Antimicrobial Resistance Expressed by Neisseria gonorrhoeae : A Major Global Public Health Problem in the 21st Century

Abstract

Neisseria gonorrhoeae is a strictly human pathogen that is typically transmitted by sexual contact. The associated disease gonorrhea has plagued humankind for thousands of years, with a current estimated incidence of 78 million cases per year. Advances in antimicrobial discovery in the 1920s and 1930s leading to the discovery of sulfonamides and penicillin begun the era of effective antimicrobial treatment of gonorrhea. Unfortunately, the gonococcus developed decreased susceptibility or even resistance to these initially employed antibiotics, a trend that continued over subsequent decades with each new antibiotic that was brought into clinical practice. As this pattern of resistance has continued into the 21st century, there is now reason for great concern, especially in an era when few new antibiotics have prospects for use as treatment of gonorrhea. Here, we review the history of gonorrhea treatment regimens and gonococcal resistance to antibiotics, the mechanisms of resistance, resistance monitoring schemes that exist in different international settings, global responses to the challenge of resistance, and prospects for future treatment regimens in the 21st century.

Sexually transmitted infections: challenges ahead

“…153,155,156 For many infectious diseases including gonorrhoea, overuse and settings with a high incidence of gonorrhoea and ineffective control measures. 152,153,155,156,158 …”

“…[152][153][154]158 The prevalence of multidrug-resistant (MDR) 155 gonococcal strains significantly increased 572 during the last decade. [152][153][154]158 Resistance to extended-spectrum cephalosporins (ESCs), the inconsistent condom use and increased numbers of sexual partners in meta-analyses. 16 …”

Deciphering the Function of New Gonococcal Vaccine Antigens Using Phenotypic Microarrays

“…Treatment failures with the last viable class of antibiotics, third-generation cephalosporins, have been encountered in several countries (7,8). The development of a protective vaccine(s) is of paramount importance (9)(10)(11)(12)(13)).…”

Atualizações em Infeções Sexualmente Transmissíveis

“…A infeção da orofaringe ou rectal habitualmente é assintomática. 31 As estimativas da OMS em 2012 apontavam para uma incidência mundial de 78 milhões de casos de gonorreia, sendo a segunda IST bacteriana mais frequente na Europa a seguir à Chlamydia trachomatis. 32 A NG é uma preocupação de saúde pública global pela possibilidade de vir a transformar-se numa bactéria resistente a todos os fármacos disponíveis.…”