scholarly journals Association between intensity of STI screening and development of antimicrobial resistance in N. gonorrhoeae in 12 cities in the USA: An ecological study

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1237
Author(s):  
Chris R. Kenyon
Keyword(s):  
United States ◽  
Antimicrobial Resistance ◽  
Ecological Study ◽  
Geometric Mean ◽  
The United States ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Antimicrobial Sensitivity ◽  
The Usa ◽  
Sex With Men

In this study, we assessed if there was a city-level association between sexually transmitted infection (STI) screening intensity in men who have sex with men and antimicrobial sensitivity in Neisseria gonorrhoeae in the United States, 2007 to 2013.  We found positive associations between STI screening intensity and increases in minimum inhibitory concentrations for cefixime and azithromycin, but not ceftriaxone when using change in city geometric mean N. gonorrhoeae MIC between 2005 and 2013.

scholarly journals Association between intensity of STI screening and development of antimicrobial resistance in N. gonorrhoeae in 12 cities in the USA: An ecological study

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1237 ◽  
Author(s):  
Chris R. Kenyon
Keyword(s):  
United States ◽  
Antimicrobial Resistance ◽  
Sexually Transmitted Infection ◽  
Ecological Study ◽  
The United States ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Antimicrobial Sensitivity ◽  
The Usa ◽  
Sex With Men

In this study, we assessed if there was a city-level association between sexually transmitted infection (STI) screening intensity in men who have sex with men and antimicrobial sensitivity in Neisseria gonorrhoeae in the United States, 2007 to 2013.  We found positive associations between STI screening intensity and increases in minimum inhibitory concentrations for cefixime and azithromycin, but not ceftriaxone.

scholarly journals Association between intensity of STI screening and development of antimicrobial resistance in N. gonorrhoeae in 12 cities in the USA: An ecological study

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1237
Author(s):  
Chris R. Kenyon
Keyword(s):  
United States ◽  
Antimicrobial Resistance ◽  
Sexually Transmitted Infection ◽  
Ecological Study ◽  
The United States ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Antimicrobial Sensitivity ◽  
The Usa ◽  
Sex With Men

In this study, we assessed if there was a city-level association between sexually transmitted infection (STI) screening intensity in men who have sex with men and antimicrobial sensitivity in Neisseria gonorrhoeae in the United States, 2007 to 2013.  We found positive associations between STI screening intensity and increases in minimum inhibitory concentrations for cefixime and azithromycin, but not ceftriaxone.

scholarly journals Association between intensity of STI screening and development of antimicrobial resistance in N. gonorrhoeae in 12 cities in the USA: An ecological study

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1237 ◽  
Author(s):  
Chris R. Kenyon
Keyword(s):  
United States ◽  
Antimicrobial Resistance ◽  
Sexually Transmitted Infection ◽  
Ecological Study ◽  
The United States ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Antimicrobial Sensitivity ◽  
The Usa ◽  
Sex With Men

In this study, we assessed if there was a city-level association between sexually transmitted infection (STI) screening intensity in men who have sex with men and antimicrobial sensitivity in Neisseria gonorrhoeae in the United States, 2007 to 2013.  We found positive associations between STI screening intensity and increases in minimum inhibitory concentrations for certain antimicrobials. Not all positive associations were statistically significant and the associations found to be statistically significant varied between the different analyses. Further studies are therefore required to assess if there is a causal relationship between the intensity of STI screening in MSM and gonococcal resistance.

scholarly journals LB11. Rapid Rise in Decreased Susceptibility to Azithromycin among Shigella Isolates in the United States: A Look at National Surveillance Data, 2011–2017

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S763-S763 ◽  
Author(s):  
Cindy Friedman ◽  
Ian Plumb ◽  
Jared Reynolds ◽  
Jessica Chen ◽  
Kaitlin Tagg ◽  
...  
Keyword(s):  
United States ◽  
Resistance Mechanism ◽  
Fold Increase ◽  
The United States ◽  
Adult Males ◽  
Rapid Rise ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Sex With Men

Abstract Background Shigella spp. cause ~500,000 illnesses in the United States annually. Antibiotics are recommended for immunocompromised patients and shorten the duration of illness, thus limiting spread. First-line treatments include ciprofloxacin (CIP) and azithromycin (AZM). CIP resistance is a growing problem in the United States; decreased susceptibility to AZM (DSA) has been reported globally, particularly among men who have sex with men (MSM). We reviewed National Antimicrobial Resistance Monitoring System (NARMS) data to determine DSA trends among Shigella isolates in the United States. Methods Health departments nationwide forward every 20th Shigella isolate to CDC NARMS for antimicrobial susceptibility testing using broth microdilution. We defined CIP resistance using CLSI clinical breakpoints and DSA using epidemiological cutoff values where available. We performed whole genome sequencing on isolates from 2016 and screened the sequences for resistance determinants using ResFinder 3.0. Results To date, we have tested 3,044 Shigella isolates collected during 2011–2017. Overall, 264 isolates (9%) had DSA, increasing from 3% in 2011 to 23% in 2017; 41 (16%) were also CIP resistant. The odds of DSA increased by 1.5 (95% confidence interval [CI] 1.4–1.6) annually. DSA was more common among adult males (OR 21.2, CI 14.9–30.3), in isolates from the West census region (OR 2.4, CI 1.8–3.2), and in S. flexneri (OR 8.2, CI 6.3–10.7). Of 543 sequenced isolates, 52 (10%) had DSA; of these, 31 (60%) contained both mph(A) and erm(B) genes, 17 (33%) contained mph(A) only, and 4 (8%) had no identified macrolide-resistance mechanism. Conclusions In 2017, nearly 1 in 4 Shigella isolates tested had DSA, a 7-fold increase since 2011. This rapid rise in DSA parallels that seen in other countries, where resistance to other clinically relevant drugs is high and macrolides are no longer useful as empiric treatment. The increased risk of DSA in adult males is consistent with previous reports of DSA Shigella in MSM. The resistance genes observed are typically plasmid-mediated and can be transferred to other bacteria. Public health strategies to mitigate the spread of resistant Shigella should include antibiotic stewardship and novel approaches for sexually transmitted infection prevention in MSM. Disclosures All authors: No reported disclosures.

