. Quinolone-resistance fluctuated between 13% and 93%. The highest level was observed in 2009. No isolates were resistant to ceftriaxone and we observed no treatment failure.
  
  
  CONCLUSIONS
  We have described a local outbreak of quinolone-resistant but ceftriaxone-susceptible gonorrhoea in the RNJ. Our study highlights the importance of microbiological confirmation, treatment and follow-up of gonorrhoea in accordance with national guidelines.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Department of Infectious Diseases, Aalborg University Hospital, 9100 Aalborg, Denmark. line_oestergaard4@hotmail.com
authors.forename: Line Østergaard
authors.initials: LØ
authors.lastname: Sørensen
authors.forename: Michael
authors.initials: M
authors.lastname: Dalager-Pedersen
authors.forename: Tove
authors.initials: T
authors.lastname: Højbjerg
authors.forename: Henrik
authors.initials: H
authors.lastname: Nielsen
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000627:therapeutic use*; D003718:Denmark / Q000453:epidemiology; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D024841:Fluoroquinolones; D006069:Gonorrhea / Q000453:epidemiology*; D019983:Guideline Adherence; D006801:Humans; D015994:Incidence; D008297:Male; D009344:Neisseria gonorrhoeae; D010406:Penicillins; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D010406:Penicillins; D002443:Ceftriaxone