Antimicrobial resistance in sexually transmitted infections

Abstract

Rationale for review International travel facilitates the spread of drug-resistant infections, including sexually transmitted infections (STIs). In 2016, the World Health Organization highlighted the global burden of ‘curable’ STIs, estimating 376 million new infections of gonorrhoea, chlamydia, syphilis and trichomoniasis annually, with considerable geographic variation in both the burden of disease and prevalence of resistance. Travelers’ risk of contracting and transmitting drug-resistant STIs depends in part on their geographic exposure. In this review, we describe the epidemiology of antimicrobial resistance (AMR) and the management of these four common STIs and Mycoplasma genitalium, an increasingly recognized cause of non-gonococcal urethritis. Key findings Multi-drug and extensively drug resistant gonorrhoea strains have been associated with international spread, particularly in travelers returning from Southeast Asia. Chlamydia is the most common bacterial STI worldwide. Although in vitro resistance has been reported, surveillance data suggest that clinically significant resistance to macrolides and tetracyclines is rare. Macrolide resistance in syphilis is now endemic in much of the world but there is no documented penicillin resistance, which remains first-line therapy. Trichomoniasis is the most common non-viral STI worldwide. Although clinical failure after treatment occurs, resistance to metronidazole is thought to be uncommon. Mycoplasma genitalium exhibits intrinsic resistance to many antibiotics, and the prevalence of resistance to both first- and second-line regimens (macrolides and fluoroquinolones) is increasing worldwide, with limited alternative therapeutic options. Recommendations International travelers are at risk for acquiring resistant STIs with limited therapeutic options. Improved diagnostics are urgently needed to improve AMR surveillance and the management of infected patients. As no vaccinations are currently available for these STIs, and pre-exposure prophylaxis is an area of active study with limited data, condom use is critical for prevention. Travel medicine providers should incorporate STI risk reduction counselling, with an emphasis on condom use, into the routine pre-travel consultation.

Antimicrobial Resistance in Humans, Animals, Water and Household Environs in Rural Andean Peru: Exploring Dissemination Pathways through the One Health Lens

“…The last time the animal was treated; did the animal receive any antibiotic? 72.5 (29) Antibiotic used for the treatment -Amoxicillin 3.1 (1) -"Biomizona" 1 21.8 (7) -"Ciclosona" 2 50 (16) -"Emicina" 3 3.1 (1) -"Hipradoxi S" 4 3.1 (1) -"Hipralona" 5 6.2 (2) -"Quinolaba" 5 6.2 (2) -"Tylogen" 6 6.2 (2)…”

“…1 Brand name for a commercial formulation of oxytetracycline and benzydamine, 2 brand name for a commercial formulation of oxytetracycline and dexamethasone, 3 brand name for oxytetracycline, 4 brand name for doxycycline, 5 brand names for enrofloxacin, 6 brand name for a commercial formulation of Gentamicin and Tylosin.…”

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: infecções que causam corrimento uretral

“…38,39 La OMS, en el "Informe de Vigilancia Global de Infecciones de Transmisión Sexual 2018", prioriza el control de las infecciones gonocócicas debido a la posibilidad inminente de convertirse en infecciones no tratables. 40,41 Brasil es uno de los países miembros del programa de vigilancia mundial de la susceptibilidad del gonococo a antimicrobianos (Gonococcal Antimicrobial Surveillance Programme, GASP). 42 Las actividades del GASP en Brasil se desarrollan en el ámbito del Proyecto SenGono, resultado de la cooperación entre el Ministerio de Salud, el Laboratorio de Referencia Nacional (Laboratorio de Biología Molecular, Microbiología y Serología de la Universidad Federal de Santa Catarina) y los sitios centinela distribuidos en todas las regiones del país (Figura 4).…”

Managing contacts of chlamydia: should clinics implement a test and wait process?

“…Antibiotic stewardship has become of increasing concern in sexual health, particularly when managing gonorrhoea and Mycoplasma genitalium infections, due to evolving antibiotic resistance. 10 Antibiotic resistance has not been a significant issue when managing chlamydia, and tetracyclines and macrolides remain highly effective in treating uncomplicated chlamydial infection. In vitro antibiotic resistance in Chlamydia trachomatis , when described, remains as a small number of case reports only, with uncertain epidemiological relevance.…”

“…In vitro antibiotic resistance in Chlamydia trachomatis , when described, remains as a small number of case reports only, with uncertain epidemiological relevance. 10 However, antibiotic resistance has been seen in other Chlamydia species, and so ongoing vigilance in cases of treatment failure is required. 11 Furthermore, STIs do not exist in isolation.…”