Association between STI screening intensity in men who have sex with men and gonococcal susceptibility in 21 States in the USA: an ecological study

2020 ◽  
Vol 96 (7) ◽  
pp. 537-540 ◽  
Author(s):  
Christophe Van Dijck ◽  
Jolein Laumen ◽  
Maria Zlotorzynska ◽  
Sheeba Santhini Manoharan-Basil ◽  
Chris Kenyon
Keyword(s):  
Ecological Study ◽  
Geometric Mean ◽  
Internet Survey ◽  
Repeated Treatment ◽  
Sexually Transmitted ◽  
Asymptomatic Patients ◽  
Ecological Association ◽  
The Usa ◽  
Sex With Men ◽  
Spearman’S Correlation

ObjectivesAntimicrobial resistance is generally linked to antimicrobial selection pressure. Antimicrobial-resistant Neisseria gonorrhoeae infections frequently emerge in core groups. We hypothesised that these groups are more often exposed to antimicrobials as a consequence of the repeated treatment of both symptomatic and asymptomatic sexually transmitted infections (STIs) and that frequent STI screening in asymptomatic patients may contribute indirectly to antimicrobial exposure. In this study, we explored the ecological association between screening intensity in men who have sex with men and antimicrobial susceptibility in N. gonorrhoeae in the USA.MethodsData on STI screening intensity came from the American Men’s Internet Survey between October 2014 and March 2015. Data on gonococcal susceptibility to azithromycin, ceftriaxone and cefixime were used from the Gonococcal Isolate Surveillance Project in 2015. Spearman’s correlation was used to determine the association between these two variables.ResultsA positive ecological association was found between STI screening intensity and geometric mean gonococcal minimum inhibitory concentration for ceftriaxone (rho=0.42, p=0.031) and cefixime (rho=0.42, p=0.029), but not for azithromycin (rho=0.31, p=0.11). The above results must be interpreted with caution as many limitations apply.ConclusionsVariation in STI screening intensity may contribute to differences in gonococcal resistance between States in the USA.

Sexually transmitted infection diagnoses among Hispanic immigrant and migrant men who have sex with men in the United States

2016 ◽  
Vol 27 (13) ◽  
pp. 1162-1169 ◽  
Author(s):  
Eduardo E Valverde ◽  
Elizabeth A DiNenno ◽  
Jeffrey D Schulden ◽  
Alexandra Oster ◽  
Thomas Painter
Keyword(s):  
United States ◽  
Sexually Transmitted Infection ◽  
The United States ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sex With Men

scholarly journals Gaps in Sexually Transmitted Infection Screening Among Men who Have Sex with Men in Pre-exposure Prophylaxis (PrEP) Care in the United States

2020 ◽  
Author(s):  
Christina Chandra ◽  
Kevin M Weiss ◽  
Colleen F Kelley ◽  
Julia L Marcus ◽  
Samuel M Jenness
Keyword(s):  
United States ◽  
Clinical Practice ◽  
Sexually Transmitted Infection ◽  
Prevalence Ratio ◽  
The United States ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Exposure Site ◽  
Sex With Men ◽  
Exposure Prophylaxis

Abstract Background The US Centers for Disease Control and Prevention (CDC) recommends comprehensive sexually transmitted infection (STI) screening every 3–6 months for men who have sex with men (MSM) using human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP). The gaps between these recommendations and clinical practice by region have not been quantified. Methods We used survey data collected from the internet-based ARTnet study between 2017 and 2019 on STI screening among MSM across the United States, stratified by current, prior, and never PrEP use. Poisson regression models with robust error variance were used to model factors, including residence in the Southeast, associated with consistent (“always” or “sometimes”) exposure site-specific STI screening during PrEP care. Results Of 3259 HIV-negative MSM, 19% were currently using PrEP, 6% had used PrEP in the past, and 75% had never used PrEP. Among ever PrEP users, 87%, 78%, 57%, and 64% reported consistent screening for STIs by blood sample, urine sample or urethral swab, rectal swab, or pharyngeal swab, respectively, during PrEP care. Compared to PrEP users in all other regions, PrEP users in the Southeast were significantly less likely to be consistently screened for urogenital (adjusted prevalence ratio [aPR], 0.86; 95% confidence interval [CI], .76–.98) and rectal STIs (aPR, 0.76; 95% CI, .62–.93) during PrEP care. Conclusions Substantial gaps exist between CDC recommendations for STI screening during PrEP care and current clinical practice, particularly for rectal and pharyngeal exposure sites that can harbor asymptomatic infections and for MSM in Southeast states where the STI burden is substantial.

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