title: Antimicrobial resistance monitoring in Neisseria gonorrhoeae and strategic use of funds from the Global Fund to set up a systematic Moroccan gonococcal antimicrobial surveillance programme.
abstract: OBJECTIVE
  The aims of this study were to assess antimicrobial resistance in Neisseria gonorrhoeae infections and update the treatment in the national guidelines for the syndromic management of sexually transmitted infections in Morocco.
  
  
  METHODS
  171 men complaining of urethral discharge were recruited from basic health services during 2009. Urethral swab samples were collected and N gonorrhoeae identification was performed by culture. Antimicrobial susceptibility testing was performed using the Etest method and the antimicrobial agents tested were ciprofloxacin, penicillin, spectinomycin, tetracycline, ceftriaxone and cefixime.
  
  
  RESULTS
  A total of 72 isolates were examined. Significant resistance to tetracycline (92.8%) and ciprofloxacin (86.8%), which was used as first-line treatment in gonococcal infections, was noted. No resistance to spectinomycin, ceftriaxone or cefixime was detected in all the isolates.
  
  
  CONCLUSIONS
  Following these results the Ministry of Health of Morocco replaced ciprofloxacin and introduced ceftriaxone 250 mg as a single dose in the treatment of gonococcal infections. Using funds from the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), a surveillance programme was set up for antimicrobial resistance testing in N gonorrhoeae.
authors.affiliation: STIs Laboratory, National Institute of Hygiene, , Ministry of Health, Morocco.
authors.forename: Amina
authors.initials: A
authors.lastname: Hançali
authors.forename: Francis
authors.initials: F
authors.lastname: Ndowa
authors.forename: Bahija
authors.initials: B
authors.lastname: Bellaji
authors.forename: Aziza
authors.initials: A
authors.lastname: Bennani
authors.forename: Amina
authors.initials: A
authors.lastname: Kettani
authors.forename: Reda
authors.initials: R
authors.lastname: Charof
authors.forename: Rajae
authors.initials: R
authors.lastname: El Aouad
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D062665:Epidemiological Monitoring; D005376:Financial Management; D006069:Gonorrhea / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D006291:Health Policy; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D009018:Morocco / Q000453:epidemiology; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000302:isolation & purification; D011635:Public Health Administration / Q000191:economics*; D014521:Urethra / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: ANTIMICROBIAL RESISTANCE; NEISSERIA GONORRHOEA; SURVEILLANCE