(P59) Patterns of antimicrobial susceptibility in Neisseria gonorrhoeae from 5 cities in Vietnam

Background: Antimicrobial resistance (AMR) in Neisseria gonorrhoeae (NG) is an urgent global health issue. The prevalence of AMR is higher in many low- and middle-income countries (LMICs), particularly in the Western Pacific Region, which includes Vietnam. Surveillance data of AMR in N. gonorrhoeae are sparse. The objectives of this study were to report on the patterns of antibiotic susceptibility in N. gonorrhoeae isolates from 5 cities in Vietnam.



Methods: From January through December 2019, urethral and/or cervical samples were collected from patients with genital discharge who attended five hospitals in five cities in Vietnam: Hanoi, Ho Chi Minh City, Haiphong, Da Nang, and Quang Ninh. Informed consent was obtained and a brief questionnaire regarding demographics and sexual behaviors was administered. Specimens were streaked onto Modified Thayer-Martin media (Oxoid, United Kingdom) and incubated at 35-37°C, 5% CO2, and growth was checked at 24-48 hours. NG colonies were confirmed by Gram stain, oxidase testing, and Bacticard Neisseria (Remel, USA). For antibiotic susceptibility testing, disk diffusion and minimum inhibitory concentrations (MICs) were performed according to Clinical and Laboratory Standards Institute procedures.



Results: In total, 512 participants were recruited, 352 (68.8%) were male and the median age was 30 years (IQR: 24– 35). The median number of sex partners in the prior 3 months was 1 (IQR: 1 – 2). There were 77 (15.0%) who reported engaging in commercial sex in the prior 3 months and 347 (67.8%) who reported antibiotic use in the prior 3 months. In total, there were 93 (18.2%) NG isolates cultured; 96.8% (90/93) were resistant to ciprofloxacin, 36.6% (34/93) were non-susceptible to azithromycin, and all were susceptible to spectinomycin and cefixime. One isolate (1.1%) was non-susceptible to ceftriaxone (MIC = 0.38), resistant to both azithromycin and ciprofloxacin, and occurred in a male who reported engaging in commercial sex.



Conclusions: Among NG isolates obtained from 5 cites in Vietnam in 2019, nearly all were resistant to ciprofloxacin and one-third were resistant to azithromycin. Importantly, the prevalence of ceftriaxone and cefixime resistance were both very low. Reports of AMR in NG from LMICs can aid in global health surveillance efforts.