ESSTI - European surveillance of sexually transmitted infections

EC contribution: : € 1.353.597,88
Duration: : 36 months
Starting date: : 01/01/2006
Funding scheme: : DG-SANCO
Keywords: : sexually transmitted infections, Neisseria gonorrhoeae, antimicrobial resistance, surveillance
Contract/Grant agreement number: : 2004210
Project web-site: : http://www.essti.org/

Background:

Sexually transmitted infections (STIs) in Europe are a major public health threat. Their increasing incidence; adverse impact on individual and public health; substantial economic costs; and emerging antimicrobial resistance have increased the need for pan-European approaches to their control. Outbreaks of STIs in Europe continue to increase, driven largely by increases in risk behaviours and overwhelmed curative services. The expansion of the EU also presents particular threats to STI control due to population movement from high incidence areas.

The ESSTI (European Surveillance of Sexually Transmitted Infections) Network aims to develop and coordinate epidemiological and laboratory surveillance of STIs in the European region in order to better inform STI prevention, care and control.

Specific objectives are to:

Operate and develop the ESSTI network with EU member states; EFTA-EEA; Turkey,
Collate, analyse and report surveillance data on the major acute STIs from participating countries
Extend ESSTI_ALERT, the European early warning system for unexpected and adverse STI transmission events (e.g. outbreaks)
Implement a European Gonococcal Antimicrobial Susceptibility Surveillance Project (Euro_GASP), including a quality assurance system, recommended methods, training programmes and molecular typing for outbreaks
Deliver training programmes on STI surveillance; lab diagnostics; and STI clinical management to network participants
Use the ESSTI website to disseminate information to European policymakers; professionals; and public.

Problem:

The number of cases of STIs continues to increase in many countries throughout Europe. In this era of widespread travel and migration STI surveillance at a European level can enable the early identification of outbreaks and problems with antimicrobial resistance. The increasing incidence of gonococcal infections is of concern due to the acquisition of resistance to antimicrobials by the causative bacterium Neisseria gonorrhoeae. Antimicrobial resistance has implications for the treatment of gonorrhoea and therefore surveillance has a key role in helping inform national treatment guidelines.

Aim:

The European Gonococcal Antimicrobial Susceptibility Surveillance Project (Euro_GASP) has three main components.

A representative sample of strains will be collected from each country and sent to reference laboratories in London, Vienna or Copenhagen. The results will be used to give estimates of the prevalence of antimicrobial resistance across Europe.

A quality assurance system will also be established as follows;

An annual exchange of ten strains of unknown susceptibility will be provided to all laboratories in triplicate. These will be tested by each laboratory, using their own methodology, and the results returned centrally for analysis. This will allow individual centres to identify reproducibility problems and comparison between labs.
A panel of control strains selected from strains that have previously been tested in all of the labs will be made available to all European reference and specialist centres. This will ensure a common reference point to which individual labs can control their own methodology.

Expected and obtained results:

Estimates of resistance to antimicrobial agents used for the therapy of gonorrhoea across Europe.
Comparability of methods for determining susceptibility to antimicrobial agents for Neisseria gonorrhoeae.
Establishment of a panel of control strains for use in laboratories across Europe.

Potential applications:

Collaboration between the laboratories in this network should establish a European Gonococcal Surveillance Programme (EuroGASP) that will monitor resistance to therapeutic agents across Europe and inform individual patient management and the production of therapeutic guidelines.

Coordinator:

Prof. Cathy Ison
Health Protection Agency
61 Colindale Avenue
London, NW9 5EQ, England, UK
Catherine.Ison@hpa.org.uk

European Commission