Mutaciones en la región determinante de resistencia a quinolonas (QRDR) del gen gyrA de Neisseria gonorrhoeae presente en muestras clínicas de hombres que tienen sexo con hombres

Palencia, Liz Sánchez; Cáceres, José Acosta

doi:10.15381/rpb.v24i3.13905

Cited by 4 publications

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“…After removing duplicates, the literature searches identified 1290 articles to be screened using title and abstract, of which 279 were retrieved for full-text assessment. Of these, 115 epidemiological studies [ 24 – 138 ] (three of which also reported data on antimicrobial resistance) [ 47 , 122 , 138 ] and one economic study [ 139 ] were eligible for inclusion in the review (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

Burden of Disease of Gonorrhoea in Latin America: Systematic Review and Meta-analysis

et al. 2023

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Introduction Neisseria gonorrhoeae causes gonorrhoea, a globally neglected but increasing disease. This systematic review and meta-analysis reviewed the epidemiology and economic burden of gonorrhoea in Latin America and the Caribbean (LAC). Methods We searched PubMed, EMBase, Cochrane Library, EconLIT, CINAHL, CRD, LILACS, Global Health, Global Dissertations and Theses, SciELO, Web of Science databases, countries’ ministries of health, and the IHME’s Global Burden of Disease databases. Studies published in the last 10 years (20 years for economic studies) were included if conducted in any LAC country, without language restrictions. The main outcome measures were incidence/prevalence, proportion of co-infections, case fatality rates, specific mortality/hospitalisation rates, direct/indirect costs, and impact of gonorrhoea on quality of life. To assess evidence quality, we used a checklist developed by the US National Heart, Lung, and Blood Institute for observational studies and trial control arms, the Cochrane Effective Practice Organization of Care Group tool for randomised controlled trials, and the CICERO checklist for economic studies. Results We identified 1290 articles; 115 included epidemiological studies and one included an economic study. Ministry of health data from Argentina, Brazil, Chile, Colombia, Mexico, and Uruguay were identified. Gonorrhoea prevalence was 1.46% (95% confidence interval [CI] 1.00–2.00%) from 48 studies and 5.68% (95% CI 4.23–7.32%) from 58 studies for non-high-risk and high-risk populations, respectively. Cumulative incidence for the high-risk population was 2.05 cases per 100 persons/year. Few published studies were rated as “good” in the risk of bias assessments. Variations in the methodology of the sources and limited information found in the countries’ surveillance systems hinder the comparison of data. Conclusion The burden of gonorrhoea in LAC is not negligible. Our results provide public health and clinical decision support to assess potential interventions to prevent gonorrhoea. Trial Registration The protocol is registered on PROSPERO (CRD42021253342). The study was funded by GlaxoSmithKline Biologicals SA (GSK study identifier VEO-000025). Supplementary Information The online version contains supplementary material available at 10.1007/s40121-023-00814-0.

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Section: Resultsmentioning

confidence: 99%

Burden of Disease of Gonorrhoea in Latin America: Systematic Review and Meta-analysis

et al. 2023

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“…The studies provided data on AMR in the following countries: Argentina ( n = 10) 29 , 45 , 48 , 52–54 , 63 , 66 , 67 , 70 during 1993 and between 2000 and 2017; Brazil ( n = 9) 42 , 44 , 46 , 47 , 50 , 55 , 57 , 58 , 65 in 2003 to 2016; Colombia ( n = 2) 43 , 61 in 2009 to 2018; Peru ( n = 6) 56 , 59 , 60 , 62 , 68 , 69 in 2012 to 2017; Uruguay ( n = 1) 41 in 2010 and 2011; and Venezuela ( n = 1) 51 during 2008. There were also two studies reporting on AMR in various LAC countries from the WHO-GASP-LAC, one of which 49 reported resistance between 1990 and 2011 in 23 LAC countries, and the other reported data from 2010 and 2011 in seven LAC countries.…”

Section: Resultsmentioning

confidence: 99%

“… 60 The remaining four studies analysed only ciprofloxacin. 62 , 65 , 68 , 69 The antibiotics included in studies evaluating several antibiotics were ciprofloxacin ( n = 26), penicillin ( n = 25), tetracycline ( n = 24), azithromycin ( n = 21), ceftriaxone ( n = 19), cefixime ( n = 8), spectinomycin ( n = 7), ceftriaxone/cefixime combined ( n = 5), gentamicin ( n = 3), erythromycin ( n = 1), chloramphenicol ( n = 1), cefoxitin ( n = 1) and ofloxacin ( n = 1).…”

