It is unclear how important bystander selection is in the genesis of antimicrobial resistance (AMR) in Neisseria gonorrhoeae. We assessed bystander selection in a novel way. Mixed-effects linear regression was used to assess if country-level prevalence of gonococcal AMR in 30 European countries predicts homologous AMR in other bacteria. The data used was from the European Antimicrobial Resistance Surveillance Network. The prevalence of gonococcal ciprofloxacin resistance was found to be positively associated with AMR prevalence in E. coli (coef. 0.52; P = 0.007), Acinetobacter spp. (coef. 0.13; P = 0.044) and Pseudomonas aeruginosa (coef. 0.36; P = 0.020) but not Klebsiella pneumoniae. Azithromycin resistance in N. gonorrhoeae was positively associated with macrolide resistance in Streptococcus pneumoniae (coef. 0.01; P = 0.018). No association was found for cephalosporins. Gonococcal AMR is linked to that in other bacteria. This finding is likely explained by high antimicrobial consumption in affected populations and provides additional motivation for strengthening antimicrobial stewardship programs.

中文翻译：

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淋球菌耐药性可以有效地视为抗菌素耐药性综合症的一部分：对30个欧洲国家的生态学分析。

尚不清楚旁观者选择在淋病奈瑟氏球菌的抗菌素耐药性（AMR）发生中有多重要。我们以一种新颖的方式评估了旁观者的选择。混合效应线性回归用于评估欧洲30个国家中淋球菌AMR的国家/地区患病率是否预测了其他细菌中的同源AMR。使用的数据来自欧洲抗菌素耐药性监测网络。发现淋球菌环丙沙星耐药的发生率与大肠杆菌中不动杆菌的AMR发生率呈正相关（系数0.52； P = 0.007）。（系数0.13； P = 0.044）和铜绿假单胞菌（系数0.36； P = 0.020），但不是肺炎克雷伯菌。淋病奈瑟菌对阿奇霉素的耐药性与肺炎链球菌对大环内酯类药物的耐药性呈正相关（系数0.01； P = 0.018）。没有发现与头孢菌素有关。淋球菌AMR与其他细菌中的AMR相关。这一发现可能是由于受影响人群中的高抗菌素消费量所致，并为加强抗菌素管理计划提供了更多动力。