Meeting the public health challenge of multidrug- and extensively drug-resistantNeisseria gonorrhoeae

Abstract

Globally, antimicrobial resistance (AMR) in Neisseria gonorrhoeae is increasing in prevalence, both within and across antibiotic classes, including extended-spectrum cephalosporins, raising concerns that gonorrhea may become untreatable in certain circumstances. The AMR surveillance that is essential to optimize standard treatments is often lacking or of poor quality in countries with high disease rates. Recent initiatives by the WHO to enhance global AMR surveillance that focus on multidrug- and extensively drug-resistant N. gonorrhoeae through revision of surveillance standards and use of a new panel of N. gonorrhoeae control strains are described. Keys to meeting these new challenges posed by gonococcal AMR remain the reduction in global burden of gonorrhea combined with implementation of wider strategies for general AMR control, and better understanding of mechanisms of emergence and spread of AMR.

Antimicrobial susceptibility of Neisseria gonorrhoeae isolates from patients attending a public referral center for sexually transmitted diseases in Belo Horizonte, State of Minas Gerais, Brazil

“…Knowledge of local susceptibility patterns of N. gonorrhoeae is essential to establish the best treatment 9,10 . Control of gonococcal infection requires the continuous and high-quality surveillance of resistance 2,6 ; however, few studies on this subject have been conducted in Brazil. The current study provides insight into the resistance of Neisseria gonorrhoeae in Belo Horizonte, Minas Gerais.…”

“…Gonorrhea remains a serious public health problem and is the second most prevalent bacterial infection and sexually transmitted disease worldwide, with 106 million new cases annually 1,2 . Its incidence is higher in underdeveloped countries and developing countries but remains unacceptably high in developed countries, particularly among those associated with vulnerable populations, marginalized ethnicities or sexu al orientations 3,4 .…”

“…Its incidence is higher in underdeveloped countries and developing countries but remains unacceptably high in developed countries, particularly among those associated with vulnerable populations, marginalized ethnicities or sexu al orientations 3,4 . Gonorrhea can cause serious complications such as epididymitis, pelvic infl ammatory disease, ectopic pregnancy and infertility and can also enhance the acquisition and transmission of human immunodefi ciency virus (HIV) 2,5 .…”

Die deutsche Laborlandschaft zu Diagnostik und Antibiotikaresistenztestung bei Neisseria gonorrhoeae

“…Obwohl NAT als Diagnostikmethode aufgrund der hohen Sensitivität und des geringeren Personalaufwands tendenziell den Anteil an kulturellen Nachweisen verringert [20][21][22], konnte in der vorliegenden Erhebung dargelegt werden, dass eine Verwendung des kulturellen Nachweisverfahrens weiterhin von der Mehrzahl der Labore durchgeführt wird. Abb.…”

“…In den letzten Jahren galten Breitspektrum-Cephalosporine der dritten Generation als letzte Mittel in der Behandlung einer NGInfektion [14,15]. In jüngster Zeit wurden in Japan, Australien, Kanada, Südafrika und in einigen europäischen Ländern wie England, Frankreich, Spanien, Österreich und Schweden zunehmende Resistenzentwicklungen gegen Cefixim beobachtet [11,[16][17][18][19][20][21][22][23]. Auch bei der GO-Behandlung mit Ceftriaxon fanden sich in den letzten Jahren vermehrt Einzelfallberichte über ein Therapieversagen, wie beispielsweise in Australien, Japan, Slowenien und Schweden [23][24][25][26][27].…”