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Title, author, year of article: Decline in Decreased Cephalosporin Susceptibility and Increase in Azithromycin Resistance in Neisseria gonorrhoeae, Canada. Martin, I., Sawatzky, P., Liu, G., and Allen, V. (2016). Brief Summary/Purpose of the study: This article evaluated the antimicrobial resistance for Neisseria gonorrhoeae strains isolated in Canada during 2010–2014. The percentage of isolates with reduced vulnerability to cephalosporins declined significantly between 2011 and 2014, while azithromycin resistance increased significantly during that period. Continued surveillance of antimicrobial drug susceptibilities is imperative to inform treatment guidelines. Continuous observation of gonococcal antimicrobial susceptibilities is vital to update the treatment strategies and alleviate the spread of isolates with reduced susceptibility to cephalosporins and resistance to azithromycin. Limitations of this study include the representativeness of isolates, because 70-75% of gonococcal infections in Canada are diagnosed by nucleic acid amplification tests, and the current passive surveillance system collects predominately resistant isolates from provinces with different susceptibility testing methods. The proportion of resistance could be higher than that indicated by our numbers.How did the study support Ms. Campbell's case: Because Ms. Campbell has had a history of multiple sexual partners with previous STDs, the study support her case by limiting the spread of N. gonorrhoeae antimicrobial drug resistance and prevent the emergence of untreatable multidrug-resistant gonorrhea.EVIDENCE-BASED ARTICLES
Title, author, year of article: Evidence Summary for Gonorrhea: Screening. Zakher, B., Cantor, A. G., and Nelson, H. D. (2014). Brief Summary/Purpose of the study: This research has supported the screening for gonorrhea and chlamydia in asymptomatic, sexually active women (including pregnant women) who are younger than 28 years or at increased risk but not in other patient populations. The purpose of this study is to modernize the 2005 and 2007 systematic reviews for the U.S. Preventive Services Task Force on screening for gonorrhea and chlamydia in women, including pregnant women and adolescents. STDs screening in young women may decrease the prevalence of pelvic inflammatory disease. Nucleic acid amplification tests are accurate for diagnosing gonorrhea and chlamydia in asymptomatic persons. The limitation of the study is only a few relevant studies of screening benefits and harms. Only screening tests and methods cleared by the U.S. Food and Drug Administration for current clinical practice were included to determine diagnostic accuracy.How did the study support Ms. Campbell's case: The study is helpful in Ms. Campbell case as it delineates a need for regular screening even in an asymptomatic individual in order to decrease the prevalence of PID.