title: Gonococcal infections in Austria: a long-term observation of prevalence and resistance profiles from 1999 to 2014.
abstract: OBJECTIVE
  The increase in minimum inhibitory concentrations (MICs) of cephalosporins for Neisseria gonorrhoeae has given rise to concerns regarding potentially untreatable gonococcal infections. The goal was to ascertain the prevalence of gonorrhea in a Viennese patient group and determine resistance patterns. Another objective was to evaluate resistance profiles and MIC values of gonococcal isolates in an Austria-wide surveillance project.
  
  
  METHODS
  From 1999 to 2014, 350,000 individuals were tested for gonococci at the Viennese Outpatient Clinic. In addition, from 2010 to 2014, the MICs of recommended antibiotics was determined in 3,584 gonococcal isolates, initially by agar dilution and breakpoint determination, and, from 2012 onwards, by Etest®.
  
  
  RESULTS
  During the observation period, the prevalence of gonorrhea increased eightfold, with a significantly greater number of quinolone, penicillin, and tetracycline- resistant strains. In gonococcal strains isolated from across Austria, there was an increase in cefixime and ceftriaxone MICs toward breakpoints. Twenty-one isolates showed cefixime resistance, and while there was an increase in azithromycin resistance from 0.9 % (2013) to 3.2 % (2014), no resistance to ceftriaxone was observed.
  
  
  CONCLUSIONS
  Currently, there is no imminent risk of untreatable gonorrhea in Austria. However, continuing the use of gonococcal cultures as a diagnostic tool for establishing resistance profiles is essential in order to monitor trends in the development of Neisseria (N.) gonorrhoeae resistance.
authors.affiliation: Outpatient Clinic and Other Venereal/Dermatologic Diseases, Vienna, Austria.
authors.forename: Angelika
authors.initials: A
authors.lastname: Stary
authors.affiliation: Outpatient Clinic and Other Venereal/Dermatologic Diseases, Vienna, Austria.
authors.forename: Claudia
authors.initials: C
authors.lastname: Heller-Vitouch
authors.affiliation: Outpatient Clinic for the Diagnosis and Treatment of Sexually Transmitted Diseases - Municipal Department 15, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Binder
authors.affiliation: Division of Immunology, Allergy, and Infectious Diseases, Department of Dermatology, University Medical Center Vienna, Vienna, Austria.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Geusau
authors.affiliation: Division of Immunology, Allergy, and Infectious Diseases, Department of Dermatology, University Medical Center Vienna, Vienna, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Stary
authors.affiliation: Department of Dermatology and Venereology, Rudolfstiftung Hospital, Vienna, Austria.
authors.forename: Klemens
authors.initials: K
authors.lastname: Rappersberger
authors.affiliation: Department of Dermatology and Venereology, University Medical Center Graz, Graz, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Komericki
authors.affiliation: Department of Dermatology and Venereology, University Medical Center Innsbruck, Innsbruck, Austria.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Hoepfl
authors.affiliation: Outpatient Clinic and Other Venereal/Dermatologic Diseases, Vienna, Austria.
authors.forename: Maria
authors.initials: M
authors.lastname: Haller
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001317:Austria / Q000453:epidemiology; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents