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Sexually

Transmitted

Disease

Surveillance

2015:

Gonococcal Isolate Surveillance Project (GISP)

Supplement & Profiles

Division of STD Prevention

February 2017

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CENTERS FOR DISEASE CONTROL AND PREVENTION

NATIONAL CENTER FOR HIV/AIDS, VIRAL HEPATITIS, STD, AND TB PREVENTION

DIVISION OF STD PREVENTION

ATLANTA, GEORGIA 30329-4027

Acknowledgments
Publication of this report would not have been possible without the contributions of
participating state and local health departments, sexually transmitted disease clinics, public
health laboratories, and regional laboratories

This report was prepared by:

Alesia Harvey, Viani Ramirez, Tremeka Sanders, and Elizabeth Torrone, Surveillance and Data
Management Branch of the Division of STD Prevention, National Center for HIV/AIDS, Viral
Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention.

Copyright Information
All material contained in this report is in the public domain and may be used and reprinted
without special permission; however, citation as to source is appreciated.

Suggested Citation
Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2015:
Gonococcal Isolate Surveillance Project (GISP) Supplement and Profiles. Atlanta: U.S.
Department of Health and Human Services; 2017.

Web Site

The online version of this report is available at https://www.cdc.gov/std/gisp/default.htm.


Gonococcal Isolate Surveillance Project (GISP)
Supplement and Profiles, 2015
Introduction

Although gonorrhea is an ancient disease that has affected humans for centuries and effective
therapy has been available since the early twentieth century, this sexually transmitted disease
(STD) remains prevalent: gonorrhea is the second most commonly reported notifiable disease in
the United States and 395,216 cases were reported in 2015.1 As with other STDs, the reporting of
gonorrhea is incomplete and the Centers for Disease Control and Prevention (CDC) estimates
that approximately 820,000 cases of gonorrhea occur yearly in the United States.2 Infections
due to Neisseria gonorrhoeae are a major cause of pelvic inflammatory disease (PID) in the
United States. PID can lead to serious reproductive outcomes in women, such as tubal infertility,
ectopic pregnancy, and chronic pelvic pain.

The cornerstone of public health gonorrhea control is detection and treatment of gonorrhea, so
as to prevent sequelae and limit disease transmission. For decades, gonorrhea has been easily
treated with a single dose of a single antimicrobial agent. However, N. gonorrhoeae has
progressively developed resistance to each antimicrobial used for treatment of gonorrhea. In the
last decade, development of fluoroquinolone resistance resulted in the availability of only a
single class of antimicrobials that met CDCs efficacy standards the cephalosporins. Recently,
declining susceptibility to cefixime resulted in a change to the CDC treatment guidelines, so that
dual therapy with ceftriaxone and azithromycin is the only CDC-recommended treatment
regimen for uncomplicated gonorrhea.3 Continued surveillance of N. gonorrhoeae antimicrobial
susceptibility is critical.

Gonococcal Isolate Surveillance Project (GISP) Overview

The Gonococcal Isolate Surveillance Project (GISP) was established in 1986 to monitor trends in
antimicrobial susceptibilities of N. gonorrhoeae strains in the United States to establish an
evidence-based rationale for selection of gonococcal therapies. GISP is a sentinel surveillance
system and collaboration between participating STD clinics and their state or local public health
authorities, GISP regional laboratories, and CDC.

N. gonorrhoeae isolates are collected monthly from up to the first 25 men with gonococcal
urethritis attending participating STD clinics. Clinical and demographic data are abstracted
from medical records. Isolates are shipped from participating clinics to the GISP regional
laboratories for agar dilution antimicrobial susceptibility testing. Isolates are tested to
determine minimum inhibitory concentrations (MICs) of penicillin, tetracycline, ceftriaxone,
cefixime, ciprofloxacin, and azithromycin. Cefixime susceptibility testing was discontinued in
2007 and re-started in 2009. Cefpodoxime susceptibility testing was conducted during 2009
2012.

Findings from GISP have directly contributed to CDCs STD Treatment Guidelines in 1993,
1998, 2002, 2006, 2010, and 2015 and updates in 2000, 2004, 2007, and 2012. Data from GISP
have also been presented in multiple scientific papers and conference presentations. Additional
information on GISP and links to recent publications can be found on the GISP website:
https://www.cdc.gov/std/gisp/default.htm.

2015 GISP Sites and Regional Laboratories

STD clinics affiliated with 24 state or city health departments contributed 5,147 gonococcal
isolates to GISP in 2015. Of these sites, 11 current sites have participated continuously since
1987: Albuquerque, New Mexico; Atlanta, Georgia; Birmingham, Alabama; Honolulu, Hawaii;
New Orleans, Louisiana; Philadelphia, Pennsylvania; Phoenix, Arizona; Portland, Oregon; San
Diego, California; San Francisco, California; and Seattle, Washington. The other current sites
are: Boston, Massachusetts (19871992, 20142015); Buffalo, New York (20142015); Chicago,
Illinois (19962015); Cleveland, Ohio (19912015); Columbus, Ohio (20122015); Dallas, Texas
(19992015); Greensboro, North Carolina (20022015); Indianapolis, Indiana (20132015);
Kansas City, Missouri (19922001, 20072015); Los Angeles, California (20032015); Las
Vegas, Nevada (20022015); Minneapolis, Minnesota (19922015); New York, New York
(20062015); Orange County, California (19912015); Pontiac, Michigan (20122015); and
Tripler Army Medical Center, Hawaii (20012015).

Antimicrobial susceptibility testing was conducted by Emory University (Atlanta, Georgia),


Johns Hopkins University (Baltimore, Maryland), Texas Department of State Health Services
(Austin, Texas), University of Alabama at Birmingham (Birmingham, Alabama), and University
of Washington (Seattle, Washington).

