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Objectives: Gonorrhoea and antimicrobial resistance (AMR) in Neisseria gonorrhoeae are major public health concerns globally. Enhanced AMR surveillance for gonococci is essential worldwide; however, recent quality-assured gonococcal AMR surveillance in Latin America, including Brazil, has been limited. Our aims were to (i) establish the first nationwide gonococcal AMR surveillance, quality assured according to WHO standards, in Brazil, and (ii) describe the antimicrobial susceptibility of clinical gonococcal isolates collected from 2015 to 2016 in all five main regions (seven sentinel sites) of Brazil.Methods: Gonococcal isolates from 550 men with urethral discharge were examined for susceptibility to ceftriaxone, cefixime, azithromycin, ciprofloxacin, benzylpenicillin and tetracycline using the agar dilution method, according to CLSI recommendations and quality assured according to WHO standards.Results: The levels of resistance (intermediate susceptibility) to tetracycline, ciprofloxacin, benzylpenicillin and azithromycin were 61.6% (34.2%), 55.6% (0.5%), 37.1% (60.4%) and 6.9% (8.9%), respectively. All isolates were susceptible to ceftriaxone and cefixime using the US CLSI breakpoints. However, according to the European EUCAST cefixime breakpoints, 0.2% (n = 1) of isolates were cefixime resistant and 6.9% (n = 38) of isolates had a cefixime MIC bordering on resistance.Conclusions: This study describes the first national surveillance of gonococcal AMR in Brazil, which was quality assured according to WHO standards. The high resistance to ciprofloxacin (which promptly informed a revision of the Brazilian sexually transmitted infection treatment guideline), emerging resistance to azithromycin and decreasing susceptibility to extended-spectrum cephalosporins necessitate continuous surveillance of gonococcal AMR and ideally treatment failures, and increased awareness when prescribing treatment in Brazil. [ABSTRACT FROM AUTHOR]

Background Enterobacteriaceae is the main pathogens of UTI. It is important to be aware the local epidemiological data for an appropriate initial treatment. Resistance to antimicrobial agents has increased, especially to first-choice antibiotics in the treatment of cystitis. Our objective is to asses the antimicrobial susceptibility profile from uropathogens isolated in community and evaluated the dissemination of extended-spectrum ß lactamase (ESBL), in E. coli and K. pneumoniae in south of Brazil. Methods From June 2016 to June 2017, all urine samples collected in the Basic Health Units and Emergency Departments were sent to a Central Laboratory. Identification and susceptibility tests were performed on the VITEK® 2 (bioMérieux, France) system. Clinical Laboratory Standards Institute (CLSI) breakpoints were used for the interpretation of susceptibility. Positive cultures were defined as those demonstrating ≥105 CFU / mL (colony-forming units). The presence of ESBL was also subjected to the Chrom ID BLEE® agar plate test (bioMérieux- Marcyl'Etoile, France). PCR technique uses specific primers for genes bla TEM and bla SHV. Detection of the bla CTX-M genes was performed by multiplex PCR. Results A total of 56,555 microbiologic tests were performed, 8189 were positive. Women were responsible for 89.4%, and 10% were pregnant. Table 1 shows uropathogens isolated. Graphic 1 shows antimicrobial susceptibility. Extended-spectrum ß lactamase production was present in 6.7% (n = 489). People older than 60 years had ESBL more frequent (P < 0.05) as well as being pregnant is not related to ESBL (P < 0.05). Table 2 shows the distribution of the bla genotypes. Table 3: Distribution of blaCTX-M. Among bla CTX-M1 genotype, bla CTX-M15 was the most frequent. Conclusion In this study, the most frequent uropathogen isolated was E. coli followed by K. pneumoniae. Cotrimoxazol had high rates of resistance and nitrofurantoin the lowest. Quinolone resistance is more than 10%. Sensitivity to aminoglycosides and carbapenems remains high.We found relevant frequency of ESBL, CTX-M-1-group most commonly found. Among CTX-M-1, bla CTX-M15 was the most isolated. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]