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The Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) aims to strengthen sentinel surveillance for gonococcal antimicrobial resistance (AMR) in selected countries. EGASP monitors trends in antimicrobial susceptibility in Neisseria gonorrhoeae by using standardized sampling and laboratory protocols linked to epidemiological data in participating countries. EGASP contributes to the WHO global action plan on antimicrobial resistance, 2015. EGASP is a special project under the Global Antimicrobial Resistance Surveillance System (GLASS). EGASP is a collaborative effort between the WHO, the United States Centers for Disease Control and Prevention (CDC) and WHO collaborating centres on STIs. The protocol document describes the objectives and the methods of EGASP surveillance and guidance on how to implement and monitor EGASP. This publication targets the national sexually transmitted infection and antimicrobial resistance programmes and other institutions to strengthen gonorrhoea AMR surveillance system. This surveillance protocol allows collaborators to improve the quality, comparability and timeliness of gonococcal antimicrobial resistance data across multiple countries. It also aims to enhance the capacity for early detection of emergence of resistance in N. gonorrhoeae strains to recommended treatment.
The WHO Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) was developed to address many of GASP’s limitations and strengthen sentinel surveillance for gonococcal AMR in selected countries. EGASP is a unique project implemented under the EGASP protocol published in 2021 for participating countries to adapt to their context. It is aligned with the WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS). The current report presents the main results of EGASP surveillance from November 2015 to December 2022.
Widespread antimicrobial resistance (AMR) in highly variable strains of Neisseria gonorrhoeae continues to cause significant public health concerns and compromise the management and control of gonorrhoea. The Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) aims to strengthen sentinel surveillance for gonococcal AMR in selected countries. Data and country experiences from EGASP implementation have shown a need to develop 3 essential supplementary protocols that play pivotal roles in the management of N. gonorrhoeae infections. These protocols are: By mastering these protocols, health workers, researchers and public health officials can contribute to a more effective and informed approach to combat N. gonorrhoeae infections.
It is the overall aim of the European sexually transmitted infection (STI) surveillance network to strengthen the surveillance of gonococcal susceptibility in EU and EEA Member States. Within this aim are the following two objectives, with an emphasis on gonococcal antimicrobial susceptibility surveillance and testing: to develop and implement sentinel surveillance of antimicrobial resistant gonorrhoea to a range of therapeutically relevant antimicrobials; and to implement an external quality assurance (EQA) scheme for gonococcal antimicrobial susceptibility testing across Europe. This report presents the results from the 2009 gonococcal antimicrobial susceptibility surveillance and the 2010 EQA scheme.
In 2010, 21 EU/EEA Member States participated in the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP), testing a total of 1766 isolates. Euro-GASP 2010 identified a significant increase in the proportion of tested isolates that show decreased susceptibility to cefixime, from 4% in 2009 to 9% in 2010, using a cut-off of >0.125 mg/L. Rates of ciprofloxacin and azithromycin resistance remain high (53% and 7%, respectively). The rapid increase and spread of decreased susceptibility to cefixime is extremely concerning as cefixime is a recommended therapy for gonorrhoea across Europe, as is ceftriaxone.