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Background: Syndromic treatment of gonorrhea infection in Argentina was implemented in late 90s since it’s considered an important tool to reduce HIV transmission and it’s recommended in developing countries where laboratory diagnosis is usually not available. To ensure valid results a previously epidemiological local survey become necessary to assess the bacterial susceptibility, since one of the disadvantage in the management application is the emergence and transmission of resistance to most antimicrobials used for treatment. Unfortunately, this strategy decreased the recovery of strains for susceptibility studies. The aims of the present study were to examine and describe the prevalence of N gonorrhoeae antimicrobial resistance (AMR) in 2012 in Argentina.
Methods: We report the susceptibility data collected during 2012 over 404 N. gonorrhoeae isolates submitted by 34 laboratories distributed in all country belonging to the AR-GASSP. The strains were examined at the National Reference Laboratory in STI, regarding their susceptibility to ceftriaxone, azithromycin, penicillin G, ciprofloxacin and tetracycline using agar dilution method, according to CLSI and WHO protocols. β-lactamase production was identified using nitrocefin discs. Susceptibility to spectinomycin was discontinued in 2011.
Results: The AMR (intermediate susceptibility) levels were as follows: Ceftriaxone 0% (0%), MIC50 0.008µg/ml – MIC90 0.032µg/ml; Azithromycin 0% (32.7%), MIC50 0.25µg/ml – MIC90 0.5µg/ml; Penicillin 36.6% (57.7%), MIC50 1µg/ml – MIC90 8µg/ml; Ciprofloxacin 49% (0%), MIC50 0.016µg/ml – MIC90 16µg/ml and tetracycline 29.7% (60.4%), MIC50 1µg/ml – MIC90 16µg/ml.
Conclusions: The AMR of N. gonorrhoeae is high, actually in Argentina only a few of isolates are susceptible to all antibiotics used in gonorrhea treatment. Ceftriaxone may still be used as first-line treatment. Surveillance programs to monitor levels of antibiotic resistant isolates are essential to ensure therapeutic success.