Resources and References
STD Surveillance Reports
- Gonorrhea - CDC Fact Sheet. (en Español)
- Basic Information about Antibiotic-Resistant Gonorrhea (ARG)
- Quinolones and the Clinical Laboratory - information from CDC.
- B88 document- Neisseria gonorrhoeae reference
strains for antimicrobial susceptibility testing
The following corrections to this document should be noted (see pg. 6, Recommended Testing and Confirmatory Testing
In the United States, reports of apparent failures of infections to respond to treatment with CDC recommended therapies should be reported to Robert D. Kirkcaldy, MD, MPH (email@example.com; 404-639-8659). Epidemiology and Surveillance Branch, Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Mailstop E02, Atlanta, GA 30333.
In the United States, it is also recommended that isolates from certain infections be submitted to the Neisseria Reference Laboratory at CDC for confirmation; these infections comprise those that fail to respond to CDC-recommended therapy and isolates determined to exhibit intermediate resistance or resistance (see pg. 6, Recommended Testing and Confirmatory Testing, for a complete list): John Papp, Ph.D. JPapp@cdc.gov; 404-639-3785), Neisseria Reference Laboratory, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Mailstop A12, Atlanta, GA 30333.
- Antimicrobial Resistance (all diseases)
- Public Health Action Plan to Combat Antimicrobial Resistance- United States
- International Collaboration on Gonococci (ICG)
- WHO estimates of global and prevalence data on STIs (2001)
- WHO guidelines for Sexually Transmitted Infections Surveillance (1999)
- WHO global strategy for containment of antimicrobial resistance (2001)
- Antimicrobial Resistance in Neisseria gonorrhoeae: background document for the WHO global strategy for containment of antimicrobial resistance (2001)
- WHO Surveillance Standards for Antimicrobial Resistance (2002)
- WHO Manual for the Laboratory Identification and Antimicrobial Susceptibility Testing of Bacterial Pathogens of Public Health Importance in the Developing World (2003)
- CDC Grand Rounds: The Growing Threat of Multidrug-Resistant Gonorrhea - MMWR February 15, 2013
- 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)
- 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
- Update to CDC's Sexually Transmitted Diseases Treatment Guidelines, 2006: Fluoroquinolones No Longer Recommended for Treatment of Gonococcal Infections - MMWR April 13, 2007
- Notice to Readers: Discontinuation of Spectinomycin - MMWR April 7, 2006
- Increases in Fluoroquinolone-Resistant Neisseria gonorrhoeae Among Men Who Have Sex with Men --- United States, 2003, and Revised Recommendations for Gonorrhea Treatment, 2004 - MMWR. April 30, 2004
- Increases in Fluoroquinolone-Resistant Neisseria gonorrhoeae --- Hawaii and California, 2001 - MMWR November 22, 2002 (Print Version )
- Alternatives to Spectinomycin for the Treatment of Neisseria Gonorrhoeae (June 8, 2001)
- Fluoroquinolone-Resistance in Neisseria gonorrhoeae, Hawaii, 1999, and Decreased Susceptibility to Azithromycin in N. gonorrhoeae, Missouri, 1999 - MMWR. September 22, 2000 (Print Version )
- Fluoroquinolone-Resistant Neisseria gonorrhoeae -- San Diego, California, 1997. - MMWR. May 29, 1998
- Gonorrhea Among Men Who Have Sex with Men -- Selected Sexually Transmitted Diseases Clinics, 1993-1996. - MMWR. September 26, 1997 (Print Version)
- Fluoroquinolone Resistance in Neisseria gonorrhoeae- Colorado and Washington, 1995. - MMWR. October 20, 1995 (Print Version)
- Sentinel Surveillance for Antimicrobial Resistance in Neisseria gonorrhoeae- United States, 1988-1991. - MMWR. August 13, 1993 (Print Version)
- Antibiotic-Resistant Strains of Neisseria gonorrhoeae: Policy Guidelines for Detection, Management, and Control. MMWR. September 11, 1987, Vol 36/ No.5S: 1-18.
- Sentinel Surveillance for Antimicrobial Resistance in Clinical Isolates of Neisseria gonorrhoeae. - MMWR. September 11, 1987
- Bolan GA, Sparling PF, Wasserheit JN. The Emerging Threat of Untreatable Gonococcal Infection. New England Journal of Medicine. 2012 Feb 9;366(6):485-487.
