Colorado's Center of Excellence for Gonorrhea
Combatting Antibiotic Resistant Gonorrhea and Other STIs – CARGOS
The Centers for Disease Control and Prevention have been involved in surveillance for resistant gonorrhea for decades. Currently, two large multi-site projects are in place: GISP and SURRG. Antibiotic susceptibility testing is an activity common to both GISP and SURRG.
Resistant Gonorrhea Surveillance Projects
GISP: The Gonococcal Isolate Surveillance Project (GISP) was established in 1986 to monitor antibiotic resistance (AR) trends in N. gonorrhoeae bacteria in the US. In GISP, N. gonorrhoeae specimens are collected each month from the first 25 men who attend STD clinics in selected U.S. cities and who have also been diagnosed with urethral gonorrhea. Participating regional laboratories test the specimens for resistance to the antibiotic drugs azithromycin, cefixime, ceftriaxone, ciprofloxacin, gentamicin, penicillin, and tetracycline.
SURRG: Strengthening the U.S. Response to Resistant Gonorrhea (SURRG) began in 2016 to enhance domestic gonorrhea surveillance and infrastructure, build capacity for rapid detection and response to resistant gonorrhea through increased culturing and local antibiotic susceptibility testing, and rapid field investigation to stop the spread of resistant infections. The Colorado Department of Public Health and Environment in collaboration with Institute of Public Health and Denver Health were involved with SURRG from 2016-2024.
CARGOS: Combatting Antibiotic Resistant Gonorrhea and Other STIs (CARGOS) started in 2024 to monitor trends in antimicrobial susceptibilities of gonorrhea and other STIs in the U.S. and strengthen state and local capacity to rapidly detect and respond to threats of Antimicrobial Resistance (AMR). The Colorado Department of Public Health and Environment in collaboration with Institute of Public Health and Denver Health have been involved with CARGOS since 2024.
Colorado CARGOS Overview
Combatting Antibiotic Resistant Gonorrhea and other STIs (CARGOS) began in 2024 as a component under the CDC’s Epidemiology and Laboratory Capacity (ELC) Grant. The project follows the Strengthening the US Response to Resistant Gonorrhea (SURRG) project that concluded mid-2024. The Colorado CARGOS project is a partnership between Colorado Department of Public Health and Environment (CDPHE), the Public Health Institute at Denver Health (PHIDH), formerly Denver Public Health, and Denver Health and Hospital Authority. CARGOS was created as a response to rising antimicrobial resistant gonorrhea (ARGC) with two goals: Monitor trends in antimicrobial susceptibilities of gonorrhea and STIs in the U.S. and Strengthen state and local capacity to rapidly detect and respond to threats of antimicrobial resistance. The project also aims to gain a better understanding of the epidemiological factors contributing to resistant gonorrhea. There are 19 different CARGOS sites and jurisdictions across the US that collect and analyze data. They help guide national recommendations for the public health response to the growing threat of resistant gonorrhea.
The Colorado CARGOS project focuses on GC infections in the Colorado Denver Metro Area. Specimens are collected at active Denver Health CARGOS clinics throughout the Denver Metro area. Gonorrhea bacteria isolated from specimens collected at CO SURRG sites are tested for reduced susceptibility to two antimicrobials with Etest strips of concentrated antimicrobials: ceftriaxone (CRO), and cefixime (CFX). Indication of reduced susceptibility for antimicrobials are MIC values ≥ 0.125 μg/mL for ceftriaxone (CRO-RS) and ≥ 0.25 μg/mL for cefixime (CFX-RS).
CARGOS Contact: Leslie Frank, MPH, Data Analytics, Program Evaluation and SURRG Program Manager, leslie.frank@state.co.us