Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy · 2025
The fourth nationwide surveillance of antimicrobial susceptibility against Neisseria gonorrhoeae from male urethritis in Japan, 2021.
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Yasuda Mitsuru, Takahashi Satoshi, Oba Saori, Kumagai Chikara, Saeki Masachika, Ono Mayumi, Yakuwa Yuuki, Nirasawa Shinya, Kobayashi Kanao, Miyazaki Jun, Wada Koichiro, Matsumoto Masahiro, Hayami Hiroshi, Yamamoto Shingo, Kiyota Hiroshi, Sato Junko, Hasegawa Naoki, Matsumoto Tetsuya
Аннотация
INTRODUCTION: Neisseria gonorrhoeae, an important pathogen of sexually transmitted infections, is resistant to all recommended antimicrobial agents, penicillins, tetracyclines, fluoroquinolones, oral third-generation cephalosporins and macrolides. Antimicrobial susceptibility surveillance of N. gonorrhoeae is needed to identify trends in its antimicrobial resistance. The fourth nationwide antimicrobial susceptibility surveillance of N. gonorrhoeae isolated from male urethritis was conducted by the Surveillance Committee of the Japanese Society of Infectious Diseases, the Japanese Society for Chemotherapy, and the Japanese Society of Clinical Microbiology.
METHODS: Specimens of 1068 N. gonorrhoeae strains collected from male patients with or suspicious for urethritis at 50 facilities in 2021 were tested for antimicrobial susceptibility to 10 antimicrobial agents by CLSI methods.
RESULTS: All strains were non-susceptible to penicillin G. The non-susceptible rate against cefixime was 7.4 %. At the Japanese dose, 39.6 % of strains were non-susceptible to cefixime. No strain was non-susceptible to ceftriaxone and spectinomycin. Susceptibility rates were ciprofloxacin, 24.7 %; tetracycline, 13.7 %; and azithromycin, 89.0 %. Only 0.47 % of isolated strains were resistant to all of cefixime, azithromycin, and ciprofloxacin. However, at the Japanese dose breakpoint, 31.8 % of strains were susceptible against azithromycin and 15.6 % of strains showed resistant to all of cefixime, azithromycin, and ciprofloxacin. Non-susceptibility rates against cefixime tended to be higher than the national average in Hokkaido, Kinki-Chugoku-Shikoku, and Tokai-Hokuriku regions, whereas those against ciprofloxacin tended to be higher in Kanto and Tokai-Hokuriku regions.
CONCLUSION: From these results, monotherapy with ceftriaxone or spectinomycin, which is currently recommended in Japanese guidelines for gonococcal infection, is considered appropriate. Continued gonococcal antimicrobial susceptibility surveillance is needed.
METHODS: Specimens of 1068 N. gonorrhoeae strains collected from male patients with or suspicious for urethritis at 50 facilities in 2021 were tested for antimicrobial susceptibility to 10 antimicrobial agents by CLSI methods.
RESULTS: All strains were non-susceptible to penicillin G. The non-susceptible rate against cefixime was 7.4 %. At the Japanese dose, 39.6 % of strains were non-susceptible to cefixime. No strain was non-susceptible to ceftriaxone and spectinomycin. Susceptibility rates were ciprofloxacin, 24.7 %; tetracycline, 13.7 %; and azithromycin, 89.0 %. Only 0.47 % of isolated strains were resistant to all of cefixime, azithromycin, and ciprofloxacin. However, at the Japanese dose breakpoint, 31.8 % of strains were susceptible against azithromycin and 15.6 % of strains showed resistant to all of cefixime, azithromycin, and ciprofloxacin. Non-susceptibility rates against cefixime tended to be higher than the national average in Hokkaido, Kinki-Chugoku-Shikoku, and Tokai-Hokuriku regions, whereas those against ciprofloxacin tended to be higher in Kanto and Tokai-Hokuriku regions.
CONCLUSION: From these results, monotherapy with ceftriaxone or spectinomycin, which is currently recommended in Japanese guidelines for gonococcal infection, is considered appropriate. Continued gonococcal antimicrobial susceptibility surveillance is needed.