P3.289 MIC Creep to Ceftriaxone and Low Levels of Resistance to Azithromycin in 7 Countries from South America and the Caribbean
Bibliographic record
Abstract
<h3>Background</h3> The World Health Organization (WHO) issued an international action plan in 2012 to mitigate the health impact of antimicrobial resistant <i>Neisseria gonorrhoeae</i> isolates. A key strategy is to strengthen international surveillance of gonococcal antimicrobial susceptibility. The Gonococcal Antimicrobial Surveillance Program (GASP) in Latin America and Caribbean (LAC) has reported on AMR trends from 1990. The present study presents regional trends in antimicrobial susceptibility between 2010 and 2011. <h3>Methods</h3> Seven countries reported using either agar dilution (CLSI), Etest or disc diffusion assays to determine antimicrobial susceptibility. Countries were asked to report MIC data and categories of susceptibility. <h3>Results</h3> Seven countries tested 1019 isolates of <i>N. gonorrhoeae</i> in 2010 and 1216 isolates in 2011 to ceftriaxone, penicillin, tetracycline and ciprofloxacin (n = 7); azithromycin (n = 4) and spectinomycin (n = 3). Several countries reported a 2-fold increase in MIC50 to ceftriaxone (from 0.004 to 0.008 µg/mL) between 2010 and 2011 and 12 isolates with ceftriaxone MICs 0.125- ≥ 0.25 µg/ml were reported in 2011. All isolates were susceptible to spectinomycin. Resistance to azithromycin increased slightly from 1. 0% (6/612) to 1.7% (20/1169) while resistance to ciprofloxacin decreased from 42.1% (429/1019) to 36.2% (439/1214) of isolates tested between 2010 and 2011. Resistance to penicillin increased from 31% (310/1016) in 2010 to 35% (428/1216) in 2011 while the percentage of isolates resistant to tetracycline was stable (2010 – 21.8%, 187/858; 2011 – 22.6%, 275/1216). <h3>Conclusions</h3> Third generation cephalosporins and spectinomycin continue to be viable options for the treatment of gonorrhoea in the countries reporting. Low percentages of resistance to azithromycin continue to be reported. There has been a steady decline in capacity for <i>N. gonorrhoeae</i> diagnosis and antimicrobial susceptibility testing in the region. The implementation of the WHO action plan to control the spread and impact of antimicrobial resistance in <i>N. gonorrhoeae</i> is an urgent priority.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".