- Soge OO, Kirkcaldy RD, Schafer S, Harger D, Holmes KK. Failure of Azithromycin Treatment for Urogenital Gonorrhea in the United States Verified by Molecular Typing Methods [Abstract]. 2012 National STD Prevention Conference, Minneapolis, Minnesota, March 12-15, 2012.
- Kirkcaldy RD, del Rio C, Hall G, Holmes KK, Hook EW, Soge OO, Papp JR, Weinstock HS. Differences in Neisseria gonorrhoeae antibiotic susceptibility among men by sex of sex partner, United States, 2005–2010 [Abstract]. 49th Annual Meeting of the Infectious Disease Society of America, Boston, Massachusetts, October 20-23, 2011.
- Kirkcaldy RD, Murray EL, Del Rio C, Hall G, Hook EW, Whittington WL, Papp J, Weinstock HS. Cephalosporin susceptibility of Neisseria gonorrhoeae isolates in the United States, 2000–2010 [Abstract]. 19th Conference of the International Society of STD Research, Quebec, Canada, July 10-13, 2011.
- Khaokham CB, Pandori M, Yee E, Kirkcaldy RD, Weinstock H, Katz K. Neisseria gonorrhoeae Infections with High Minimum Inhibitory Concentrations to Azithromycin — San Diego County, California, 2009 [Abstract]. 2011 Annual Conference of the Council of State and Territorial Epidemiologists, Pittsburgh, Pennsylvania, June 12-16, 2011.
- Wang SA, Harvey AB, Conner SM, Zaidi AA, Knapp JS, Whittington WL, del Rio C, Judson FN, Holmes KK. Antimicrobial resistance for Neisseria gonorrhoeae in the United States, 1988 to 2003: the spread of fluoroquinolone resistance. Annals of Internal Medicine. 2007 Jul 17;147(2):81-8.
- Siedner MJ, Pandori M, Castro L, Barry P, Whittington WL, Liska S, Klausner JD. Real-time PCR assay for detection of quinolone-resistant Neisseria gonorrhoeae in urine samples. Journal of Clinical Microbiology. 2007 Apr;45(4):1250-4.
- Bauer HM, Hannah P, Moore D, Wolfe J, Knapp J, Trees D, Wang S, Bolan G. Molecular epidemiology of quinolone-resistant Neisseria gonoeehoeae in California, 2000-2002. [Abstract 283] 15th Biennial Congress of the International Society for Sexually Transmitted Diseases Research, Ottawa, Canada, July 27-30, 2003.
- Conner SM, Wang SA, Weinstock HS. Ciprofloxacin resistant gonorrhea within the continental United States, 1991-2000 [Abstract]. 2002 National STD Prevention Conference, San Diego, CA. March 4-7, 2002.
- Fox KK, del Rio C, Holmes KK, Hook EW, Judson FN, Knapp JS, Procop GW, Wang SA, Whittington WL, Levine WC. Gonorrhea in the HIV Era: A Reversal in Trends Among Men Who Have Sex With Men. American Journal of Public Health. 2001;91:959-964.
- Fox KK, Knapp JS, Homes KK, Hook EW, Judson FN, Thompson SE, Washington JA, Whittington WL. Antimicrobial Resistance in Neisseria gonorrhoeae in the United States, 1988-1994: The Emergence of Decreased Susceptibility to the Fluoroquinolones. Journal of Infectious Disease. 1997;175:1396-1403.
- Iverson CJ, Wang SA, Ohye R, Lee V, Domen H, Neal S, Trees D, Whiticar P, Effler P. Emergence of a possible endemic focus of ciprofloxacin-resistant Neisseria gonorrhoeae in Hawaii. [Abstract] Second International Conference on Emerging Infectious Diseases, Atlanta, GA. July 16-19, 2000.
- Johnson SR, Sandul AL, Parekh M, Wang SA, Knapp JS, Trees DL. Mutations causing in vitro resistance to azithromycin in Neisseria gonorrhoeae. International Journal of Antimicrobial Agents. 2003;21:414-419.