Susceptibility to Antimicrobial Agents

Susceptibility to cefixime
Susceptibility testing for cefixime began in 1992, was discontinued in GISP in 2007, and was re-
started in 2009. The distribution of cefixime MICs each year from 20112015 is displayed in
Figure 1 and Table 1. Each year, over 90% of isolates exhibited cefixime MICs 0.03 g/ml.
The percentage of isolates with elevated cefixime MICs (0.25 g/ml) declined from 1.4% in
2011 to 0.5% in 2015. Site-specific data are presented in the Site Profiles section of this report
(Figure H).

Additional data on susceptibility to cefixime can be found in Sexually Transmitted Disease


Surveillance 2015.1

Susceptibility to ceftriaxone
Susceptibility testing for ceftriaxone began in 1987. The distribution of ceftriaxone MICs each
year from 20112015 is displayed in Figure 2 and Table 2. Each year, approximately 90% of
isolates exhibited ceftriaxone MICs 0.015 g/ml. The percentage of GISP isolates that
exhibited elevated ceftriaxone MICs, defined as 0.125 g/ml, decreased from 0.4% in 2011 to
0.3% in 2015. Site-specific data are presented in the Site Profiles section of this report (Figure
G).
Additional data on susceptibility to ceftriaxone can be found in Sexually Transmitted Disease
Surveillance 2015.1
Susceptibility to azithromycin

Susceptibility testing for azithromycin began in 1992. The distribution of azithromycin MICs
each year from 20112015 is displayed in Table 3 and Figure 3. Most isolates had azithromycin
MICs of 0.1250.25 g/ml. The proportion of GISP isolates with azithromycin MICs of 2.0
g/ml increased from 0.3% in 2011 to 2.6% in 2015. Site-specific data are presented in the Site
Profiles section of this report (Figure J).
Additional data on susceptibility to azithromycin can be found in Sexually Transmitted Disease
Surveillance 2015.1

Susceptibility to ciprofloxacin

Susceptibility testing for ciprofloxacin began in 1990. The proportion of GISP isolates with
ciprofloxacin resistance (MIC 1 g/ml) peaked in 2007 at 14.8%. Following a decline in 2008 and
2009, the proportion increased to 22.3% by 2015. The prevalence of resistance increased sharply
among isolates from gay, bisexual and other men who have sex with men (MSM) during the
2000s, and peaked at 38.9% in 2006 (Figure 4). In 2015, 32.1% of isolates from MSM exhibited
ciprofloxacin resistance. The prevalence of ciprofloxacin resistance increased during 2000
2007 among isolates from men who report sex exclusively with women (MSW), decreased
during 2008 and 2009, and increased during 20102015. In 2015, 16.4% of isolates from MSW
exhibited ciprofloxacin resistance. Site-specific data on intermediate resistance and resistance to
ciprofloxacin are presented in the Site Profiles section of this report (Figure I).
Site Profiles

The Site Profiles consist of figures depicting the demographic and clinical data of the men who
submitted specimens for GISP and the antimicrobial susceptibility results of the N. gonorrhoeae
isolates submitted. Each figure is labeled with the participating site and the number of isolates
on which the sites data are based. The maximum number of isolates submitted by each site
annually is 300. The number of isolates submitted is lower for some sites located in areas with
low gonorrhea morbidity.

Definitions of terms and abbreviations used in the site-specific figures

Figure A: Cases with unknown age were excluded.

Figure B: Cases are reported using Office of Management and Budget (OMB) compliant race
and ethnicity categories. The Other category includes participants who selected more than one
race category and participants with unknown race.

Figure C: Men who self-identified as gay or bisexual or reported recent male sex partners were
categorized as men who have sex with men.

Figure D: Other = other less frequently used drugs, including azithromycin.

Figure E: Azi/Ery = azithromycin/erythromycin; Doxy/Tet = doxycycline/tetracycline.


Figure F: PenR = penicillinase-producing N. gonorrhoeae and chromosomally mediated
penicillin-resistant N. gonorrhoeae; TetR = chromosomally and plasmid-mediated tetracycline-
resistant N. gonorrhoeae; QRNG = ciprofloxacin-resistant N. gonorrhoeae.

GISP Antimicrobial Susceptibility Criteria

Antimicrobial susceptibility criteria used in GISP in 2015 are as follows:

Ceftriaxone, minimum inhibitory concentration (MIC) 0.5 g/ml (decreased


susceptibility)*
Ceftriaxone, MIC 0.125 g/ml (elevated MIC)*
Cefixime, MIC 0.5 g/ml (decreased susceptibility)*
Cefixime, MIC 0.25 g/ml (elevated MIC)*
Azithromycin, MIC 2.0 g/ml (decreased susceptibility)*
Ciprofloxacin, MIC 0.1250.5 g/ml (intermediate resistance)
Ciprofloxacin, MIC 1.0 g/ml (resistance)
Penicillin, MIC 2.0 g/ml (resistance)
Tetracycline, MIC 2.0 g/ml (resistance)

The majority of these criteria are also recommended by the Clinical and Laboratory Standards
Institute (CLSI).4

* Resistance to cefixime and ceftriaxone, and resistance and susceptibility to azithromycin are
not defined by CLSI.

