How Public Health Surveillance Systems Can Contribute to Antimicrobial Resistance Prevention: The Massachusetts Experience.

We describe the detection and early response to identified cases of cephalosporin-nonsusceptible Neisseria gonorrhoeae in Massachusetts and provide a rationale for the necessity of surveillance beyond sentinel STI clinics. Regulatory change nearly a decade prior set the stage for statewide laboratory surveillance, which in turn lead to the detection of cephalosporin nonsusceptible cases found through culture surveillance, not through treatment failure. We detail critical collaborations necessary to assure absence of circulating cephalosporin-resistant cases and implications for how public health surveillance systems can contribute to antimicrobial resistance prevention.