Colorado's Center of Excellence for Gonorrhea
Strengthening the U.S. Response to Resistant Gonorrhea - SURRG
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. (https://www.cdc.gov/std/gisp/default.htm)
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 have been involved with SURRG since 2016.
Colorado SURRG Overview
Strengthening the US Response to Resistant Gonorrhea (SURRG) began in 2016 as a component under the CDC’s Epidemiology and Laboratory Capacity (ELC) Grant. The Colorado SURRG 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. SURRG was created as a response to rising antimicrobial resistant gonorrhea (ARGC) with three goals: 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 project also aims to gain a better understanding of the epidemiological factors contributing to resistant gonorrhea. There are eight SURRG sites and jurisdictions in the US that collect and analyze data, helping guide national recommendations for the public health response to the growing threat of resistant gonorrhea.
The Colorado SURRG project focuses on GC infections in Denver County, Colorado. Specimens are collected at six active Denver Health SURRG 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).
To contact Colorado SURRG please email karen.gieseker@state.co.us
Outbeak Resources
In order to provide resources for local health departments to prepare and respond to outbreaks of antibiotic resistant gonorrhea (ARGC), the CDC has created materials that can be used to create press releases or other formal communications during an outbreak.
- Health Alert Template for Gonorrhea with Reduced Susceptibility
- Antibiotic Resistant Gonorrhea (ARGC) Tabletop Exercise