Additional resources

Additional information on GISP, as well as useful resources and links, can be found on the CDC
Division of STD Prevention (DSTDP) Antimicrobial Resistant Gonorrhea website:
https://www.cdc.gov/std/Gonorrhea/arg/default.htm

Other United States surveillance data on N. gonorrhoeae and other STDs and additional data
from GISP may be found on the CDC DSTDP Surveillance and Statistics website:
https://www.cdc.gov/std/stats/

Data on antimicrobial resistance in N. gonorrhoeae and other bacterial pathogens may be found
in CDCs report, Antibiotic Resistance Threats in the United States, 2013:
https://www.cdc.gov/drugresistance/threat-report-2013/
References

1. CDC. Sexually Transmitted Diseases Surveillance 2015. Atlanta: US Department of


Health and Human Services; 2016.
2. Satterwhite CL, Torrone E, Meites E, et al. Sexually transmitted infections among US
women and men: prevalence and incidence estimates, 2008. Sexually Transmitted
Diseases 2013; 40(3):187193.
3. CDC. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep
2015; 64(3):1137.
4. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial
susceptibility testing; Twentieth Informational Supplement, M100-S20. National
Committee for Clinical Laboratory Standards, 2010;29(3):8486.
Figure 1. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs)
Among Neisseria gonorrhoeae Isolates, Gonococcal Isolate Surveillance
Project (GISP), 2011-2015

80
2011
2012
70 2013
2014
2015
60

50
Percentage

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 0.5 1.0

MICs (g/ml)
Figure 2. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs)
Among Neisseria gonorrhoeae Isolates, Gonococcal Isolate Surveillance
Project (GISP), 2011-2015

80
2011
2012
70 2013
2014
2015
60

50
Percentage

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 0.5

MICs (g/ml)
Figure 3. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs)
Among Neisseria gonorrhoeae Isolates, Gonococcal Isolate Surveillance
Project (GISP), 2011-2015

40
2011
2012
2013
2014
2015
30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)
Figure 4. Percentage of Neisseria gonorrhoeae Isolates that are Ciprofloxacin-
Resistant by Reported Sex of Sex Partner, Gonococcal Isolate
Surveillance Project (GISP), 1995-2015

45
MSM* MSW*
40

35

30
Percentage

25

20

15

10

0
1995 96 97 98 99 2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

*MSM=men who have sex with men; MSW=men who have sex with women only.
Table 1. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs)
Among Neisseria gonorrhoeae Isolates, Gonococcal Isolate Surveillance
Project (GISP), 20112015

Minimum Inhibitory Concentrations (g/ml)

0.015 0.030 0.060 0.125 0.250 0.500 1.000 Total


Year n (%) n (%) n (%) n (%) n (%) n (%) n (%) n

2011 3930 1054 319 90 71 3 0 5467


(71.9) (19.3) (5.8) (1.7) (1.3) (0.1) (0.0)

2012 3951 1083 298 111 49 2 1 5495


(71.9) (19.7) (5.4) (2.0) (0.9) (0.0) (0.0)

2013 4165 1250 402 103 25 0 0 5945


(70.1) (21.0) (6.8) (1.7) (0.4) (0.0) (0.0)

2014 3132 1282 482 159 36 2 0 5093


(61.5) (25.2) (9.5) (3.1) (0.7) (0.0) (0.0)

2015 3821 923 286 92 20 5 0 5147


(74.2) (17.9) (5.6) (1.8) (0.4) (0.1) (0.0)

Note: Percentages represent row percentages.


Table 2. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs)
Among Neisseria gonorrhoeae Isolates, Gonococcal Isolate Surveillance
Project (GISP), 20112015

Minimum Inhibitory Concentrations (g/ml)

0.008 0.015 0.030 0.060 0.125 0.250 0.500 Total


Year n (%) n (%) n (%) n (%) n (%) n (%) n (%) n

2011 4161 830 289 166 20 1 0 5467


(76.1) (15.2) (5.3) (3.0) (0.4) (0.0) (0.0)

2012 4241 779 331 129 14 0 1 5495


(77.2) (14.2) (6.0) (2.4) (0.3) (0.0) (0.0)

2013 4491 880 463 108 3 0 0 5945


(75.5) (14.8) (7.8) (1.8) (0.1) (0.0) (0.0)

2014 3650 839 437 160 5 2 0 5093


(71.7) (16.5) (8.6) (3.1) (0.1) (0.0) (0.0)

2015 3694 901 373 165 13 1 0 5147


(71.8) (17.5) (7.2) (3.2) (0.2) (0.0) (0.0)

Note: Percentages represent row percentages.


Table 3. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs)
Among Neisseria gonorrhoeae Isolates, Gonococcal Isolate Surveillance
Project (GISP), 20112015

Minimum Inhibitory Concentrations (g/ml))

0.030 0.060 0.125 0.250 0.500 1.000 2.000 4.000 8.000 16.00 Total
Year n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%) n

2011 518 663 1242 1801 1046 181 7 3 5 1 5467


(9.5) (12.1) (22.7) (32.9) (19.1) (3.3) (0.1) (0.0) (0.1) (0.0)

2012 369 567 1421 1963 1041 119 7 1 2 5 5495


(6.7) (10.3) (25.9) (35.7) (18.9) (2.2) (0.1) (0.0) (0.0) (0.1)

2013 353 498 1465 2257 1157 182 22 2 6 3 5945


(5.9) (8.4) (24.6) (38.0) (19.5) (3.1) (0.4) (0.0) (0.1) (0.0)

2014 323 464 1077 1782 1086 236 50 37 28 10 5093


(6.3) (9.1) (21.2) (35.0) (21.3) (4.6) (1.0) (0.7) (0.6) (0.2)

2015 349 475 1198 1793 980 219 80 32 9 12 5147


(6.8) (9.2) (23.3) (34.8) (19.0) (4.2) (1.5) (0.6) (0.2) (0.2)

Note: Percentages represent row percentages.


