001.3 High-level azithromycin resistance in<i>neisseria gonorrhoeae</i>clinical isolates in nanjing, china, 2013–2014
Bibliographic record
Abstract
Introduction Dual antimicrobial therapy with ceftriaxone plus azithrothmycin has recently been recommended for uncomplicated gonorrhoea in the United States, the United Kingdom and Canada because of increases in MICs of N. gonorrhoeae for extended-spectrum cephalosporins. However, emergence of high-level azithromycin resistance in N. gonorrhoeae have been reported in many countries. No high-level azithromycin-resistant isolates of N.gonorrhoeae have been reported in China. Azithromycin has been added into antibiotic susceptibility panel since 2013. In this study, we present the results of amtimicrobial susceptibility testing of 384 gonococcal strains isolated between 2013 and 2014 and evidence of high-level azithromycin resistance in Nanjing, China. Methods 384 N. gonorrhoeae isolates were isolated sequentially from male adults with symptoms/signs of urethritis attending a single STD clinic in Nanjing, China between 2013 and 2014. Minimum inhibitory concentrations (MICs) of N. gonorrhoeae to penicillin, tetracycline, ciprofloxacin, spectinomycin, azithromycin, cefixime and ceftriaxone were determined by the agar dilution technique. b-lactamase production was determined by paper acidometric testing. Results Resistance to penicillin and tetracycline was 72.1% (277/384) and 85.9% (330/384), respectively; 46.9% (180/384) of strains were PPNG and 34.6% (133/384) were TRNG. All isolates (100%) were resistant to ciprofloxacin (MIC ≥1 μg/ml). A total of 32.3% (124/384) of isolates were resistant to azithromycin (MIC ≥1μg/ml), among them 25% (31/124) isolates displayed high-level azithromycin resistance (MIC ≥256 μg/ml). All isolates were susceptible to spectinomycin, cefixime and ceftriaxone. However, 16 isolates (4.3%) had elevated MICs (≥0.125 μg/ml) for cefixime and 38 isolates (10.1%) had an MIC of 0.125 μg/ml for ceftriaxone. Conclusion The present study shows a high prevalence of N. gonorrhoeae isolates displaying resistance to penicillin, tetracycline, azithromycin and ciprofloxacin and reduced susceptibility to extended-spectrum cephalosporins. High-level azithromycin resistance in N. gonorrhoeae has emerged in Nanjing, China. Disclosure of interest statement Nothing to declare
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".