Section: Resultsmentioning

confidence: 99%

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Antimicrobial resistance of Neisseria gonorrhoeae in Latin American countries: a systematic review

Sandoval

Bardach

Rojas‐Roque

et al. 2023

Journal of Antimicrobial Chemotherapy

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Background Detailed information is needed on the dynamic pattern of antimicrobial resistance (AMR) in Neisseria gonorrhoeae in Latin America and the Caribbean (LAC). Objectives To conduct a systematic review of AMR in N. gonorrhoeae in LAC. Methods Electronic searches without language restrictions were conducted in PubMed, Embase, Cochrane Library, EconLIT, Cumulative Index of Nursing and Allied Health Literature, Centre for Reviews and Dissemination, and Latin American and Caribbean Literature in Health Sciences. Studies were eligible if published between 1 January 2011 and 13 February 2021, conducted in any LAC country (regardless of age, sex and population) and measured frequency and/or patterns of AMR to any antimicrobial in N. gonorrhoeae. The WHO Global Gonococcal Antimicrobial Surveillance Programme (WHO-GASP) for LAC countries and Latin American AMR Surveillance Network databases were searched. AMR study quality was evaluated according to WHO recommendations. Results AMR data for 38, 417 isolates collected in 1990–2018 were included from 31 publications, reporting data from Argentina, Brazil, Colombia, Peru, Uruguay, Venezuela and WHO-GASP. Resistance to extended-spectrum cephalosporins was infrequent (0.09%–8.5%). Resistance to azithromycin was up to 32% in the published studies and up to 61% in WHO-GASP. Resistance to penicillin, tetracycline and ciprofloxacin was high (17.6%–98%, 20.7%–90% and 5.9%–89%, respectively). Resistance to gentamicin was not reported, and resistance to spectinomycin was reported in one study. Conclusions This review provides data on resistance to azithromycin, potentially important given its use as first-line empirical treatment, and indicates the need for improved surveillance of gonococcal AMR in LAC. Trial registration: Registered in PROSPERO, CRD42021253342.

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Extra-genital Neisseria gonorrhoeae infections with genetic mutations conferring ciprofloxacin resistance among men who have sex with men and transgender women in Lima, Peru

et al. 2023

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Background The increasing prevalence of drug-resistant Neisseria gonorrhoeae (NG) infections has caused great concern. Ciprofloxacin remains the empiric antimicrobial recommended to treat NG infections in Peru disregarding the susceptibility profile of circulating NG strains. We report the prevalence of individuals infected with NG strains presenting mutations in the gyrA gene that confers ciprofloxacin resistance. Methods We conducted a descriptive study assessing extragenital swab samples collected from a cohort of men who have sex with men and transgender women in Lima, Peru. Anal and pharyngeal NG positive swabs for Aptima Combo 2 assay (Hologic Inc., USA) were used for DNA extraction. We performed TaqMan real time PCR assays to detect a point mutation at codon Ser91 of the gyrase A ( gyrA) gene. Results From 156 individuals who had at least one positive sample for NG reported by the Aptima assay, 80 individuals had at least one amplified DNA for the gyrA gene. We found that 67 of them (84.0%) were infected with a gyrA-mutated NG strain at the Ser91 codon. Conclusions We report a high prevalence of gyrA mutation conferring ciprofloxacin resistance among individuals with extragenital NG infection. Empirical treatment of NG needs to be urgently updated in Peru in concordance with international guidelines.

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Mutaciones en la región determinante de resistencia a quinolonas (QRDR) del gen gyrA de Neisseria gonorrhoeae presente en muestras clínicas de hombres que tienen sexo con hombres

Cited by 4 publications

References 15 publications

Burden of Disease of Gonorrhoea in Latin America: Systematic Review and Meta-analysis

Burden of Disease of Gonorrhoea in Latin America: Systematic Review and Meta-analysis

Antimicrobial resistance of Neisseria gonorrhoeae in Latin American countries: a systematic review

Extra-genital Neisseria gonorrhoeae infections with genetic mutations conferring ciprofloxacin resistance among men who have sex with men and transgender women in Lima, Peru

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