Albuquerque, New Mexico (N=115)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Albuquerque, New Mexico (N=115)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

60

50

40
Percentage

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Albuquerque, New Mexico

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

40

30
Percentage

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Albuquerque, New Mexico (N=115)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

100.0%

Ceftriaxone 250 mg
Albuquerque, New Mexico (N=115)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

99.1% 0.9%

Azi/Ery Doxy/Tet
Albuquerque, New Mexico (N=115)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

1.7%
83.5% 2.6%
1.7%
0.9%
3.5%
3.5%
2.6%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
Albuquerque, New Mexico

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

80
2011
2012
70 2013
2014
2015
60

50
Percentage

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Albuquerque, New Mexico

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Albuquerque, New Mexico

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

30

20
Percentage

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance


Albuquerque, New Mexico

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

40
2011
2012
2013
2014
2015
30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Atlanta, Georgia (N=299)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Atlanta, Georgia (N=299)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

100

90

80

70

60
Percentage

50

40

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Atlanta, Georgia

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

40

30
Percentage

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Atlanta, Georgia (N=299)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

0.7%
2.0%
97.0%
0.3%

Ceftriaxone 250 mg Other


Azithromycin 2gm None
Atlanta, Georgia (N=299)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

98.0%
2.0%

Azi/Ery None/Other
Atlanta, Georgia (N=299)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

3.3%
3.7%
4.3%
67.2% 0.7%

8.4%

8.0%

4.3%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
Atlanta, Georgia

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Atlanta, Georgia

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Atlanta, Georgia

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

30

20
Percentage

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance


Atlanta, Georgia

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

40
2011
2012
2013
2014
2015
30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Birmingham, Alabama (N=175)

Figure A. Percentage of GISP Participants by Age Group, 2015

40

30
Percentage

20

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Birmingham, Alabama (N=175)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

100

90

80

70

60
Percentage

50

40

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Birmingham, Alabama

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

10

6
Percentage

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Birmingham, Alabama (N=175)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

89.7%

5.7%

4.6%

Ceftriaxone 250 mg Azithromycin 2gm Other


Birmingham, Alabama (N=175)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

81.6%

9.8%

8.6%

Azi/Ery Doxy/Tet None/Other


Birmingham, Alabama (N=175)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

5.7%
75.4% 3.4%
1.1%
0.6%
5.1%

8.0%
0.6%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
Birmingham, Alabama

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

100
2011
90 2012
2013
80 2014
2015
70

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Birmingham, Alabama

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Birmingham, Alabama

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

30

20
Percentage

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance


Birmingham, Alabama

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

50
2011
2012
2013
40 2014
2015

30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Boston, Massachusetts (N=38)

Figure A. Percentage of GISP Participants by Age Group, 2015

40

30
Percentage

20

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Boston, Massachusetts (N=38)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

60

50

40
Percentage

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Boston, Massachusetts

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

80

70

60

50
Percentage

40

30

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Note: Site participated in GISP from 2014-2015.


Boston, Massachusetts (N=38)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

2.6%

97.4%

Ceftriaxone 125 mg Ceftriaxone 250 mg


Boston, Massachusetts (N=38)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

94.7%

5.3%

Azi/Ery Doxy/Tet
Boston, Massachusetts (N=38)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

42.1%

7.9%

2.6%
2.6%

10.5%

2.6%
18.4%
13.2%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
Boston, Massachusetts

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)

Note: Site participated in GISP from 2014-2015.


Boston, Massachusetts

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

80
2011
2012
70 2013
2014
2015
60

50
Percentage

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)

Note: Site participated in GISP from 2014-2015.


Boston, Massachusetts

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

30

20
Percentage

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance

Note: Site participated in GISP from 2014-2015.


Boston, Massachusetts

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

50
2011
2012
2013
40 2014
2015

30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

Note: Site participated in GISP from 2014-2015.


Buffalo, New York (N=140)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Buffalo, New York (N=140)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

90

80

70

60
Percentage

50

40

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Buffalo, New York

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

20

18

16

14

12
Percentage

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Note: Site participated in GISP from 2014-2015.


Buffalo, New York (N=140)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

0.7%
99.3%

Ceftriaxone 250 mg None


Buffalo, New York (N=140)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

98.6% 1.4%

Azi/Ery Doxy/Tet
Buffalo, New York (N=140)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

8.6%
2.1%
5.0%
0.7%
5.7%
1.4%
0.7%

75.7%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
Buffalo, New York

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

100
2011
90 2012
2013
80 2014
2015
70

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)

Note: Site participated in GISP from 2014-2015.


Buffalo, New York

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)

Note: Site participated in GISP from 2014-2015.


Buffalo, New York

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

30

20
Percentage

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance

Note: Site participated in GISP from 2014-2015.


Buffalo, New York

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

40
2011
2012
2013
2014
2015
30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

Note: Site participated in GISP from 2014-2015.


