Last data update: May 06, 2024. (Total: 46732 publications since 2009)
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Query Trace: Ouk V[original query] |
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High prevalence of ceftriaxone-resistant and XDR Neisseria gonorrhoeae in several cities of Cambodia, 2022-23: WHO Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP)
Ouk V , Heng LS , Virak M , Deng S , Lahra MM , Frankson R , Kreisel K , McDonald R , Escher M , Unemo M , Wi T , Maatouk I . JAC Antimicrob Resist 2024 6 (2) dlae053 OBJECTIVES: Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a global public health concern. Ceftriaxone is the last effective and recommended option for empirical gonorrhoea therapy worldwide, but several ceftriaxone-resistant cases linked to Asia have been reported internationally. During January 2022-June 2023, the WHO Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) investigated N. gonorrhoeae AMR and epidemiological factors in patients from 10 clinical sentinel sites in Cambodia. METHODS: Urethral swabs from males with urethral discharge were cultured. ETEST determined the MIC of five antimicrobials, and EGASP MIC alert values and EUCAST breakpoints were used. EGASP demographic, behavioural and clinical variables were collected using a standardized questionnaire. RESULTS: From 437 male patients, 306 had positive N. gonorrhoeae cultures, AMR testing and complete epidemiological data. Resistance to ceftriaxone, cefixime, azithromycin and ciprofloxacin was 15.4%, 43.1%, 14.4% and 97.1%, respectively. Nineteen (6.2%) isolates were resistant to all four antimicrobials and, accordingly, categorized as XDR N. gonorrhoeae. These XDR isolates were collected from 7 of the 10 sentinel sites. No EGASP MIC alert values for gentamicin were reported. The nationally recommended cefixime 400 mg plus azithromycin 1 g (65.4%) or ceftriaxone 1 g plus azithromycin 1 g (34.6%) was used for treatment. CONCLUSIONS: A high prevalence of ceftriaxone-resistant, MDR and XDR N. gonorrhoeae in several cities of Cambodia were found during 2022-23 in WHO EGASP. This necessitates expanded N. gonorrhoeae AMR surveillance, revision of the nationally recommended gonorrhoea treatment, mandatory test of cure, enhanced sexual contact notification, and ultimately novel antimicrobials for the treatment of gonorrhoea. |
The enhanced gonococcal surveillance programme, Cambodia
Ouk V , Pham CD , Wi T , van Hal SJ , Lahra MM . Lancet Infect Dis 2023 23 (9) e332-e333 Antimicrobial resistance in Neisseria gonorrhoeae is a global public health threat, exemplified by increasing reports of isolates with high minimum inhibitory concentrations (MICs) to cephalosporin antibiotics, the last remaining first-line agent.1 Since 2015, there have been sporadic reports of N gonorrhoeae isolates with elevated ceftriaxone MIC values from several countries. The overwhelming majority of these isolates harbour the penA-60.001 allele (a gene encoding the gonococcal penicillin binding protein 2, associated with ceftriaxone resistance) and are closely related to the original described resistant strain, FC428.2, 3 An increase in the detection of such isolates from returned travellers was reported in the UK and Austria.3, 4 | | The Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) uses standardised methods for antimicrobial resistance surveillance5 and was established in Cambodia in 2020. In 2021–22, N gonorrhoeae was isolated from 93 urethral specimens collected from symptomatic males in Cambodia where the clinical guidelines recommend a single oral 400 mg dose of cefixime. The N gonorrhoeae isolates were referred to the partnering WHO collaborating centre in Australia for confirmation and genomic analysis (see appendix pp 7–8). |
Programmatic implications of national recent HIV infection surveillance in Cambodia
Suthar AB , Ouk V , Samreth S , Ngauv B , Bain R , Eng B , Hy C , Ernst A , Rutherford GW , Yang C , Ly V , Albalak R . J Infect Dis 2023 228 (10) 1347-1351 We compared characteristics of HIV diagnosis and recent HIV infection (i.e., likely acquired within the last year) in Cambodia. We included individuals ≥ 15 years old accessing HIV testing. From August/2020-August/2022, 53,031 people were tested for HIV, 6,868 were newly diagnosed, and 192 were recently infected. We found differences in geographical burden and risk behaviors with diagnosis and recency (e.g., men who have sex with men, transgender women, and entertainment workers had a nearly two-fold increased odds of testing recent compared to being diagnosed with HIV). Recent infection surveillance may provide unique insights into ongoing HIV acquisition to inform programs. |
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