ArticlePLoS medicine2018
Susceptibility of Neisseria gonorrhoeae to azithromycin and ceftriaxone in China: A retrospective study of national surveillance data from 2013 to 2016.
Article in PLoS medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 3 of them syntheses that pooled it.
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Who cites it
61 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- A systematic review and meta-analysis of sexually transmitted infections and blood-borne viruses in travellers.Journal of travel medicine · 2024Pooled it
- Global status of Azithromycin and Erythromycin Resistance Rates inThe Yale journal of biology and medicine · 2022Pooled it
- Surveillance systems to monitor antimicrobial resistance inEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2022Pooled it
- App-Based Training Module on Guiding Physicians' Prescription for Antibiotic Treatment of Gonorrhea: Cluster Randomized Controlled Trial.JMIR mHealth and uHealth · 2026Trial
- Antimicrobial Resistance in Neisseria gonorrhoeae: Proceedings of the STAR Sexually Transmitted Infection-Clinical Trial Group Programmatic Meeting.Sexually transmitted diseases · 2019Trial
- Rapid expansion of penA allele 60.001-containing endemic ceftriaxone-resistant gonococcal ST8123 lineage in Hangzhou, China.Infection · 2026Article
- Evidence for a Constrained Mutational Pathway to High-Level Spectinomycin Resistance inInternational journal of molecular sciences · 2026Article
- China's nationwide antimicrobial resistance surveillance networks: a systematic analysis from One Health perspective.The Lancet regional health. Western Pacific · 2026Review
- Global genomic and antimicrobial resistance profiling of Neisseria gonorrhoeae: Insights from whole genome sequencing and minimum inhibitory concentration analysis.PLoS neglected tropical diseases · 2025Article
- Effect of 13 traditional Chinese medicine drug preparations againstFrontiers in pharmacology · 2025Article
- Analytical and clinical validation of a multiplex PCR assay for detection ofMicrobiology spectrum · 2024Article
- Review
- Etiological, sociodemographic and clinical characteristics of sexually transmitted infections andFrontiers in cellular and infection microbiology · 2024Article
- Identification of ceftriaxone-resistant Neisseria gonorrhoeae FC428 clone and isolates harboring a novel mosaic penA gene in Chengdu in 2019-2020.Annals of clinical microbiology and antimicrobials · 2023Article
- Pay-it-forward gonorrhea and chlamydia testing among men who have sex with men and male STD patients in China: the PIONEER pragmatic, cluster randomized controlled trial protocol.BMC public health · 2023Article
- Article
- Dissemination of Neisseria gonorrhoeae with decreased susceptibility to extended-spectrum cephalosporins in Southern China, 2021: a genome-wide surveillance from 20 cities.Annals of clinical microbiology and antimicrobials · 2023Article
- Identification of Emerging Multidrug-ResistantMedical sciences (Basel, Switzerland) · 2023Article
- Evaluation ofInfection and drug resistance · 2023Article
- Emergence and Genomic Characterization of Neisseria gonorrhoeae Isolates with High Levels of Ceftriaxone and Azithromycin Resistance in Guangdong, China, from 2016 to 2019.Microbiology spectrum · 2022Article
1 more citing papers are in PubMed but not listed here.
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Authors and funding
15 authors.
Funding
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Abstract
backgroundGonorrhea remains one of the most common sexually transmitted diseases worldwide. Successful treatment has been hampered by emerging resistance to each of the antibiotics recommended as first-line therapies. We retrospectively analyzed the susceptibility of gonorrhea to azithromycin and ceftriaxone using data from the China Gonococcal Resistance Surveillance Programme (China-GRSP) in order to provide evidence for updating the treatment recommendations in China. METHODS AND
findingsIn this study, we included 3,849 isolates collected from patients with a confirmed positive Neisseria gonorrhoeae (N. gonorrhoeae) culture at clinic visits during the period of 1 January 2013 through 31 December 2016 in 7 provinces. Antimicrobial susceptibility testing of gonorrhea isolates using agar dilution was conducted to determine minimum inhibitory concentration (MIC). Resistance to azithromycin (RTA) was defined as MIC ≥ 1.0 mg/l, and decreased susceptibility to ceftriaxone (DSC) was defined as MIC ≥ 0.125 mg/l. The prevalence of isolates with RTA was 18.6% (710/3,827; 95% CI 17.4%-19.8%). The percentage of patients with DSC fluctuated between 9.7% and 12.2% over this period. The overall prevalence of isolates with both RTA and DSC was 2.3% (87/3,827; 95% CI 1.9%-2.8%) and it increased from 1.9% in 2013 to 3.3% in 2016 (chi-squared test for trend, P = 0.03). Study limitations include the retrospective study design and potential biases in the sample, which may overrepresent men with symptomatic infection, coastal residents, and people reporting as heterosexual.
conclusionsTo our knowledge, this is the first national study on susceptibility of N. gonorrhoeae to azithromycin and ceftriaxone in China. Our findings indicate high rates of RTA and DSC from 2013 to 2016. Although dual therapy with azithromycin and ceftriaxone has been recommended by WHO and many countries to treat gonorrhea, reevaluation of this therapy is needed prior to its introduction in China.
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