Chicago, Illinois (N=150)

Figure A. Percentage of GISP Participants by Age Group, 2015

40

30
Percentage

20

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Chicago, Illinois (N=150)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

70

60

50
Percentage

40

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Chicago, Illinois

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

50

40

30
Percentage

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Chicago, Illinois (N=150)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

99.3%
0.7%

Ceftriaxone 250 mg Azithromycin 2gm


Chicago, Illinois (N=150)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

98.6%
1.4%

Azi/Ery None/Other
Chicago, Illinois (N=150)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

69.3% 1.3%
4.0%
0.7%

8.7%

6.7%

9.3%

Susceptible PenR TetR


QRNG PenR/QRNG TetR/QRNG
PenR/TetR/QRNG
Chicago, Illinois

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

100
2011
90 2012
2013
80 2014
2015
70

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Chicago, Illinois

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Chicago, Illinois

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

20

15
Percentage

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance


Chicago, Illinois

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

40
2011
2012
2013
2014
2015
30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Cleveland, Ohio (N=123)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Cleveland, Ohio (N=123)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

90

80

70

60
Percentage

50

40

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Cleveland, Ohio

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

30

20
Percentage

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Cleveland, Ohio (N=123)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

72.4%

26.8%

0.8%

Ceftriaxone 250 mg None Other


Cleveland, Ohio (N=123)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

85.4%

12.2%

2.4%

Azi/Ery Doxy/Tet None/Other


Cleveland, Ohio (N=123)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

76.4%
1.6%
2.4%
3.3%
0.8%
5.7%

7.3%
2.4%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
Cleveland, Ohio

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

100
2011
90 2012
2013
80 2014
2015
70

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Cleveland, Ohio

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Cleveland, Ohio

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

18

16

14

12
Percentage

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance


Cleveland, Ohio

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

60
2011
2012
2013
50 2014
2015

40
Percentage

30

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Columbus, Ohio (N=300)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Columbus, Ohio (N=300)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

80

70

60

50
Percentage

40

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Columbus, Ohio

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

30

20
Percentage

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Note: Site participated in GISP from 2012-2015.


Columbus, Ohio (N=300)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

96.0%

4.0%

Ceftriaxone 250 mg Azithromycin 2gm


Columbus, Ohio (N=300)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

92.3%

4.0%
3.7%

Azi/Ery Doxy/Tet None/Other


Columbus, Ohio (N=300)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

74.3%
5.3%
0.3%
3.3%
1.3%
6.7%

5.3%
3.3%

Susceptible PenR TetR


QRNG PenR/TetR TetR/QRNG
PenR/QRNG PenR/TetR/QRNG
Columbus, Ohio

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

100
2011
90 2012
2013
80 2014
2015
70

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)

Note: Site participated in GISP from 2012-2015.


Columbus, Ohio

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)

Note: Site participated in GISP from 2012-2015.


Columbus, Ohio

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

16

12
Percentage

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance

Note: Site participated in GISP from 2012-2015.


Columbus, Ohio

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

60
2011
2012
2013
50 2014
2015

40
Percentage

30

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

Note: Site participated in GISP from 2012-2015.


Dallas, Texas (N=283)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Dallas, Texas (N=283)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

70

60

50
Percentage

40

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Dallas, Texas

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

40

30
Percentage

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Dallas, Texas (N=283)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

98.9%
1.1%

Ceftriaxone 250 mg None


Dallas, Texas (N=283)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

99.6%
0.4%

Azi/Ery Doxy/Tet
Dallas, Texas (N=283)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

64.7%

4.9%

3.2%
3.5%
0.7%
5.3%

14.5%
3.2%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
Dallas, Texas

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Dallas, Texas

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Dallas, Texas

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

18

16

14

12
Percentage

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance


Dallas, Texas

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

50
2011
2012
2013
40 2014
2015

30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Greensboro, North Carolina (N=259)

Figure A. Percentage of GISP Participants by Age Group, 2015

40

30
Percentage

20

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Greensboro, North Carolina (N=259)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

100

90

80

70

60
Percentage

50

40

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Greensboro, North Carolina

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

30

20
Percentage

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Note: Site participated in GISP from 2002-2015.


Greensboro, North Carolina (N=259)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

100.0%

Ceftriaxone 250 mg
Greensboro, North Carolina (N=259)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

100.0%

Azi/Ery
Greensboro, North Carolina (N=259)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

0.8%

14.7%
61.8%
0.8%
1.2%
6.6%

10.8%
3.5%

Susceptible PenR TetR


QRNG PenR/TetR TetR/QRNG
PenR/QRNG PenR/TetR/QRNG
Greensboro, North Carolina

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

100
2011
90 2012
2013
80 2014
2015
70

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Greensboro, North Carolina

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Greensboro, North Carolina

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

30

20
Percentage

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance

Note: Site participated in GISP from 2002-2015.


Greensboro, North Carolina

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

50
2011
2012
2013
40 2014
2015

30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Honolulu, Hawaii (N=123)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Honolulu, Hawaii (N=123)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

30

20
Percentage

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Honolulu, Hawaii

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

70

60

50
Percentage

40

30

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Honolulu, Hawaii (N=123)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

99.2%
0.8%

Ceftriaxone 250 mg Other


Honolulu, Hawaii (N=123)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

98.4%
1.6%

Azi/Ery None/Other
Honolulu, Hawaii (N=123)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

8.1%
48.0%

6.5%

2.4%
0.8%
4.1%

4.1%
26.0%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
Honolulu, Hawaii

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Honolulu, Hawaii

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Honolulu, Hawaii

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

50

40

30
Percentage

20

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance


Honolulu, Hawaii

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

60
2011
2012
2013
50 2014
2015

40
Percentage

30

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Indianapolis, Indiana (N=298)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Indianapolis, Indiana (N=298)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

80

70

60

50
Percentage

40

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Indianapolis, Indiana

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

25

20

15
Percentage

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Note: Site participated in GISP from 2013-2015.


Indianapolis, Indiana (N=298)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

0.3%

6.0%

92.3%
1.3%

Ceftriaxone 125 mg Ceftriaxone 250 mg


Azithromycin 2gm Other
Indianapolis, Indiana (N=298)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

92.3%

7.0%

0.7%

Azi/Ery Doxy/Tet None/Other


Indianapolis, Indiana (N=298)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

75.2%

3.0%
0.3%
4.4%
0.7%
7.0%

7.4%
2.0%

Susceptible PenR TetR


QRNG PenR/TetR TetR/QRNG
PenR/QRNG PenR/TetR/QRNG
Indianapolis, Indiana

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

100
2011
90 2012
2013
80 2014
2015
70

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)

Note: Site participated in GISP from 2013-2015.


