{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:06:51Z","timestamp":1788930411263,"version":"build-2803163510"},"reference-count":19,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2018,11,4]],"date-time":"2018-11-04T00:00:00Z","timestamp":1541289600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"The Sacharuna Foundation"},{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["5U54EB007958"],"award-info":[{"award-number":["5U54EB007958"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012306","name":"Johns Hopkins Center for Innovative Medicine","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012306","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:p>Antimicrobial resistance (AMR) to gonorrhoea is a threat to global health security. There have been concerns expressed that countries with high rates of disease have poor surveillance. The objectives of the study were to determine the AMR patterns of Neisseria gonorrhoeae clinical isolates to antimicrobial agents in patients with HIV or high risk of HIV acquisition, to compare the concordance of disk diffusion and agar dilution as methods for determining AMR to N. gonorrhoeae, and to describe methodological challenges to carrying out AMR testing. The study was conducted at an HIV outpatient service for at-risk populations and an outreach clinic for commercial sex workers in Kampala. Patients were offered a sexually transmitted infection screen using a polymerase chain reaction (PCR)-based assay. Samples positive for gonorrhoea were cultured. Antimicrobial susceptibility testing was performed using disk diffusion and isolates were sent to a reference laboratory for agar dilution direct susceptibility testing. Five hundred and seventy-five patients were screened. There were 33 (5.7%) patients with gonorrhoea detected by PCR. Of the 16 viable N. gonorrhoeae isolates, 100% were resistant to ciprofloxacin and tetracycline by disk diffusion and 31% exhibited reduced susceptibility to ceftriaxone and cefixime. By agar dilution, 100% of isolates were resistant to ciprofloxacin and all isolates were susceptible to ceftriaxone and cefixime. There was concordance between disk diffusion and agar dilution for ciprofloxacin and tetracycline resistance and a significant discordance for third-generation cephalosporins. More than half the women with gonorrhoea were asymptomatic and represent a potential reservoir for ongoing transmission. AMR testing of N. gonorrhoeae isolates is needed to ensure optimal treatment and prevention of antibiotic resistance progression.<\/jats:p>","DOI":"10.1177\/0956462418799017","type":"journal-article","created":{"date-parts":[[2018,11,4]],"date-time":"2018-11-04T07:00:01Z","timestamp":1541314801000},"page":"256-263","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["Complete ciprofloxacin resistance in gonococcal isolates in an urban Ugandan clinic: findings from a cross-sectional study"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9610-8726","authenticated-orcid":false,"given":"Emily","family":"Mabonga","sequence":"first","affiliation":[{"name":"Waldron Sexual Health Centre, Lewisham and Greenwich NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalind","family":"Parkes-Ratanshi","sequence":"additional","affiliation":[{"name":"Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK"},{"name":"Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Riedel","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila","family":"Nabweyambo","sequence":"additional","affiliation":[{"name":"Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olive","family":"Mbabazi","sequence":"additional","affiliation":[{"name":"Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Taylor","sequence":"additional","affiliation":[{"name":"King\u2019s College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Gaydos","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukari C","family":"Manabe","sequence":"additional","affiliation":[{"name":"Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda"},{"name":"Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,11,4]]},"reference":[{"key":"bibr1-0956462418799017","unstructured":"WHO Media Centre. Antimicrobial resistance. Fact sheet, http:\/\/www.who.int\/mediacentre\/factsheets\/fs194\/en\/ (2017, accessed 20 October 2017)."},{"key":"bibr2-0956462418799017","unstructured":"WHO Media Centre. Sexually transmitted infections (STIs). Fact sheet, http:\/\/www.who.int\/mediacentre\/factsheets\/fs110\/en\/# (2016, accessed 2 January 2017)."},{"key":"bibr3-0956462418799017","unstructured":"World Health Organization. Antimicrobial resistance: global report on surveillance, http:\/\/apps.who.int\/iris\/bitstream\/10665\/112642\/1\/9789241564748_eng.pdf?ua=1 (2014, accessed 2 January 2017)."},{"key":"bibr4-0956462418799017","unstructured":"World Health Organization, Department of Reproductive Health and Research. Global action plan to control the spread and impact of antimicrobial resistance in\n                      Neisseria gonorrhoeae\n                      , http:\/\/www.who.int\/reproductivehealth\/publications\/rtis\/9789241503501\/en\/ (2012, accessed 10 September 2017)."},{"key":"bibr5-0956462418799017","unstructured":"World Health Organization. Global surveillance network for gonococcal antimicrobial susceptibility, http:\/\/apps.who.int\/medicinedocs\/documents\/s16348e\/s16348e.pdf (1990, accessed 10 September 2017)."},{"key":"bibr6-0956462418799017","doi-asserted-by":"crossref","unstructured":"Wi T, Lahra MM, Ndowa F, et\u00a0al. Antimicrobial resistance in Neisseria gonorrhoeae: global surveillance and a call for international collaborative action.\n                      PLoS Med\n                      . Epub ahead of print July, 7 2017. DOI: 10.1371\/journal.pmed.1002344.","DOI":"10.1371\/journal.pmed.1002344"},{"key":"bibr7-0956462418799017","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2012-050907"},{"key":"bibr8-0956462418799017","unstructured":"World Health Organization. WHO guidelines for the treatment of\n                      Neisseria gonorrhoeae\n                      , http:\/\/apps.who.int\/iris\/bitstream\/10665\/246114\/1\/9789241549691-eng.pdf (2016, accessed 7 December 2016)."},{"key":"bibr9-0956462418799017","doi-asserted-by":"publisher","DOI":"10.2807\/ese.16.43.19998-en"},{"key":"bibr10-0956462418799017","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1512757"},{"key":"bibr11-0956462418799017","unstructured":"Ministry of Health. Uganda clinical guidelines 2012. http:\/\/apps.who.int\/medicinedocs\/documents\/s21741en\/s21741en.pdf (2012, accessed 2 January 2017)."},{"key":"bibr12-0956462418799017","unstructured":"Cockerill F, Wikler M, Alder et al. CLSI.\n                      Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement\n                      . CLSI document M100-S22. Wayne PA: Clinical and Laboratory Standards Institute; 2012; 32: 100\u2013102."},{"key":"bibr13-0956462418799017","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000099"},{"key":"bibr14-0956462418799017","first-page":"186","volume":"53","author":"Amito FP","year":"2012","journal-title":"J Prev Med Hyg"},{"key":"bibr15-0956462418799017","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7883\/yoken.JJID.2009.467","volume":"62","author":"Srifeung S","year":"2009","journal-title":"Jpn J Infect Dis"},{"key":"bibr16-0956462418799017","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkw025"},{"key":"bibr17-0956462418799017","unstructured":"Powell M, Future Science Group. Gonorrhoea \u2013 the current antibiotic pipeline and the need for new drugs, https:\/\/www.id-hub.com\/2017\/07\/07\/gonorrhoea-current-antibiotic-pipeline-need-new-drugs\/ (2017, accessed 2 October 2017)."},{"key":"bibr18-0956462418799017","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02131-13"},{"key":"bibr19-0956462418799017","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2010.01.007"}],"container-title":["International Journal of STD &amp; AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0956462418799017","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0956462418799017","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0956462418799017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:38:45Z","timestamp":1777675125000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0956462418799017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,4]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1177\/0956462418799017"],"URL":"https:\/\/doi.org\/10.1177\/0956462418799017","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,4]]}}}