Gonococcal Isolate Surveillance Project (GISP)
Antibiotics have been a critical public health tool in fighting disease for decades. Today, however, the emergence of drug resistance in bacteria is reversing many of the gains of the past eighty years. Antibiotic resistance (AR) is the ability of bacteria to resist the effects of drugs used to treat them – that is, the germs are not killed, and their growth is not stopped. Neisseria gonorrhoeae, the bacterium that causes the sexually-transmitted disease gonorrhea, has developed resistance to nearly all of the antibiotics used for gonorrhea treatment.
The Gonococcal Isolate Surveillance Project (GISP) was established in 1986 to monitor AR trends in N. gonorrhoeae bacteria in the United States. GISP is a collaborative project among selected STD clinics, five regional laboratories, and CDC. Public health officials and healthcare providers use the data collected in GISP to ensure that gonorrhea is successfully treated with the right antibiotic.
In GISP, N. gonorrhoeae specimens are collected each month from the first 25 men who attend STD clinics in 26 selected U.S. cities and who have also been diagnosed with urethral gonorrhea. Participating regional laboratories test the specimens for resistance to the antibiotic drugs azithromycin, cefixime, ceftriaxone, ciprofloxacin, gentamicin, penicillin, and tetracycline. These are antibiotics which either are currently or were previously used for gonorrhea treatment. The ability of the bacteria to resist the effect of the antibiotics in the laboratory is measured, and the results are interpreted according to criteria recommended by the Clinical and Laboratory Standards Institute (CLSI). The results of these tests are then transmitted to CDC where they are collated and analyzed.
(Updated February 17, 2015)
- 2013 STD Surveillance Report - Gonorrhea (overall GISP data)
- 2013 GISP Profiles (site-specific GISP data)
- GISP Profiles (2008-2013) and Annual Reports (1998-2007)
- GISP Form 1: Demographic/Clinical Data
- GISP Form 2: Antimicrobial Susceptibility Testing
- GISP Form 3: Control Strain Susceptibility Testing
- Coding Guide for GISP Forms (updated December 2013)
- Ciprofloxacin resistance and gonorrhea incidence rates in 17 cities, United States, 1991–2006. Emerg Infect Dis [Internet]. 2014 Apr
- Trends in antimicrobial resistance in Neisseria gonorrhoeae in the United States—the Gonococcal Isolate Surveillance Project (GISP), January 2006–June 2012. Sexually Transmitted Infections 2013; 89(Suppl 4): iv5–iv10.
- Neisseria gonorrhoeae antibiotic resistance among men who have sex with men and men who have sex exclusively with women, the Gonococcal Isolate Surveillance Project, 2005–2010. Annals of Internal Medicine 2013;158(5):321–328.
- Cephalosporin-resistant gonorrhea in North America. Journal of the American Medical Association (JAMA) 2013;309(2):185–187.
- Emergence of increased azithromycin resistance during unsuccessful treatment of Neisseria gonorrhoeae infection with azithromycin (Portland, Oregon, 2011). Sexually Transmitted Diseases 2012;39(11):877-9. Abstract
- Update to CDC’s 2010 Sexually Transmitted Disease Treatment Guidelines: Oral Cephalosporins No Longer Recommended Treatment for Gonococcal Infections – MMWR August 10, 2012 (August 9, 2012)
- The Emerging Threat of Untreatable Gonococcal Infection. New England Journal of Medicine 2012; 366(6):485-487.
- Cephalosporin Susceptibility Among Neisseria gonorrhoeae Isolates --- United States, 2000—2010 - MMWR July 8, 2011
- Neisseria gonorrhoeae with Reduced Susceptibility to Azithromycin --- San Diego County, California, 2009 – MMWR May 13, 2011
- Albuquerque, NM
- Atlanta, GA
- Birmingham, AL
- Boston, MA
- Buffalo, NY
- Chicago, IL
- Cleveland, OH
- Columbus, OH
- Dallas, TX
- Greensboro, NC
- Honolulu, HI
- Indianapolis, IN
- Kansas City, MO
- Las Vegas, NV
- Los Angeles, CA
- Minneapolis, MN
- New Orleans, LA
- New York, NY
- Orange County, CA
- Philadelphia, PA
- Phoenix, AZ
- Pontiac, MI
- Portland, OR
- San Diego, CA
- San Francisco, CA
- Seattle, WA
- Tripler Army Medical center, Honolulu, HI
- Emory University, Atlanta, GA
- Johns Hopkins University, Baltimore, MD
- Texas Department of State Health Services, Austin, TX
- University of Alabama at Birmingham, AL
- University of Washington, Seattle, WA