The objectives of this study were to monitor epidemiologic trends in Neisseria gonorrhoeae (NG) infections and to assess antimicrobial resistance patterns of NG.
RENAGO, a voluntary-based laboratory surveillance system, including private and public laboratories, was set up in France in 1986. Every NG strain isolated by the participating laboratories was sent to the National Reference Center, Institut Alfred Fournier, Paris, where susceptibility to 6 antibiotics was tested. These laboratories reported monthly numbers of positive NG isolates and associated epidemiologic data. Because the number of laboratories varied every year, the average number of NG isolates per laboratory per year was computed to monitor annual trends in gonorrhea incidence.
The average number of NG isolated per laboratory per year decreased steadily from 10.6 in 1986 to 0.6 in 1997 but then yearly increased and reached 1.9 in 2000. Increasing gonorrhea was observed mostly in men and in the Paris area. The proportion of rectal strains increased significantly from 0.9% in 1986 to 9.2% in 2000. From 1998 to 2000, 5.3% of the isolates had reduced susceptibility or were resistant to ciprofloxacin, 7.3% were PPNG strains and 27.4% were resistant to tetracycline, 18.5% had a reduced susceptibility to thiamphenicol, and 1 strain was resistant to the latter. Neither strain was resistant to ceftriaxone or to spectinomycin.
From 1998 to 2000, gonorrhea markedly increased in France and seemed to affect mainly gay men in Paris, which suggests relapses to risky sexual behaviors and highlights the need for strengthening prevention. During the same period, NG ciprofloxacin resistance has sharply increased and should be carefully monitored because of the wide use of ciprofloxacin single-dose treatment.
RENAGO is a laboratory sentinel surveillance system for gonorrhoea implemented in France. Epidemiological trends in incidence and antimicrobial resistance patterns in Neisseria gonorrhoeae between 1986 and 2000 are reported.
*Institut de Veille Sanitaire, Saint-Maurice, France; and †Institut Alfred Fournier, Paris, France
The authors thank all the voluntary participating biologists, Edith Laurent for technical assistance, Françoise Hamers for reviewing the manuscript, and Cathy Ison for her helpful comments and advice.
Correspondence: Magid Herida, MD, Infectious Diseases Department, Institut de Veille Sanitaire, 12 rue du Val d’Osne, 94415 Saint-Maurice cedex, France. E-mail: email@example.com
Received for publication June 12, 2003,
revised December 8, 2003, and accepted December 11, 2003.