Indianapolis, Indiana

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)

Note: Site participated in GISP from 2013-2015.


Indianapolis, Indiana

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

16

12
Percentage

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance

Note: Site participated in GISP from 2013-2015.


Indianapolis, Indiana

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

40
2011
2012
2013
2014
2015
30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

Note: Site participated in GISP from 2013-2015.


Kansas City, Missouri (N=270)

Figure A. Percentage of GISP Participants by Age Group, 2015

40

30
Percentage

20

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Kansas City, Missouri (N=270)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

90

80

70

60
Percentage

50

40

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Kansas City, Missouri

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

10

6
Percentage

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Note: Site participated in GISP from 2000-2001 and 2007-2015.


Kansas City, Missouri (N=270)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

95.9%
0.7%
1.1%
2.2%

Ceftriaxone 250 mg Azithromycin 2gm


None Gentamicin
Kansas City, Missouri (N=270)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

97.0%
2.6%
0.4%

Azi/Ery Doxy/Tet None/Other


Kansas City, Missouri (N=270)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

4.4%
7.8%

5.2%
0.7%
1.5%
70.4%
7.0%

3.0%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
Kansas City, Missouri

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Kansas City, Missouri

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Kansas City, Missouri

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

30

20
Percentage

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance

Note: Site participated in GISP from 1991-2001 and 2007-2015.


Kansas City, Missouri

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

50
2011
2012
2013
40 2014
2015

30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Las Vegas, Nevada (N=300)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Las Vegas, Nevada (N=300)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

50

40

30
Percentage

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Las Vegas, Nevada

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

50

40

30
Percentage

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Note: Site participated in GISP from 2002-2015.


Las Vegas, Nevada (N=300)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

100.0%

Ceftriaxone 250 mg
Las Vegas, Nevada (N=300)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

100.0%

Azi/Ery
Las Vegas, Nevada (N=300)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

4.7%

55.7%
8.3%

3.7%
0.3%

8.7%

16.7%
2.0%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
Las Vegas, Nevada

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Las Vegas, Nevada

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Las Vegas, Nevada

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

30

20
Percentage

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance

Note: Site participated in GISP from 2002-2015.


Las Vegas, Nevada

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

50
2011
2012
2013
40 2014
2015

30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Los Angeles, California (N=81)

Figure A. Percentage of GISP Participants by Age Group, 2015

40

30
Percentage

20

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Los Angeles, California (N=81)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

40

30
Percentage

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Los Angeles, California

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

90

80

70

60
Percentage

50

40

30

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Note: Site participated in GISP from 2003-2015.


Los Angeles, California (N=81)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

6.2%

1.2%
90.1%
2.5%

Ceftriaxone 125 mg Ceftriaxone 250 mg


Azithromycin 2gm None
Los Angeles, California (N=81)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

93.8%

6.2%

Azi/Ery None/Other
Los Angeles, California (N=81)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

2.5%
12.3%

4.9%
1.2%
2.5%

55.6%

18.5%

2.5%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
Los Angeles, California

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

70
2011
2012
60 2013
2014
2015
50
Percentage

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Los Angeles, California

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

70
2011
2012
60 2013
2014
2015
50
Percentage

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Los Angeles, California

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

40

30
Percentage

20

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance

Note: Site participated in GISP from 2003-2015.


Los Angeles, California

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

50
2011
2012
2013
40 2014
2015

30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Minneapolis, Minnesota (N=105)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Minneapolis, Minnesota (N=105)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

50

40

30
Percentage

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Minneapolis, Minnesota

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

70

60

50
Percentage

40

30

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Minneapolis, Minnesota (N=105)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

98.1%
1.9%

Ceftriaxone 250 mg Azithromycin 2gm


Minneapolis, Minnesota (N=105)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

98.1%
1.9%

Azi/Ery None/Other
Minneapolis, Minnesota (N=105)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

1.9%
6.7%
1.0%
55.2%

27.6%

1.0% 6.7%

Susceptible PenR TetR


QRNG PenR/QRNG TetR/QRNG
PenR/TetR/QRNG
Minneapolis, Minnesota

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

100
2011
90 2012
2013
80 2014
2015
70

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Minneapolis, Minnesota

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Minneapolis, Minnesota

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

50

40

30
Percentage

20

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance


Minneapolis, Minnesota

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

50
2011
2012
2013
40 2014
2015

30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
New Orleans, Louisiana (N=131)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
New Orleans, Louisiana (N=131)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

90

80

70

60
Percentage

50

40

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
New Orleans, Louisiana

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

40

30
Percentage

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
New Orleans, Louisiana (N=131)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

1.5%

25.4%

71.5% 1.5%

Ceftriaxone 250 mg Azithromycin 2gm


Other Gentamicin
New Orleans, Louisiana (N=131)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

74.6%

25.4%

Azi/Ery None/Other
New Orleans, Louisiana (N=131)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

62.6%

2.3%
6.1%

8.4%

3.8%
1.5%
15.3%

Susceptible PenR TetR


QRNG PenR/QRNG TetR/QRNG
PenR/TetR/QRNG
New Orleans, Louisiana

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
New Orleans, Louisiana

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
New Orleans, Louisiana

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

30

20
Percentage

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance


New Orleans, Louisiana

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

50
2011
2012
2013
40 2014
2015

30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
New York City, New York (N=141)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
New York City, New York (N=141)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

70

60

50
Percentage

40

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
New York City, New York

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

60

50

40
Percentage

30

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Note: Site participated in GISP from 2006-2015.


