Retrospective Analysis of Antimicrobial Susceptibility Trends (2000–2009) in Neisseria gonorrhoeae Isolates from Countries in Latin America and the Caribbean Shows Evolving Resistance to Ciprofloxacin, Azithromycin and Decreased Susceptibility to Ceftriaxone

Starnino, Stefania; Galarza, Patricia; Carvallo, Marıa Elena Trigoso; Benzaken, Adèle Schwartz; Ballesteros, Aurora Maldonado; Cruz, Olga Marina Sanabria; Hernández, Alina Llop; Carbajal, José Luis Portilla; Borthagaray, Graciela; Payares, Daisy; Dillon, Jo-Anne R.

doi:10.1097/olq.0b013e3182631c9f

Cited by 47 publications

(40 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Compared to erythromycin, azithromycin has a substantially higher activity against N. gonorrhoeae. However, by the mid-to late 1990s, decreased susceptibility and resistance to azithromycin were reported from Latin America, where azithromycin was frequently used early on for treatment of bacterial STIs, including gonorrhea (99,128,129). Subsequently, azithromycin resistance emerged in many countries, particularly where there was a high level of azithromycin usage for treatment of gonorrhea and also, e.g., for Chlamydia trachomatis infections (99,102,130,131).…”

Section: Figmentioning

confidence: 99%

“…This enhanced gonococcal AMR surveillance should monitor trends in resistance (including regional differences), identify newly emerging AMR, and inform treatment recommendations in a timely manner. Worryingly, longitudinal quality-assured GASPs have been incomplete in some regions (such as Latin America and the Caribbean [99,129]) or have been sporadic or completely lacking in large parts of the world, including Eastern Europe, Central Asia, and Africa (104,106,152). The latter regions also suffer from a high burden of gonorrhea, creating the prerequisites for rapid emergence and spread of gonococcal AMR.…”

Section: International Responses To Resistance Evolution and Possiblementioning

confidence: 99%

See 1 more Smart Citation

Antimicrobial Resistance in Neisseria gonorrhoeae in the 21st Century: Past, Evolution, and Future

2014

View full text Add to dashboard Cite

SUMMARY Neisseria gonorrhoeae is evolving into a superbug with resistance to previously and currently recommended antimicrobials for treatment of gonorrhea, which is a major public health concern globally. Given the global nature of gonorrhea, the high rate of usage of antimicrobials, suboptimal control and monitoring of antimicrobial resistance (AMR) and treatment failures, slow update of treatment guidelines in most geographical settings, and the extraordinary capacity of the gonococci to develop and retain AMR, it is likely that the global problem of gonococcal AMR will worsen in the foreseeable future and that the severe complications of gonorrhea will emerge as a silent epidemic. By understanding the evolution, emergence, and spread of AMR in N. gonorrhoeae , including its molecular and phenotypic mechanisms, resistance to antimicrobials used clinically can be anticipated, future methods for genetic testing for AMR might permit region-specific and tailor-made antimicrobial therapy, and the design of novel antimicrobials to circumvent the resistance problems can be undertaken more rationally. This review focuses on the history and evolution of gonorrhea treatment regimens and emerging resistance to them, on genetic and phenotypic determinants of gonococcal resistance to previously and currently recommended antimicrobials, including biological costs or benefits; and on crucial actions and future advances necessary to detect and treat resistant gonococcal strains and, ultimately, retain gonorrhea as a treatable infection.

show abstract

Section: Figmentioning

confidence: 99%

Section: International Responses To Resistance Evolution and Possiblementioning

confidence: 99%

Antimicrobial Resistance in Neisseria gonorrhoeae in the 21st Century: Past, Evolution, and Future

2014

View full text Add to dashboard Cite

show abstract

“…It is a big problem that not only compromises the surveillance program but increases selective pressure and facilitates the development of drug resistance (29). Prevalence data on and plasmid profiles of PPNG isolates from South America are limited (30). In our study, the prevalence allele in the Toronto/Rio and African plasmids circulating in our country and the association of bla TEM-135 as a possible direct precursor of ESBL suggest a need for surveillance studies to monitor the presence of PPNG isolates and ␤-lactamase type and epidemiological data to assess the distribution of these isolates in the population.…”

mentioning

confidence: 99%

Identification of TEM-135 β-Lactamase in Neisseria gonorrhoeae Strains Carrying African and Toronto Plasmids in Argentina

