Vol. 8, Issue 5, Part B (2022)

Abstract
Background: Emergence of extensively drug resistant (XDR) N. gonorrhoeae in Europe and Australia from patients who had travelled to south - east Asia strengthens the need for strict antimicrobial resistance (AMR) surveillance. Based on the on the ongoing surveillance data, the present study compares AMR profile of N. gonorrhoeae between two time-frames, A and B, viz 2012-16 and 2017-21, respectively, and also ascertains the susceptibility of N. gonorrhoeae to the currently recommended first line antimicrobials. Material and Methods: N. gonorrhoeae isolated from patients attending the regional center for diagnosis and treatment of sexually transmitted infections (STIs) in Government Medical College & Hospital, Nagpur, India. Between 2012 and 2021, were conventionally identified. Antimicrobial susceptibility testing was performed using Australian Gonococcal Surveillance Programme (AGSP)10 method based on Calibrated Dichotomous Sensitivity (CDS) test using azithromycin, ceftriaxone, cefixime, cefpodoxime, ciprofloxacin, gentamicin, nalidixic acid, penicillin, spectinomycin and tetracycline. Statistical analysis: Using Chi square test and Fisher Exact test for small sized samples, p value compared the trends between the two time frames.Results: The ten year surveillance data was compared between two time-frames 2012-16 and 2017-21. In both time-frames all isolates were sensitive to ceftriaxone, spectinomycin and gentamycin and resistant to ciprofloxacin and nalidixic acid. Changing trends were observed with emergence of 10% isolates with decreased susceptibility to cefixime. Increased in resistance to azithromycin from 7.1% to 17.5% (p=0.664), to tetracycline from 7.1% to 20% (p=0.418) & to penicillin from 28.6% to 40% (p=0.533) was observed. Susceptibility to cefpodoxime was incongruous.Conclusion: The study highlights emergence of N. gonorrhoeae with decreased susceptibility to cefixime and increasing resistance to azithromycin in our region which is an indicator of impending threat to recommended first line treatment of gonorrhoea.