New York City, New York (N=141)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

90.8%

1.4%
0.7%

7.1%

Ceftriaxone 250 mg Azithromycin 2gm


None Gentamicin
New York City, New York (N=141)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

92.2%

7.8%

Azi/Ery None/Other
New York City, New York (N=141)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

11.3%

53.9%
5.7%

9.9%

2.1%
7.1%
2.8% 7.1%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
New York City, New York

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
New York City, New York

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
New York City, New York

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

40

30
Percentage

20

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance

Note: Site participated in GISP from 2006-2015.


New York City, New York

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

40
2011
2012
2013
2014
2015
30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Orange County, California (N=183)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Orange County, California (N=183)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

60

50

40
Percentage

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Orange County, California

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

80

70

60

50
Percentage

40

30

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Orange County, California (N=183)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

93.4%

0.5%
2.2%

3.8%

Ceftriaxone 250 mg Azithromycin 2gm


None Gentamicin
Orange County, California (N=183)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

94.0%

4.4%
1.6%

Azi/Ery Doxy/Tet None/Other


Orange County, California (N=183)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

47.0%
7.7%

6.0%

3.3%

4.9%
2.7%
12.0%
16.4%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
Orange County, California

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

80
2011
2012
70 2013
2014
2015
60

50
Percentage

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Orange County, California

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

70
2011
2012
60 2013
2014
2015
50
Percentage

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Orange County, California

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

50

40

30
Percentage

20

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance


Orange County, California

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

50
2011
2012
2013
40 2014
2015

30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Philadelphia, Pennsylvania (N=300)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Philadelphia, Pennsylvania (N=300)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

80

70

60

50
Percentage

40

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Philadelphia, Pennsylvania

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

40

30
Percentage

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Philadelphia, Pennsylvania (N=300)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

93.0%

1.3%

5.7%

Ceftriaxone 250 mg Cefixime Azithromycin 2gm


Philadelphia, Pennsylvania (N=300)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

98.7% 1.0%
0.3%

Azi/Ery None/Other Doxy/Tet


Philadelphia, Pennsylvania (N=300)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

17.0%

59.0%
2.0%
2.0%
2.3%
4.3%
3.0%

10.3%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
Philadelphia, Pennsylvania

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Philadelphia, Pennsylvania

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

80
2011
2012
70 2013
2014
2015
60

50
Percentage

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Philadelphia, Pennsylvania

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

40

30
Percentage

20

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance


Philadelphia, Pennsylvania

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

50
2011
2012
2013
40 2014
2015

30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Phoenix, Arizona (N=300)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Phoenix, Arizona (N=300)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

50

40

30
Percentage

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Phoenix, Arizona

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

50

40

30
Percentage

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Phoenix, Arizona (N=300)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

100.0%

Ceftriaxone 250 mg
Phoenix, Arizona (N=300)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

98.7% 1.0%
0.3%

Azi/Ery None/Other Doxy/Tet


Phoenix, Arizona (N=300)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

6.0%

16.0%
43.0%

0.7%
1.0%
6.0%

1.7%
25.7%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
Phoenix, Arizona

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Phoenix, Arizona

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Phoenix, Arizona

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

30

20
Percentage

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance


Phoenix, Arizona

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

50
2011
2012
2013
40 2014
2015

30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Pontiac, Michigan (N=198)

Figure A. Percentage of GISP Participants by Age Group, 2015

40

30
Percentage

20

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Pontiac, Michigan (N=198)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

80

70

60

50
Percentage

40

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Pontiac, Michigan

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

50

40

30
Percentage

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Note: Site participated in GISP from 2012-2015.


Pontiac, Michigan (N=198)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

94.4%

3.6%

2.0%

Ceftriaxone 250 mg Azithromycin 2gm None


Pontiac, Michigan (N=198)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

91.9%

3.0%

5.1%

Azi/Ery Doxy/Tet None/Other


Pontiac, Michigan (N=198)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

69.7% 4.5%
4.5%
0.5%
4.0%

10.6%

6.1%

Susceptible PenR TetR


QRNG PenR/QRNG TetR/QRNG
PenR/TetR/QRNG
Pontiac, Michigan

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

100
2011
90 2012
2013
80 2014
2015
70

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)

Note: Site participated in GISP from 2012-2015.


Pontiac, Michigan

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

90
2011
2012
80
2013
2014
70 2015

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)

Note: Site participated in GISP from 2012-2015.


Pontiac, Michigan

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

16

12
Percentage

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance

Note: Site participated in GISP from 2012-2015.


Pontiac, Michigan

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

60
2011
2012
2013
50 2014
2015

40
Percentage

30

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

Note: Site participated in GISP from 2012-2015.


Portland, Oregon (N=148)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Portland, Oregon (N=148)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

70

60

50
Percentage

40

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Portland, Oregon

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

80

70

60

50
Percentage

40

30

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Portland, Oregon (N=148)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

97.3%
2.7%

Ceftriaxone 250 mg None


Portland, Oregon (N=148)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

96.6%

3.4%

Azi/Ery Doxy/Tet
Portland, Oregon (N=148)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

2.0%
7.4%
43.2%

19.6%

4.1%
4.1%
5.4%
14.2%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
Portland, Oregon

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

80
2011
2012
70 2013
2014
2015
60

50
Percentage

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Portland, Oregon

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

80
2011
2012
70 2013
2014
2015
60

50
Percentage

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Portland, Oregon

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

60

50

40
Percentage

30

20

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance


Portland, Oregon

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

60
2011
2012
2013
50 2014
2015

40
Percentage

30

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
San Diego, California (N=189)

