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Table
Indicator name:
Proportion of isolates with decreased susceptibility or resistance (DS/R) to ceftriaxone/cefixime/ciprofloxacine/extended-spectrum cephalosporins reported to World Health Organization Global Gonococcal Antimicrobial Surveillance Program
Data type:
Percent
Indicator Id:
5550
Topic:
Antimicrobial resistance
Rationale:
One of the greatest challenges to STI prevention and control is the epidemic of AMR strains of Neisseria gonorrhoeae. Monitoring the susceptibility patterns of N. gonorrhoeae is essential for detecting and tracking emerging resistance and adjusting treatment recommendations for optimal outcomes. Since 1992, countries monitor the emergence of resistance to N. gonorrhoeae through WHO GASP. WHO recommends that treatment guidelines are refined based on data from recent and quality-assured gonococcal AMR surveillance and that the use of an antimicrobial in empiric treatment is discontinued when the rates of therapeutic failures and/or AMR reach a level of 5%.
Definition:
What it measures: proportion (percentage) of isolates reported with decreased susceptibility or resistance to ceftriaxone. Numerator: Number of isolates with decreased susceptibility or resistance to ceftriaxone reported to GASP for the specific year; Denominator: Number of tested isolates reported for ceftriaxone to GASP for the specific year
Method of measurement
Countries perform quality assured cultural and antimicrobial susceptibility tests according to their national or regional protocol, ideally using quantitative methods for determination of the minimum inhibitory concentration (MIC) of antimicrobials and using validated and standardized interpretative criteria. According to the regional or national surveillance protocol, countries can report to GASP AMR data on pharyngeal, anogenital, urethral or another anatomical site N. gonorrhoea strains. Countries report aggregated number of tested and of resistant isolates. For ceftriaxone and cefixime decreased susceptibility or resistance were combined due to the different antimicrobial resistance testing methods (minimum inhibitory concentration (MIC) determination using agar dilution, or MIC gradient strip tests, or disc diffusion methods) and breakpoints used. For extended-spectrum cephalosporins (ESC): ceftriaxone and cefixime data are combined to give the extended-spectrum cephalosporins figures as follow: • For countries reporting only one of the two antibiotics for the year, the data for the tested antibiotic is reported for ESC • For countries reporting testing for both, ceftriaxone and cefixime, the antibiotic with the highest level of resistant is selected for ESC.
Method of estimation:
Isolate-based resistance surveillance data are reported by national reference laboratories to the regional reference laboratory focal points, and collated data are then submitted to WHO-GASP. WHO compiles this data and compute this indicator.
Expected frequency of data dissemination:
Annual
Expected frequency of data collection:
Annual
Contact person email:
wit@who.int
Name:
Teodora Elvira Wi
IMRID:
5550
Links:
Global Antimicrobial Resistance and Use Surveillance System (GLASS)
Indicator Metadata Registry List
≥5% of N. gonorrhoea isolates with in vitro resistance and/or treatment failure to a specific antibiotic is the level WHO set to discontinue the use of an antibiotic as first-line empirical gonorrhoea treatment.
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