Gianecini

Oviedo

Littvik³

et al. 2015

Antimicrob Agents Chemother

View full text Add to dashboard Cite

One hundred forty-three penicillinase-producing Neisseria gonorrhoeae (PPNG) isolates obtained in Argentina from 2008 and 2012 were examined to detect bla TEM-135 genes and to investigate plasmid profiles and multiantigen sequence types. Forty-two PPNG isolates were found to carry TEM-135, and two contained a new TEM derivative characterized as TEM-220. The bla TEM-135 allele was carried by the Toronto/Rio and African plasmids. Molecular epidemiology revealed that two bla TEM-135 isolates were related to previously described isolates from Thailand and China, indicating a common evolutionary origin.A ntibiotic resistance in Neisseria gonorrhoeae is a global public health problem (1). Through the years, N. gonorrhoeae has developed resistance to the first-line antibiotics used for treatment (2). Penicillinase-producing N. gonorrhoeae (PPNG) isolates with plasmid-mediated high-level resistance to penicillin were first reported in 1976 and have spread since then (3). These first PPNG isolates contained TEM-1-type ␤-lactamase plasmids encoded by transposon TnA (Tn2), which are responsible for the transference and dissemination of resistance (4). To date, eight plasmid types have been described in N. gonorrhoeae and named after their epidemiological origin as African, Toronto/Rio, Asian, Nîmes, New Zealand, Johannesburg, and Australian plasmids (5-7). The PPNG isolates carrying a bla TEM-135 gene were found in Thailand, Japan, and China and recently reported in Australia and 15 other countries (8-12). TEM-135 differs from TEM-1 by a single nucleotide substitution at position 539, resulting in a single amino acid substitution, M182T. This substitution is also found in TEM-type extended-spectrum ␤-lactamase (ESBL) but has little effect on enzyme activity, and it has been proposed to stabilize substitutions near the active site, which collaboratively results in the emergence of a stable ESBL (13-15). The first PPNG isolate in Argentina was reported in 1980 and has since been disseminated in our country (16). The prevalence of PPNG isolates has been increasing through the years, with the highest level of 40% in the 1990's. The aim of this study was to detect bla TEM-135 and investigate plasmid types carrying ␤-lactamase in the PPNG strains in 2008 and 2012 in Argentina.We studied 49 and 94 PPNG isolates collected in 2008 and 2012, respectively, from GASSP-AR, which includes 70 laboratories distributed all around the country. The MIC S (g/ml) of penicillin, ciprofloxacin, ceftriaxone, and azithromycin for the isolates were determined by the agar dilution method (17, 18). The N. gonorrhoeae ATCC 49226 and World Health Organization (WHO) reference strains were used for quality control in antimicrobial susceptibility testing (19). Mismatch amplification mutation assay (MAMA) PCR was performed to identify the bla TEM-135 allele, and TEM PCR was used to recognize both the bla TEM-1 and bla . The whole bla TEM , porB, and tbpB genes of all isolates that were MAMA PCR positive were amplified and sequenced to confirm the bla TEM-1...

show abstract

“…The connections and programmes of the GASP-LAC have been maintained in many LAC countries, and, in response to the WHO 2009 call for revitalization, the GASP--LAC regional network has been renewed (15,16) . Several countries in Latin America have on-going national GASP networks.…”

mentioning

confidence: 99%

“…Gono-coccal AMR surveillance efforts, such as the one reported from Brazil in the current issue by Medeiros et al, will help catalyse enhanced regional and national GASP networks that are important not only for Brazil, but also for the entire LAC region. Recent GASP-LAC surveillance established that several countries in the region, including Brazil, still recommend ciprofloxacin for the treatment of gonococcal infections (15) . The paper by Medeiros et al, which reports on high percentages of isolates resistant to ciprofloxacin, underscores the importance of GASP surveillance to inform the development and implementation of updated treatment guidelines for gonorrhoea infections.…”

mentioning

confidence: 99%

Neisseria gonorrhoeae Is Evolving into a ‘Superbug’ – what Measures Can Be Implemented to Combat the Emergence of Multidrug and Extensively-drug Resistant Gonorrhoea in Latin America and Globally?

Unemo¹,

Dillon²,

Lewis³

2013

J bra doenças sex transm

View full text Add to dashboard Cite

Retrospective Analysis of Antimicrobial Susceptibility Trends (2000–2009) in Neisseria gonorrhoeae Isolates from Countries in Latin America and the Caribbean Shows Evolving Resistance to Ciprofloxacin, Azithromycin and Decreased Susceptibility to Ceftriaxone

Cited by 47 publications

References 23 publications

Antimicrobial Resistance in Neisseria gonorrhoeae in the 21st Century: Past, Evolution, and Future

Antimicrobial Resistance in Neisseria gonorrhoeae in the 21st Century: Past, Evolution, and Future

Identification of TEM-135 β-Lactamase in Neisseria gonorrhoeae Strains Carrying African and Toronto Plasmids in Argentina

Neisseria gonorrhoeae Is Evolving into a ‘Superbug’ – what Measures Can Be Implemented to Combat the Emergence of Multidrug and Extensively-drug Resistant Gonorrhoea in Latin America and Globally?

Contact Info

Product

Resources

About