{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T18:32:30Z","timestamp":1779301950943,"version":"3.51.4"},"update-to":[{"DOI":"10.12688\/f1000research.14869.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T00:00:00Z","timestamp":1533772800000}}],"reference-count":36,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T00:00:00Z","timestamp":1533772800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background:<\/ns4:bold>\n                    It is unclear why antimicrobial resistance in\n                    <ns4:italic>Neisseria<\/ns4:italic>\n                    <ns4:italic>gonorrhoeae<\/ns4:italic>\n                    in the United Kingdom (UK) and the United States has tended to first appear in men who have sex with men (MSM). We hypothesize that increased exposure to antimicrobials from intensive STI screening programmes plays a role.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods:<\/ns4:bold>\n                    We assess if there is a difference in the distribution of azithromycin, cefixime and ceftriaxone minimum inhibitory concentrations (MICs) between MSM and women in the United Kingdom (UK) where 70% of MSM report STI screening in the past year vs. Belgium where 9% report STI screening in the past year. Our hypothesis is that MICs of the MSM should be higher than those of the women in the UK but not Belgium. Data for the MICs were taken from the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) in the UK in 2010\/2011 and 2014 and a similar national surveillance programme in Belgium in 2013\/2014 (the first most complete available data). We used the Mann\u2013Whitney\u00a0test to compare the MIC distributions between MSM and women within each country\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Results:<\/ns4:bold>\n                    In the UK the MICs for all three antimicrobials were significantly higher in MSM than women at both time points (P all &lt;0.0005). In Belgium only the MIC distribution for azithromycin was higher in MSM (P&lt;0.0005).\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusion:<\/ns4:bold>\n                    The findings for cefixime and ceftriaxone, but not azithromycin are compatible with our hypothesis that screening-intensity could contribute to the emergence of AMR. Numerous other interpretations of our results are discussed.\n                  <\/ns4:p>","DOI":"10.12688\/f1000research.14869.2","type":"journal-article","created":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T07:05:05Z","timestamp":1533798305000},"page":"569","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Does gonorrhoea screening intensity play a role in the early selection of antimicrobial resistance in men who have sex with men (MSM)? A comparative study of Belgium and the United Kingdom"],"prefix":"10.12688","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2557-8998","authenticated-orcid":false,"given":"Chris R.","family":"Kenyon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irith","family":"De Baetselier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tania","family":"Crucitti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2018,8,9]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"iv47-51","DOI":"10.1136\/sextrans-2013-051020","article-title":"The role of core groups in the emergence and dissemination of antimicrobial-resistant N gonorrhoeae.","volume":"89 Suppl 4","author":"D Lewis","year":"2013","journal-title":"Sex Transm Infect."},{"key":"ref-2","article-title":"Surveillance of antimicrobial resistance in Neisseria gonorrhoeae: Key findings from the \u2018Gonococcal resistance to antimicrobials surveillance programme' (GRASP) and related surveillance data.","year":"2011"},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"762-8","DOI":"10.1016\/S1473-3099(13)70143-9","article-title":"Decreased susceptibility to cephalosporins among gonococci: data from the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) in England and Wales, 2007-2011.","volume":"13","author":"C Ison","year":"2013","journal-title":"Lancet Infect Dis."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"321-8","DOI":"10.7326\/0003-4819-158-5-201303050-00004","article-title":"Neisseria gonorrhoeae Antimicrobial Resistance Among Men Who Have Sex With Men and Men Who Have Sex Exclusively With Women: The Gonococcal Isolate Surveillance Project, 2005-2010.","volume":"158","author":"R Kirkcaldy","year":"2013","journal-title":"Ann Intern Med."},{"key":"ref-5","article-title":"Surveillance of antimicrobial resistance in Neisseria gonorrhoeae: Key findings from the \u2018Gonococcal resistance to antimicrobials surveillance programme' (GRASP) and related surveillance data.","year":"2010"},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"3","DOI":"10.2807\/ese.14.37.19330-en","article-title":"Multidrug-resistant Neisseria gonorrhoeae with reduced cefotaxime susceptibility is increasingly common in men who have sex with men, Amsterdam, the Netherlands.","volume":"14","author":"H de Vries","year":"2009","journal-title":"Euro Surveill."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1186\/s12879-017-2707-z","article-title":"Overall Low Extended-Spectrum Cephalosporin Resistance but high Azithromycin Resistance in Neisseria gonorrhoeae in 24 European Countries, 2015.","volume":"17","author":"M Cole","year":"2017","journal-title":"BMC Infect Dis."},{"key":"ref-8","article-title":"EMIS 2010: The European Men-Who-Have-Sex-With-Men Internet Survey. 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