{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:39:04Z","timestamp":1787017144436,"version":"build-2736575974"},"reference-count":19,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2020,1,28]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Antimicrobial resistance is generally linked to antimicrobial selection pressure. Antimicrobial-resistant\n                      <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n                      infections frequently emerge in core groups. We hypothesised that these groups are more often exposed to antimicrobials as a consequence of the repeated treatment of both symptomatic and asymptomatic sexually transmitted infections (STIs) and that frequent STI screening in asymptomatic patients may contribute indirectly to antimicrobial exposure. In this study, we explored the ecological association between screening intensity in men who have sex with men and antimicrobial susceptibility in\n                      <jats:italic>N. gonorrhoeae<\/jats:italic>\n                      in the USA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data on STI screening intensity came from the American Men\u2019s Internet Survey between October 2014 and March 2015. Data on gonococcal susceptibility to azithromycin, ceftriaxone and cefixime were used from the Gonococcal Isolate Surveillance Project in 2015. Spearman\u2019s correlation was used to determine the association between these two variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A positive ecological association was found between STI screening intensity and geometric mean gonococcal minimum inhibitory concentration for ceftriaxone (rho=0.42, p=0.031) and cefixime (rho=0.42, p=0.029), but not for azithromycin (rho=0.31, p=0.11). The above results must be interpreted with caution as many limitations apply.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Variation in STI screening intensity may contribute to differences in gonococcal resistance between States in the USA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2019-054313","type":"journal-article","created":{"date-parts":[[2020,2,17]],"date-time":"2020-02-17T17:17:50Z","timestamp":1581959870000},"page":"537-540","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Association between STI screening intensity in men who have sex with men and gonococcal susceptibility in 21 States in the USA: an ecological study"],"prefix":"10.1136","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8010-1351","authenticated-orcid":false,"given":"Christophe","family":"Van Dijck","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolein","family":"Laumen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Zlotorzynska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheeba Santhini","family":"Manoharan-Basil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Kenyon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,2,17]]},"reference":[{"key":"2024092304250614000_96.7.537.1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6507a1"},{"key":"2024092304250614000_96.7.537.2","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.3201\/eid2310.170488","article-title":"Antimicrobial Drug Prescription and Neisseria gonorrhoeae Susceptibility, United States, 2005\u20132013","volume":"23","author":"Kirkcaldy","year":"2017","journal-title":"Emerg Infect Dis"},{"key":"2024092304250614000_96.7.537.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(13)70693-5"},{"key":"2024092304250614000_96.7.537.4","doi-asserted-by":"crossref","first-page":"400","DOI":"10.12688\/f1000research.13600.1","article-title":"Epidemiological, behavioural, and clinical factors associated with antimicrobial-resistant gonorrhoea: a review","volume":"7","author":"Abraha","year":"2018","journal-title":"F1000Res"},{"key":"2024092304250614000_96.7.537.5","doi-asserted-by":"publisher","DOI":"10.1086\/432801"},{"key":"2024092304250614000_96.7.537.6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix249"},{"key":"2024092304250614000_96.7.537.7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fmed.2018.00329","article-title":"Antimicrobial consumption and susceptibility of Neisseria gonorrhoeae: a global ecological analysis","volume":"5","author":"Kenyon","year":"2018","journal-title":"Front Med"},{"key":"2024092304250614000_96.7.537.8","doi-asserted-by":"crossref","unstructured":"Kenyon C , Buyze J , Spiteri G , et al . Population-Level antimicrobial consumption is associated with decreased antimicrobial susceptibility in Neisseria gonorrhoeae in 24 European countries: an ecological analysis. J Infect Dis 2019;27.doi:10.1093\/infdis\/jiz153","DOI":"10.1093\/infdis\/jiz153"},{"key":"2024092304250614000_96.7.537.9","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1093\/infdis\/jiy551","article-title":"Azithromycin Susceptibility Among Neisseria gonorrhoeae Isolates and Seasonal Macrolide Use","volume":"219","author":"Olesen","year":"2019","journal-title":"J Infect Dis"},{"key":"2024092304250614000_96.7.537.10","unstructured":"Centers for Disease Control and Prevention . US Public Health Service. Preexposure prophylaxis for the prevention of HIV infection in the United States - 2017 update: a clinical practice guideline 2018."},{"key":"2024092304250614000_96.7.537.11","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/QAD.0000000000002020","article-title":"We need to consider collateral damage to resistomes when we decide how frequently to screen for chlamydia\/gonorrhoea in preexposure prophylaxis cohorts","volume":"33","author":"Kenyon","year":"2019","journal-title":"AIDS"},{"key":"2024092304250614000_96.7.537.12","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.12688\/f1000research.15569.4","article-title":"Association between intensity of STI screening and development of antimicrobial resistance in N. gonorrhoeae in 12 cities in the USA: An ecological study","volume":"7","author":"Kenyon","year":"2018","journal-title":"F1000Res"},{"key":"2024092304250614000_96.7.537.13","doi-asserted-by":"crossref","first-page":"2413","DOI":"10.1007\/s10461-018-2168-4","article-title":"National trends in sexual behavior, substance use and HIV testing among United States men who have sex with men recruited online, 2013 through 2017","volume":"22","author":"Sanchez","year":"2018","journal-title":"AIDS Behav"},{"key":"2024092304250614000_96.7.537.14","unstructured":"CDC Division of STD Prevention . Gonococcal isolate surveillance project (GISP) profiles, 2018. Available: https:\/\/www.cdc.gov\/std\/stats17\/GISP2017 [Accessed 20 Aug 2019]."},{"key":"2024092304250614000_96.7.537.15","unstructured":"CDC Division of STD Prevention . Gonococcal isolate surveillance project (GISP): protocol 2015."},{"key":"2024092304250614000_96.7.537.16","unstructured":"CDC Division of STD Prevention . Distribution of primary antimicrobial drugs used to treat gonorrhea among participants, gonococcal isolate SurveillanceProject (GISP), 1988\u20132017, 2018. Available: https:\/\/www.cdc.gov\/std\/stats17\/figures\/33.htm"},{"key":"2024092304250614000_96.7.537.17","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1099\/jmm.0.000889","article-title":"How actively should we screen for Chlamydia and gonorrhoea in MSM and other high-ST-prevalence populations as we enter the era of increasingly untreatable infections? A viewpoint","volume":"68","author":"Kenyon","year":"2019","journal-title":"J Med Microbiol"},{"key":"2024092304250614000_96.7.537.18","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1097\/OLQ.0000000000000892","article-title":"Screening Peter to save Paul: the population-level effects of screening men who have sex with men for gonorrhea and Chlamydia","volume":"45","author":"Ridpath","year":"2018","journal-title":"Sex Transm Dis"},{"key":"2024092304250614000_96.7.537.19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fpubh.2019.00154","article-title":"Toward a set of criteria to decide which STIs to screen for in PreP cohorts","volume":"7","author":"Kenyon","year":"2019","journal-title":"Front Public Health"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2019-054313","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T07:25:40Z","timestamp":1727076340000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2019-054313"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,17]]},"references-count":19,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2020,10,19]]},"published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1136\/sextrans-2019-054313"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2019-054313","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,17]]}}}