- Katz AR, Lee MV, Ohye RG, Whiticar PM, Effler PV. Ciprofloxacin resistance in Neisseria gonorrhoeae: trends in Hawaii, 1997-2002. The Lancet. 2003;362(9382):495.
- Knapp JS, Fox KK, Trees DL, Whittington WL. Fluoroquinolone Resistance in Neisseria gonorrhoeae. Emerging Infectious Diseases. 1997;3:33-39.
- Mark KE, Bauer HM, Gunn RA, Wang SA, Knapp JS, Moore DS, Weismuller P, Klausner JD, De Augustine N, Bolan G, and the California Resistance Working Group. Increase in fluoroquinolone-resistant Neisseria gonorrhoea- California, 2001 [Abstract 21]. 40th Annual Meeting of the Infectious Diseases Society of America, Chicago, Illinois, October 24-27, 2002.
- McLean CA, Wang SA, Hoff G, Dennis L, Neal S, Knapp J, Markowitz L, Levine WC. Emergence of Neisseria gonorrhoeae with decreased susceptibility to azithromycin associated with commercial sex in Kansas City, Missouri, 1999. [Abstract 543] 38th Annual Meeting of the Infectious Diseases Society of America, New Orleans, LA. September 7-10, 2000.
- McLean CA, Wang SA, Hoff GL, Dennis LY, Trees DL, Knapp JS, Markowitz LE, Levine WC. The emergence of Neisseria gonorrhoeae with decreased susceptibility to azithromycin in Kansas City, Missouri, 1999-2000. Sexually Transmitted Diseases 2004;31:73-78.
- Newman LM, Wang, SA, Ohye RG, Lee MV, Weinstock, HS. The epidemiology of fluoroquinolone-resistant Neisseria gonorrhoeae in Hawaii, 2001. Clinical Infectious Diseases 2004;38:649-654.
- Newman LM, Wang SA, Weinstock HS. Emergence of ciprofloxacin-resistant Neisseria gonorrhoea prevalence and risk factors for infection- United States, 1998-2000 [Abstract 651]. 40th Annual Meeting of the Infectious Diseases Society of America, Chicago, Illinois, October 24-27, 2002.
- Roy K, Wang S, Meltzer M. Identifying the optimal diagnostic and treatment strategy for gonorrhea in a time of increasing ciprofloxacin-resistance [Abstract]. 2002 National Foundation for Infectious Diseases Conference on Antimicrobial Resistance, Bethesda, Maryland, June 27-29, 2002.
- Schwarcz SK, Zenilman JM, Schnell D, Knapp JS, Hook EW, Thompson S, Judson FN, Holmes KK. National Surveillance of Antimicrobial Resistance in Neisseria gonorrhoeae. JAMA. 1990;264:1413-1417.
- Wang SA. The continuing saga of gonococcal resistance : current epidemiology and challenges. 2002 National Foundation for Infectious Diseases Conference on Antimicrobial Resistance, Bethesda, Maryland, June 29, 2002.
- Wang SA, Harvey AB, Conner SM, Weinstock HS. Gonococcal susceptibility and epidemiological trends: data from the Gonococcal Isolate Surveillance Project, United States, 2002. [Abstract 284] 15th Biennial Congress of the International Society for Sexually Transmitted Diseases Research, Ottawa, Canada, July 27-30, 2003.
- Wang SA, Harvey AB, Conner SM, Weinstock HS, and the Gonococcal Isolate Surveillance Project Investigators. Trends in gonococcal susceptibility and epidemiology in the United States for 2002 identified through the Gonococcal Isolate Surveillance Project. [Abstract 924]. 41st Annual Meeting of the Infectious Diseases Society of America, San Diego, California, October 9-10, 2003.
- Wang SA, Harvey AB, Weinstock HS. Antimicrobial susceptibilities of Neisseria gonorrhoeae in the United States [Abstract 401]. Thirteenth International Pathogenic Neisseria Conference , Olso, Norway, September 1-6, 2002.
- Wang SA, Lee MV, Iverson CJ, O'Connor N, Ohye RG, Hale JA, Knapp JS, Effler PV, Weinstock HS. Multi-drug resistant Neisseria gonorrhoeae with decreased susceptibility to cefixime, Hawaii 2001. [Abstract] International Conference on Emerging Infectious Diseases, Atlanta, Georgia. March 25, 2002.
