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Cross-sectional results are reported herein.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Between 1 January 2016 and 31 December 2019, data from 886 individuals accounting for 941 gonorrhoea cases were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Epidemiological and clinical data were collected using an auto-administered questionnaire, direct case interviews and chart reviews. Antimicrobial susceptibility testing was performed using the agar dilution method. Generalised estimating equations were used for regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of azithromycin resistance with a minimal inhibitory concentration (MIC) of \u22652\u2009mg\/L was 21.3%. In 2016, men who have sex with men were more likely to be infected with an azithromycin-resistant\n                      <jats:italic>N. gonorrhoeae<\/jats:italic>\n                      isolate (adjusted prevalence ratio (aPR)=4.73, 95%\u2009CI 1.48 to 15.19) or with an isolate with increased third-generation cephalosporin (3GC) MIC (aPR=5.32, 95%\u2009CI 1.17 to 24.11 for cefixime (MIC\u22650.06\u2009mg\/L) and aPR=4.38, 95%\u2009CI 1.53 to 12.54 for ceftriaxone (MIC\u22650.03\u2009mg\/L)). However, these associations were not maintained between 2017 and 2019, with increased MIC observed in men who have sex exclusively with women and women. Overall, azithromycin resistance was significantly more likely in cases who self-reported HIV infection (aPR=1.65, 95%\u2009CI 1.00 to 2.71). Cefixime increased MIC were more likely in individuals 25\u201334 years old (aPR=2.23, 95%\u2009CI 1.18 to 4.21). Cefixime and ceftriaxone increased MIC were both more likely in cases who reported \u22655 sexual partners (cefixime: aPR=2.10, 95%\u2009CI 1.34 to 3.27 and ceftriaxone: aPR=1.62, 95%\u2009CI 1.14 to 2.30).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Significant correlates of\n                      <jats:italic>N. gonorrhoeae<\/jats:italic>\n                      AMR to first-line antimicrobials were observed. Antimicrobial stewardship may be particularly important for 3GC. Active monitoring and interventions are critical for 3GC non-susceptible strains, especially considering the very low prevalence in Qu\u00e9bec.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-073849","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T12:35:28Z","timestamp":1691152528000},"page":"e073849","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Correlates of\n                    <i>Neisseria gonorrhoeae<\/i>\n                    antimicrobial resistance: cross-sectional results from an open cohort sentinel surveillance network in Qu\u00e9bec, Canada, 2016\u20132019"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6657-9874","authenticated-orcid":false,"given":"Karine","family":"Blouin","sequence":"first","affiliation":[{"name":"Direction des risques biologiques, Institut national de sant\u00e9 publique du Qu\u00e9bec, Qu\u00e9bec, Qu\u00e9bec, Canada"},{"name":"\u00c9cole de Sant\u00e9 Publique, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Lefebvre","sequence":"additional","affiliation":[{"name":"Laboratoire de sant\u00e9 publique du Qu\u00e9bec, Sainte-Anne-de-Bellevue, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annick","family":"Trudelle","sequence":"additional","affiliation":[{"name":"Direction des risques biologiques, Institut national de sant\u00e9 publique du Qu\u00e9bec, Qu\u00e9bec, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fannie","family":"Defay","sequence":"additional","affiliation":[{"name":"Direction des risques biologiques, Institut national de sant\u00e9 publique du Qu\u00e9bec, Qu\u00e9bec, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gentiane","family":"Perrault Sullivan","sequence":"additional","affiliation":[{"name":"Direction des risques biologiques, Institut national de sant\u00e9 publique du Qu\u00e9bec, Qu\u00e9bec, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e9ni Nina D\u00e9bora","family":"Ezin Aloffan","sequence":"additional","affiliation":[{"name":"Direction des risques biologiques, Institut national de sant\u00e9 publique du Qu\u00e9bec, Qu\u00e9bec, Qu\u00e9bec, Canada"},{"name":"\u00c9cole de Sant\u00e9 Publique, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie-Claude","family":"Labb\u00e9","sequence":"additional","affiliation":[{"name":"D\u00e9partement de microbiologie, infectiologie et immunologie, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"D\u00e9partement de microbiologie et d\u2019infectiologie, H\u00f4pital Maisonneuve-Rosemont, CIUSSS de l\u2019Est-de-l\u2019\u00eele-de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,8,4]]},"reference":[{"key":"2025121410012385000_13.8.e073849.1","doi-asserted-by":"crossref","DOI":"10.1038\/s41572-019-0128-6","article-title":"Gonorrhoea","volume":"5","author":"Unemo","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"2025121410012385000_13.8.e073849.2","unstructured":"World Health Organization . 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