Figure A. Percentage of GISP Participants by Age Group, 2015

18
17
16
15
14
13
12
11
Percentage

10
9
8
7
6
5
4
3
2
1
0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
San Diego, California (N=189)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

50

40

30
Percentage

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
San Diego, California

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

90

80

70

60
Percentage

50

40

30

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
San Diego, California (N=189)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

98.4%
1.6%

Ceftriaxone 250 mg None


San Diego, California (N=189)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

92.0%

8.0%

Azi/Ery None/Other
San Diego, California (N=189)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

36.5% 13.8%

5.3%

2.6%
4.8%

7.9%
9.5%

19.6%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
San Diego, California

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

70
2011
2012
60 2013
2014
2015
50
Percentage

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
San Diego, California

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

70
2011
2012
60 2013
2014
2015
50
Percentage

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
San Diego, California

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

50

40

30
Percentage

20

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance


San Diego, California

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

50
2011
2012
2013
40 2014
2015

30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
San Francisco, California (N=300)

Figure A. Percentage of GISP Participants by Age Group, 2015

30

20
Percentage

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
San Francisco, California (N=300)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

40

30
Percentage

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
San Francisco, California

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

80

70

60

50
Percentage

40

30

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
San Francisco, California (N=300)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

99.3%
0.7%

Ceftriaxone 250 mg Azithromycin 2gm


San Francisco, California (N=300)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

99.0% 1.0%

Azi/Ery Doxy/Tet
San Francisco, California (N=300)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

4.0%
9.0%

5.7%
42.0%
4.7%

11.3%

11.0%
12.3%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
San Francisco, California

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

70
2011
2012
60 2013
2014
2015
50
Percentage

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
San Francisco, California

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

70
2011
2012
60 2013
2014
2015
50
Percentage

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
San Francisco, California

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

50

40

30
Percentage

20

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance


San Francisco, California

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

60
2011
2012
2013
50 2014
2015

40
Percentage

30

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Seattle, Washington (N=187)

Figure A. Percentage of GISP Participants by Age Group, 2015

40

30
Percentage

20

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Seattle, Washington (N=187)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

60

50

40
Percentage

30

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Seattle, Washington

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

90

80

70

60
Percentage

50

40

30

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Seattle, Washington (N=187)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

1.1%

69.5%

25.1%

4.3%

Ceftriaxone 250 mg Azithromycin 2gm


Other Gentamicin
Seattle, Washington (N=187)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

30.5%
67.4%

2.1%

Azi/Ery Doxy/Tet None/Other


Seattle, Washington (N=187)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

10.2%
50.3%

8.0%

2.7%
1.6%
7.0%

5.9%
14.4%

Susceptible PenR TetR


QRNG PenR/TetR PenR/QRNG
TetR/QRNG PenR/TetR/QRNG
Seattle, Washington

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

70
2011
2012
60 2013
2014
2015
50
Percentage

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Seattle, Washington

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

70
2011
2012
60 2013
2014
2015
50
Percentage

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Seattle, Washington

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

50

40

30
Percentage

20

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance


Seattle, Washington

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

60
2011
2012
2013
50 2014
2015

40
Percentage

30

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)

.
Tripler Army Medical Center, Hawaii (N=11)

Figure A. Percentage of GISP Participants by Age Group, 2015

50

40

30
Percentage

20

10

0
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Tripler Army Medical Center, Hawaii (N=11)

Figure B. Percentage of GISP Participants by Race/Ethnicity, 2015

40

30
Percentage

20

10

0
White Black Hispanic Asian NHOPI AI/AN Multirace Other/Unk

NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native; Unk = Unknown
Tripler Army Medical Center, Hawaii

Figure C. Percentage of GISP Participants Identifying as Men who Have Sex with Men, 2000-2015

40

30
Percentage

20

10

0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Note: Site participated in GISP from 2001-2015.


Tripler Army Medical Center, Hawaii (N=11)

Figure D. Primary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

88.9%

11.1%

Ceftriaxone 250 mg Azithromycin 2gm


Tripler Army Medical Center, Hawaii (N=11)

Figure E. Secondary Antimicrobial Drug Used to Treat Gonorrhea Among GISP Participants, 2015

88.9%

11.1%

Azi/Ery None/Other
Tripler Army Medical Center, Hawaii (N=11)

Figure F. Percentage of GISP Isolates with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, 2015

90.9%

9.1%

Susceptible PenR/TetR/QRNG
Tripler Army Medical Center, Hawaii

Figure G. Distribution of Ceftriaxone Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

100
2011
90 2012
2013
80 2014
2015
70

60
Percentage

50

40

30

20

10

0
<=0.008 0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Tripler Army Medical Center, Hawaii

Figure H. Distribution of Cefixime Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

100
2011
90 2012
2013
80 2014
2015
70

60
Percentage

50

40

30

20

10

0
<=0.015 0.03 0.06 0.125 0.25 >=0.5

MICs (g/ml)
Tripler Army Medical Center, Hawaii

Figure I. Percentage of GISP Isolates with Intermediate Resistance or Resistance to Ciprofloxacin, 2000-2015

40

30
Percentage

20

10

0
2000 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Intermediate resistance Resistance

Note: Site participated in GISP from 2001-2015.


Tripler Army Medical Center, Hawaii

Figure J. Distribution of Azithromycin Minimum Inhibitory Concentrations (MICs) Among GISP Isolates, 2011-2015

50
2011
2012
2013
40 2014
2015

30
Percentage

20

10

0
<=0.03 0.06 0.125 0.25 0.5 1.0 2.0 >=4.0

MICs (g/ml)