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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.

GISP Protocol

GISP Protocol 
(Updated February 17, 2015)


GISP Annual Reports and Profiles

GISP Forms & Coding Guide

Recently Published GISP Studies

STD Regional Laboratories

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Sentinel Sites

  • 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

Regional Labs

  • 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
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