Adherence to CDC Recommendations for the Treatment of Uncomplicated Gonorrhea — STD Surveillance Network, United States, 2016

Weston, Emily; Workowski, Kimberly A.; Torrone, Elizabeth; Weinstock, Hillard; Stenger, Mark

doi:10.15585/mmwr.mm6716a4

Cited by 30 publications

(37 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…GISP, used for the analysis of N. gonorrhoeae, is based on convenience sampling of male patients at sexually transmitted disease clinics. In 2016, the CDC estimated that 90.8% of patients in sexually transmitted disease clinics received the recommended azithromycin/ceftriaxone regimen compared with 79.8% of patients in other provider settings; the same relationship, though much weaker, was observed when comparing men to women (23). Since these differences are fairly small, any underestimation of bystander selection for N. gonorrhoeae due to the recommended antibiotics of azithromycin and ceftriaxone is likely to be minor.…”

Section: Discussionmentioning

confidence: 99%

Estimating the proportion of bystander selection for antibiotic resistance among potentially pathogenic bacterial flora

Tedijanto

Olesen

Grad

et al. 2018

Proc. Natl. Acad. Sci. U.S.A.

168

183

View full text Add to dashboard Cite

Bystander selection—the selective pressure for resistance exerted by antibiotics on microbes that are not the target pathogen of treatment—is critical to understanding the total impact of broad-spectrum antibiotic use on pathogenic bacterial species that are often carried asymptomatically. However, to our knowledge, this effect has never been quantified. We quantify bystander selection for resistance for a range of clinically relevant antibiotic–species pairs as the proportion of all antibiotic exposures received by a species for conditions in which that species was not the causative pathogen (“proportion of bystander exposures”). Data sources include the 2010–2011 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, the Human Microbiome Project, and additional carriage and etiological data from existing literature. For outpatient prescribing in the United States, we find that this proportion over all included antibiotic classes is over 80% for eight of nine organisms of interest. Low proportions of bystander exposure are often associated with infrequent bacterial carriage or concentrated prescribing of a particular antibiotic for conditions caused by the species of interest. Applying our results, we roughly estimate that pneumococcal conjugate vaccination programs result in nearly the same proportional reduction in total antibiotic exposures of Streptococcus pneumoniae, Staphylococcus aureus, and Escherichia coli, despite the latter two organisms not being targeted by the vaccine. These results underscore the importance of considering antibiotic exposures of bystanders, in addition to the target pathogen, in measuring the impact of antibiotic resistance interventions.

show abstract

Section: Discussionmentioning

confidence: 99%

Estimating the proportion of bystander selection for antibiotic resistance among potentially pathogenic bacterial flora

Tedijanto

Olesen

Grad

et al. 2018

Proc. Natl. Acad. Sci. U.S.A.

168

183

View full text Add to dashboard Cite

show abstract

“…gonorrhoeae has become increasingly resistant to antimicrobial agents, including third-generation cephalosporins such as ceftriaxone and cefixime; several highly resistant ceftriaxone strains have resulted in therapeutic failure, reported worldwide (26)(27)(28)(29), and cefixime has been removed from public health guidelines as recommended therapy (30). Azithromycin, recently recommended for use in combination with ceftriaxone as first-line treatment of gonorrhea (31), increasingly has become ineffective in many parts of the world (3, 32-34). These developments will seriously limit treatment options (3,34).…”

Section: Discussionmentioning

confidence: 99%

Bypassing Phase Variation of Lipooligosaccharide (LOS): Using Heptose 1 Glycan Mutants To Establish Widespread Efficacy of Gonococcal Anti-LOS Monoclonal Antibody 2C7

et al. 2020

View full text Add to dashboard Cite

The sialylatable lacto-N-neotetraose (LNnT; Gal-GlcNAc-Gal-Glc) moiety from heptose I (HepI) of the lipooligosaccharide (LOS) of Neisseria gonorrhoeae undergoes positive selection during human infection. Lactose (Gal-Glc) from HepII, although phase variable, is commonly expressed in humans; loss of HepII lactose compromises gonococcal fitness in mice. Anti-LOS monoclonal antibody (MAb) 2C7, a promising antigonococcal immunotherapeutic that elicits complement-dependent bactericidal activity and attenuates gonococcal colonization in mice, recognizes an epitope comprised of lactoses expressed simultaneously from HepI and HepII. Glycan extensions beyond lactose on HepI modulate binding and function of MAb 2C7 in vitro. Here, four gonococcal LOS mutants, each with lactose from HepII but fixed (unable to phase-vary) LOS HepI glycans extended beyond the lactose substitution of HepI (lactose alone, Gal-lactose, LNnT, or GalNAc-LNnT), were used to define how HepI glycan extensions affect (i) mouse vaginal colonization and (ii) efficacy in vitro and in vivo of a human IgG1 chimeric derivative of MAb 2C7 (2C7-Ximab) with a complement-enhancing E-to-G Fc mutation at position 430 (2C7-Ximab-E430G). About 10-fold lower 2C7-Ximab-E430G concentrations achieved similar complement-dependent killing of three gonococcal mutants with glycan extensions beyond lactose-substituted HepI (lactose alone, LNnT, or GalNAc-LNnT) as 2C7-Ximab (unmodified Fc). The fourth mutant (Gal-lactose) resisted direct complement-dependent killing but was killed approximately 70% by 2C7-Ximab-E430G in the presence of polymorphonuclear leukocytes and complement. Only mutants with (sialylatable) LNnT from HepI colonized mice for >3 days, reiterating the importance of LNnT sialylation for infection. 2C7-Ximab-E430G significantly attenuated colonization caused by the virulent mutants.

show abstract

“…Neisseria gonorrhoeae is the causative agent of gonorrhea, the second most commonly reported notifiable disease in the United States (1). Gonorrhea poses a major public health threat, with emerging resistance to nearly all available antibiotics, including first-line dual therapy with azithromycin and ceftriaxone.…”

Section: Announcementmentioning

confidence: 99%

Closed Genome Sequences of Clinical Neisseria gonorrhoeae Strains Obtained from Combined Oxford Nanopore and Illumina Sequencing

White

Torralba

Colt

et al. 2019

Microbiol Resour Announc

View full text Add to dashboard Cite

show abstract

Adherence to CDC Recommendations for the Treatment of Uncomplicated Gonorrhea — STD Surveillance Network, United States, 2016

Cited by 30 publications

References 9 publications

Estimating the proportion of bystander selection for antibiotic resistance among potentially pathogenic bacterial flora

Estimating the proportion of bystander selection for antibiotic resistance among potentially pathogenic bacterial flora

Bypassing Phase Variation of Lipooligosaccharide (LOS): Using Heptose 1 Glycan Mutants To Establish Widespread Efficacy of Gonococcal Anti-LOS Monoclonal Antibody 2C7

Closed Genome Sequences of Clinical Neisseria gonorrhoeae Strains Obtained from Combined Oxford Nanopore and Illumina Sequencing

Contact Info

Product

Resources

About