European Surveillance of Sexually Transmitted Infections (ESSTI): the first combined antimicrobial susceptibility data for Neisseria gonorrhoeae in Western Europe

J Antimicrob Chemother. 2006 Sep;58(3):587-93. doi: 10.1093/jac/dkl265. Epub 2006 Jul 1.


Objectives: To conduct a sentinel surveillance study for antimicrobial resistance in Neisseria gonorrhoeae in Western Europe in 2004 as part of the European Surveillance of Sexually Transmitted Infections (ESSTI) Programme.

Methods: Gonococcal isolates were collected from centres in 12 countries and transferred to two reference centres for testing. The same methodology of agar dilution was used to determine susceptibility to a range of antimicrobials used for the treatment of gonorrhoea including azithromycin, ceftriaxone, ciprofloxacin, penicillin and tetracycline. Quality control between the two laboratories was assessed during the testing.

Results: A total of 1055 gonococcal isolates were collected, of which 965 (91.5%) were retrievable for susceptibility testing. Resistance was found to be high to ciprofloxacin (30.9%), but also present to penicillin (21.3%) and tetracycline (59.8%). Azithromycin resistance was above 5%, the first time this has been documented in Europe. Three isolates had a low level of resistance to ceftriaxone. With regard to quality control between the two reference laboratories, 92% of MIC results were within two dilutions.

Conclusions: These are the first sentinel surveillance data for Western Europe for N. gonorrhoeae and they have implications for choice of antimicrobial for treatment of gonorrhoea on a European and a local level. This is the start of the formation of a European gonococcal antimicrobial surveillance programme (EURO-GASP).

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Child
  • Child, Preschool
  • Drug Resistance, Multiple, Bacterial*
  • Europe / epidemiology
  • Feasibility Studies
  • Female
  • Gonorrhea* / drug therapy
  • Gonorrhea* / epidemiology
  • Gonorrhea* / microbiology
  • Humans
  • Infant
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Neisseria gonorrhoeae* / drug effects
  • Neisseria gonorrhoeae* / isolation & purification
  • Population Surveillance*
  • Prevalence
  • Sexually Transmitted Diseases / epidemiology
  • Sexually Transmitted Diseases / microbiology


  • Anti-Bacterial Agents