ECDC: resistente gonorroe neemt snel toe in Europa
Op 11 juni publiceerde het ECDC een rapport over resistente (MDR) gonorroe in Europa.
Meer Europese landen vinden deze resistentie, ook wordt meer resistentie per land gevonden.
Met name Denemarken, Spanje, Oostenrijk en Slovenië springen er uit. Meer dan 15% van de isolaten heeft een (sterk) verminderde reactie op antibiotica.
Enkele landen meldden patienten die zo goed als onbehandelbaar bleken te zijn.
Ook in Nederland is gonorroe aangetroffen die minder goed reageert, echter bij minder dan 5% van de ca 6000 jaarlijkse gevallen .
Het rapport bevat aanbevelingen om verdere verspreiding te voorkomen of te vertragen.
In Nederland is nog geen resistente gonorroe gevonden, maar dat is volgens Rijksinstituut voor Volksgezondheid en Milieu (RIVM) een kwestie van tijd. “De bacterie wordt steeds resistenter en er zijn nog geen nieuwe medicijnen klaar waar we dan naar kunnen grijpen'', aldus Marianne van der Sande, hoofd van de afdeling Epidemiologie.
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Epidemiological information on multidrug-resistant gonorrhoea
Neisseria gonorrhoeae has developed resistance to several antimicrobial drugs over the years. Drugs such as
sulphonamides, penicillin, tetracyclines and quinolones are now unsuitable as treatment options. Current treatment
guidelines in most European countries recommend the use of single-dose injectable (ceftriaxone) or oral (cefixime)
third-generation cephalosporins.
Since 2000, however, treatment failures with the use of third-generation cephalosporins have been reported in
Japan. In Europe there were reports of treatment failures with cefixime standard treatment in England and Norway
in 2010. In 2011, the first N. gonorrhoeae strain with decreased susceptibility to cefixime and subsequent
treatment failure was reported in Austria. The recent emergence of the highly ceftriaxone-resistant N. gonorrhoeae
strain H041 in Japan triggered worldwide concerns as ceftriaxone is the last remaining option for empirical first-line
treatment. The first case of genital infection of highly cefixime- and ceftriaxone-resistant N. gonorrhoeae in Europe
was reported in France and a suspected ceftriaxone-resistant strain was reported in Spain. Ceftriaxone treatment
failure of pharyngeal gonorrhoea has been reported in Sweden.
The results from the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) have shown that
susceptibility to cefixime and ceftriaxone is decreasing in Europe. In 2009, 17 EU/EEA countries participated in
Euro-GASP and more than 1300 gonococcal isolates were tested against a panel of relevant antimicrobials. Five
percent of the tested isolates had decreased susceptibility to cefixime; decreased susceptibility was detected in
10 countries.
In 2010, decreased susceptibility to cefixime has increased rapidly to nine percent (of over 1700 tested isolates)
and is now present in 21 countries, of which 11 reported a decreased susceptibility of more than 5 %. In four
countries, decreased susceptibility was above 15 %. A total increase of 4 % was reported over 2009 and 2010.
ECDC
Neisseria gonorrhoeae has developed resistance to several antimicrobial drugs over the years. Drugs such as
sulphonamides, penicillin, tetracyclines and quinolones are now unsuitable as treatment options. Current treatment
guidelines in most European countries recommend the use of single-dose injectable (ceftriaxone) or oral (cefixime)
third-generation cephalosporins.
Since 2000, however, treatment failures with the use of third-generation cephalosporins have been reported in
Japan. In Europe there were reports of treatment failures with cefixime standard treatment in England and Norway
in 2010. In 2011, the first N. gonorrhoeae strain with decreased susceptibility to cefixime and subsequent
treatment failure was reported in Austria. The recent emergence of the highly ceftriaxone-resistant N. gonorrhoeae
strain H041 in Japan triggered worldwide concerns as ceftriaxone is the last remaining option for empirical first-line
treatment. The first case of genital infection of highly cefixime- and ceftriaxone-resistant N. gonorrhoeae in Europe
was reported in France and a suspected ceftriaxone-resistant strain was reported in Spain. Ceftriaxone treatment
failure of pharyngeal gonorrhoea has been reported in Sweden.
The results from the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) have shown that
susceptibility to cefixime and ceftriaxone is decreasing in Europe. In 2009, 17 EU/EEA countries participated in
Euro-GASP and more than 1300 gonococcal isolates were tested against a panel of relevant antimicrobials. Five
percent of the tested isolates had decreased susceptibility to cefixime; decreased susceptibility was detected in
10 countries.
In 2010, decreased susceptibility to cefixime has increased rapidly to nine percent (of over 1700 tested isolates)
and is now present in 21 countries, of which 11 reported a decreased susceptibility of more than 5 %. In four
countries, decreased susceptibility was above 15 %. A total increase of 4 % was reported over 2009 and 2010.
ECDC
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