- Wang SA, Lee MVC, Norman O'Connor N, Iverson CJ, Ohye RG, Whiticar PM, Hale JA, Trees DL, Knapp JS, Effler PV, Weinstock HS. Multi-drug resistant Neisseria gonorrhoeae with decreased susceptibility to cefixime, Hawaii, 2001. Clinical Infectious Diseases 2003;37:849-52
- Wang SA, Lee MVC, O'Connor N, Iverson CJ, Ohye RG, Whiticar PM, Hale JA, Trees DL, Knapp JS, Effler PV, and Weinstock HS. Multidrug-resistant Neisseria gonorrhoeae with decreased susceptibility to cefixime -- Hawaii, 2001. Clinical Infectious Diseases 2003;37:849-52
- Goldstein E, Kirkcaldy RD, Reshef D, Berman S, Weinstock H, Sabeti P, et al. Factors related to increasing prevalence of resistance to ciprofloxacin and other antimicrobial drugs in Neisseria gonorrhoeae, United States. Emerg Infect Dis. Volume 18, Number 8—August 2012 - CME activity
- Katz AR, Komeya AY, Soge OO, Kiaha MI, Lee MV, Wasserman GM, Maningas EV, Whelen AC, Kirkcaldy RD, Shapiro SJ, Bolan GA, Holmes KK. Neisseria gonorrhoeae with high-level resistance to azithromycin: case-report of the first isolate identified in the United States. Clinical Infectious Disease 2012;54(6):841-3.
- WHO. Surveillance of Antibiotic Resistance in Neisseria gonorrhoeae in the WHO Western Pacific and South East Asian Regions, 2007-2008. Communicable Diseases Intelligence, 2010; 34(1): 1-7.
- The Australian Gonococcal Surveillance Programme. Annual Report of the Australian Gonococcal Surveillance Programme, 2008. Communicable Diseases Intelligence. 2009;33(3):268-274.
- Tapsall JW, Ndowa F, Lewis DA, Unemo M. Meeting the public health challenge of multidrug and extensively drug-resistant Neisseria gonorrhoeae. Expert Review of Anti-Infective Therapy. 2009;7(7):821-834.
- Lo JY, Ho KM, Leung AO, Tiu FS, Tsang GK, Lo AC, et al. Ceftibuten resistance and treatment failure of Neisseria gonorrhoeae infection. . Antimicrobial Agents and Chemotherapy. 2008;52(10):3564-3567.
- Yokoi S, Deguchi T, Ozawa Y, Yasuda M, Ito S, Kubota Y, et al. Threat to cefixime treatment for gonorrhea. Emerging Infectious Diseases. 2007;13(8):1275-1277.
- Ito M, Yasuda M, Yokoi S, Ito S, Takahashi Y, Ishihara S, et al. Remarkable increase in central Japan in 2001-2002 of Neisseria gonorrhoeae isolates with decreased susceptibility to penicillin, tetracycline, oral cephalosporins, and fluoroquinolones. Antimicrobial Agents and Chemotherapy. 2004;48(8):3185-3187.
- Akasaka S, Muratani T, Kobayashi T, Yamada Y, Inatomi H, Takahashi K, Matsumoto T. Gonococcal urethritis and cervicitis caused by CZRNG (cefozopran-resistant Neisseria gonorrhoeae)- clinical failure cases treated with expanded spectrum cephems, fluoroquinolones and minocycline [Abstract]. Thirteenth International Pathogenic Neisseria Conference, Norwegian Institute of Public Health, Olso, Norway. September 1-6, 2002.
- Etkind P, Ratelle S, and George H. International travel and sexually transmitted disease. Emerging Infectious Diseases. [Letter] 2003;9(12):654-1656.
- Muratani T, Kobayashi T, Yamada Y, Akasaka S, Inatomi H, Takahashi K, Matsumoto T. Prevalence of super multi-drug resistant Neisseria gonorrhoeae CZRNG (cefozopran-resistant N. gonorrhoeae) in Japan. Thirteenth International Pathogenic Neisseria Conference, Norwegian Institute of Public Health, Olso, Norway. September 1-6, 2002.