P663 Sharp increase of ciprofloxacin resistance ofneisseria gonorrhoeaein yaoundé, cameroon

Background We hypothesize that in Yaounde, Cameroon, the circulating Neisseria gonorrhoeae strains would have acquired resistance mechanisms to ciprofloxacin since the availability of the antibiotic under the form of a generic drug formulation in 2012. Methods We conducted a retrospective study (2012–2017) using data collected at the Centre Pasteur du Cameroun. Antimicrobial susceptibility results of N. gonorrhoeae isolates were retrieved from the laboratory information system and the laboratory worksheets. We included results of the disk method for tetracycline, azithromycin, spectinomycin and the minimal inhibitory concentrations (MICs) obtained with the E-test method for penicillin, ceftriaxone and ciprofloxacin. Data on the beta-lactamase activity was included, if available. European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints were applied. Results Over the years N. gonorrhoeae isolates showed resistance towards all tested antibiotics: the MICs of ciprofloxacin shifted to higher concentrations (with MIC90% of 6 mg/l in 2013 to 32 mg/l in 2017) and 84% of the tested strains were resistant in 2017; resistance to penicillin was highest in 2016 (91%) and overall mainly plasmid mediated; the highest MIC values of 1 and 1.5 mg/l for ceftriaxone were detected in 2017 in 2 isolates; a total of 7 and 8 isolates resistant to ceftriaxone and spectinomycin, respectively, were detected over the time period; 7% of the isolates was resistant to azithromycin in both 2013 and 2015; a high percentage (mean: 59%) of resistance to tetracycline was observed over the whole period. Overall, 42% of the isolates were resistant to three or more antimicrobials. Conclusion A sharp increase in ciprofloxacin resistance of N. gonorrhoeae was detected, requiring the revision of the current Cameroonian treatment guidelines recommending ciprofloxacin. In addition, multidrug resistant N. gonorrhoeae strains are present in Yaounde, Cameroon. A national surveillance program to monitor the antimicrobial susceptibility at national level should be installed and supported. Disclosure No significant relationships.