Gonococcal Isolate Surveillance Project (GISP)

Antibiotic resistance (AR) is the ability of bacteria to resist the effects of all of the drugs used to treat them. This means the germs are not killed and they will continue to reproduce. Neisseria gonorrhoeae, the bacterium that causes the sexually-transmitted disease gonorrhea, has developed resistance to nearly all of the antibiotics used for gonorrhea treatment.

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Area chart showing the distribution of primary antimicrobial drugs used to treat gonorrhea among participants from 1988 to 2019.

The Gonococcal Isolate Surveillance Project (GISP) was established in 1986 to monitor AR trends in N. gonorrhoeae bacteria in the United States. GISP is a collaborative project among selected STD clinics and their state or local public health authorities,  GISP regional laboratories, and CDC. Public health officials and healthcare providers use the data collected in GISP to ensure that gonorrhea is successfully treated with the right antibiotic.

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. These are antibiotics which either are currently or were previously used for gonorrhea treatment. The ability of the bacteria to resist the effect of the antibiotics in the laboratory is measured, and the results are interpreted according to criteria recommended by the Clinical and Laboratory Standards Institute (CLSI). The results of these tests are then transmitted to CDC where they are collated and analyzed.