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A statistical information site that deepens the understanding of AMR (drug resistance) and one health

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National Institute of Infectious Diseases

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The 618, 675, and 982 Neisseria gonorrhoeae strains that were respectively isolated in 2015, 2016, and 2017 were tested for antimicrobial susceptibility (based on EUCAST breakpoints; Table). Ceftriaxone (CTRX)-resistant strains respectively accounted for 6.2%, 4.3%, and 4.3%. Strains assessed as resistant based on the CLSI Criteria (MIC ≥ 0.5 μg/mL) accounted for 0.6%, 0.4%, and 0.5%. No spectinomycin (SPCM)-resistant strains were present. On the other hand, the proportion (%) of azithromycin (AZM)-resistant strains increased from 13.0% in 2015 to 33.5% in 2016 and 42.6% in 2017.
The CLSI Criteria do not provide a resistance breakpoint for azithromycin, but, using the azithromycin MIC distribution of strains with the 23S rRNA gene mutation as the basis, strains with a MIC of 2 μg/mL or higher are referred to as “non-wild-type.” The resistance rate was investigated for reference purposes (see Appendix (8)) and a MIC of 2 μg/mL or higher was found in 3.2%, 4.0%, and 4.0% of strains respectively between 2015 and 2017. According to clinical assessments in Japan, strains indicating an azithromycin MIC of 1 μg/mL or higher can reasonably be regarded as resistant. Under this criterion (R ≥ 1 μg/mL), azithromycin-resistant strains accounted for 11%, 9.3%, and 11.2% of strains respectively between 2015 and 2017. Among the other three antimicrobials, the proportion of cefixime (CFIX)-resistant strains accounted for approximately 30-40%, and that of ciprofloxacin (CPFX)-resistant strains accounted for approximately 80%. Penicillins (PCG) would not have a therapeutic effect on more than 90% of strains.

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The EUCAST (Appendix 8) standards were used for susceptibility and resistance assessment.
* Figures in parentheses indicate the sum of resistance and intermediate resistance.
"The EUCAST resistance breakpoints are as follows. CTRX (>0.125 μg/mL), SPCM (> 64 μg/mL), AZM (>0.5 μg/mL), PCR (> 1 μg/mL), CFIX (>0.125 μg/mL), CPFX (> 0.06 μg/mL)"
The user must cite the source when using the Information on this page.Nippon AMR One Health Report (NAOR) 2018(Examples of source citation)
"Source: Nippon AMR One Health Report (NAOR) 2018"