Two decades of the gonococcal antimicrobial surveillance program in South America and the Caribbean: challenges and opportunities

Dillon, Jo-Anne R.; Trecker, Molly A.; Thakur, Sidharath Dev

doi:10.1136/sextrans-2012-050905

Cited by 37 publications

(33 citation statements)

References 21 publications

(40 reference statements)

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“…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). Worryingly, gonococcal isolates with high-level resistance to azithromycin (MICs of Ն256 g/ml) were identified in Scotland (132), England (37), Argentina (38), Italy (133), the United States (39), and Sweden (42).…”

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%

“…The emergence of the tetM determinant (causing high-level tetracycline resistance) on the conjugative plasmid in the mid-1980s (107) resulted in the exclusion of tetracycline from treatment guidelines in the United States and many countries worldwide. These gonococcal strains with plasmid-mediated high-level resistance to tetracyclines were first reported in 1986 in the United States and soon thereafter in the Netherlands (108) and are now widespread internationally (8,19,81,(98)(99)(100)(101)(102)(103)(104).…”

Section: The Antimicrobial Eramentioning

confidence: 99%

“…Due to high levels of fluoroquinolone resistance, many Asian and European countries removed ciprofloxacin as a first-line treatment in the early to mid2000s (8). Currently, the prevalences of fluoroquinolone-resistant gonococcal strains are high worldwide (5,8,19,63,81,(98)(99)(100)(101)(102)(103)(104)(105)(106).…”

Section: Figmentioning

confidence: 99%

“…An outbreak of chromosomally mediated penicillin-resistant gonorrhea in Durham, NC (96,97), was the first major blow to the continued use of penicillin. Currently, gonococcal strains with plasmid-and/or chromosomally mediated resistance to penicillin are common globally (5,8,19,81,(98)(99)(100)(101)(102)(103)(104)(105)(106).…”

Section: The Antimicrobial Eramentioning

confidence: 99%

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

2014

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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.

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Section: Figmentioning

confidence: 99%

Section: International Responses To Resistance Evolution and Possiblementioning

confidence: 99%

Section: The Antimicrobial Eramentioning

confidence: 99%

Section: Figmentioning

confidence: 99%

Section: The Antimicrobial Eramentioning

confidence: 99%

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

2014

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Mechanism of action, resistance, synergism, and clinical implications of azithromycin

Heidary

Samangani

Kargari

et al. 2022

Clinical Laboratory Analysis

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Background Azithromycin (AZM), sold under the name Zithromax, is classified as a macrolide. It has many benefits due to its immunomodulatory, anti‐inflammatory, and antibacterial effects. This review aims to study different clinical and biochemisterial aspects and properties of this drug which has a priority based on literature published worldwide. Methods Several databases including Web of Science, Google Scholar, PubMed, and Scopus were searched to obtain the relevant studies. Results AZM mechanism of action including the inhibition of bacterial protein synthesis, inhibition of proinflammatory cytokine production, inhibition of neutrophil infestation, and macrophage polarization alteration, gives it the ability to act against a wide range of microorganisms. Resistant organisms are spreading and being developed because of the irrational use of the drug in the case of dose and duration. AZM shows synergistic effects with other drugs against a variety of organisms. This macrolide is considered a valuable antimicrobial agent because of its use as a treatment for a vast range of diseases such as asthma, bronchiolitis, COPD, cystic fibrosis, enteric infections, STIs, and periodontal infections. Conclusions Our study shows an increasing global prevalence of AZM resistance. Thus, synergistic combinations are recommended to treat different pathogens. Moreover, continuous monitoring of AZM resistance by registry centers and the development of more rapid diagnostic assays are urgently needed.

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Problematic Groups of Multidrug-Resistant Bacteria and Their Resistance Mechanisms

Kohler

Vaishampayan

Grohmann

2019

Antibacterial Drug Discovery to Combat MDR

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Two decades of the gonococcal antimicrobial surveillance program in South America and the Caribbean: challenges and opportunities

Abstract: Gonococcal AMS surveillance initiatives are urgently needed in every country in the region to ensure that effective treatments for gonococcal infections are in place and to better understand emerging trends in gonococcal antimicrobial resistance.

Cited by 37 publications

References 21 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

Mechanism of action, resistance, synergism, and clinical implications of azithromycin

Problematic Groups of Multidrug-Resistant Bacteria and Their Resistance Mechanisms

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