Background: Neisseria gonorrhoeae, the causative agent for sexually transmitted infection (STI) gonorrhoea, has emerged with a significant public health impact on acquiring resistance to antimicrobials available for treatment. The resistance ofN. gonorrhoeaelimit treatment options and contributed to high morbidity associated with gonorrhoea. Data on antimicrobial resistance (AMR) profiles inN. gonorrhoeaeis scares in Zambia. This study aimed to determine the antibiotic susceptibilities inN. gonorrhoeaeisolates from Lusaka, Zambia.Methods: A prospective cross-sectional study was conducted on 630 STI patients who presented with urethral or vaginal discharge from 2019 to 2020. Urethral and endocervical secretions were cultured on Modified Thayer Martin agar and incubated at 36 °C ± 1 °C in 5% CO₂for 24 h. Identification ofN. gonorrhoeaeisolates was achieved by Gram stain, oxidase, nitrocefin disk, BactiCardNeisseria, and Viteck® Compact. The AMR profiles were determined using E-test. Statistical significant was determined by Pearson’s Chi-square test, Mann-Whitney U test, or logistic regression withp-values of < 0.05 indicating significance.Results: A total of 630 patients were recruited of which 46% (290/630) with the median of 29 years and interquartile range (IQR) of 19–39 years were male. The median of the females was 26 years and IQR of 15–37 years.Neisseria gonorrhoeaewas isolated from 19.4% (122/630) patients of which 72.9% (89/122) were male, with highest prevalence of isolation in the age category of 25–34 years. The prevalence of resistance was high to penicillin (85.2%), tetracycline (68.9%) and ciprofloxacin (59.8%) with MIC₉₀of 32 µg/mL, 8 µg/mL, and 8 µg/mL respectively. The isolates had reduced susceptibility to cefixime (1.6%), spectinomycin (4.9%) and (4.9%) for azithromycin. All isolates were susceptible to ceftriaxone. Risk factors associated with AMR were douching in females (AOR 6.69, 95% CI; 1.11–40.31,p = 0.039), female gender (AOR 7.64, 95% CI; 1.11–52.33,p = 0.048), HIV-positivity (AOR 26.59, 95% CI; 3.67–192.7,p = 0.005), no condom use or unprotected sex (AOR 5.48, 95% CI; 1.17–22.75p = 0.026), sex trading (AOR 4.19, 95% CI; 1.55–11.33,p = 0.010), and over-counter treatment of ciprofloxacin (AOR 3.44, 95% CI; 1.17–22.75,p = 0.023).Conclusion: TheN. gonorrhoeaeresistance to penicillin, tetracycline and ciprofloxacin was high necessitating revision of the treatment guidelines. However, no resistance to ceftriaxone was detected. Therefore, monitoring of antibiotic resistance remains critical in Zambia.

Surgical site infections (SSIs) are on the rise and are a global concern as they complicate the recovery of patients postoperatively. Bacterial colonization of the patient’s skin and alimentary tract are known to be major contributing sources to SSIs. However, Zambia lacks data relating to carriage rates of antibiotic-resistant rectal Escherichia coli among surgical patients. This was a cross-sectional study aimed at determining the preoperative (preop) and postoperative (postop) carriage and antimicrobial susceptibility patterns of rectal ESBL-producing E. coli (ESBL-Ec) in elective surgery patients at the highest tertiary hospital in Lusaka, Zambia. Phenotypic methods were used in the identification of E. coli. Antibiotic susceptibility patterns and identification of ESBL-Ec was determined by Kirby–Bauer disc diffusion. A total of 120 study participants were recruited, of which 75 were followed up at least 72 h after surgery. From 195 rectal swabs cultured, 177 (90.8%) were positive for E. coli, of which 53 (29.9%) were ESBL-Ec, with a significantly (P < 0.0001) higher proportion in postop (47.9%) than preop (17.3%) participants. Overall, ESBL-Ec isolates showed higher resistance in postop than preop to cefotaxime (100% versus 88.9%, respectively), ampicillin (100% versus 94.4%), ciprofloxacin (88.3% versus 83.3%), amoxicillin/clavulanic acid (80% versus 66.7%) and cefepime (80% versus 77.8%). MDR ESBL-Ec strains were more frequent in postop than in preop participants (91.4% versus 88.9%). The study showed a significantly higher rate of antimicrobial-resistant rectal E. coli in postop than preop participants. There is a need to ascertain the source of the resistance and to institute robust infection control measures, preop screening of surgical patients for ESBL-Ec, and to raise awareness on prudent use of antibiotics.