<i>Neisseria gonorrhoeae</i>Antimicrobial Resistance Among Men Who Have Sex With Men and Men Who Have Sex Exclusively With Women: The Gonococcal Isolate Surveillance Project, 2005–2010

Kirkcaldy, Robert D.; Zaidi, Akbar A.; Hook, Edward W.; Holmes, King K.; Soge, Olusegun O.; Rı́o, Carlos del; Hall, Geraldine S.; Papp, John R.; Bolan, Gail; Weinstock, Hillard

doi:10.7326/0003-4819-158-5-201303050-00004

Cited by 103 publications

(89 citation statements)

References 35 publications

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“…It is notable that the first identified N. gonorrhoeae strain with high-level resistance to ceftriaxone was isolated from the pharynx (8). Furthermore, high rates of resistance and elevated MICs are frequently observed among gay men, bisexual men, and other men who have sex with men (MSM) (7,23), among whom extragenital infections are common (24)(25)(26).…”

mentioning

confidence: 99%

Comparison of Antimicrobial Susceptibilities of Pharyngeal, Rectal, and Urethral Neisseria gonorrhoeae Isolates among Men Who Have Sex with Men

Kidd

Zaidi

Asbel

et al. 2015

Antimicrob Agents Chemother

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N eisseria gonorrhoeae has developed resistance to multiple antimicrobials that were previously recommended for treatment, including penicillin, tetracycline, and ciprofloxacin (1). Currently, the only recommended treatment for gonorrhea in Europe and the United States is dual treatment with ceftriaxone and azithromycin (2, 3). However, decreases in susceptibilities to cephalosporins (4-7) and reports of cefixime and ceftriaxone treatment failures worldwide (8-10) indicate that the emergence of cephalosporin-resistant gonorrhea could be imminent. Because there are limited remaining effective therapeutic options for gonorrhea (11, 12), ceftriaxone resistance in N. gonorrhoeae would present significant challenges for individual case management and gonorrhea control in the community. As a result, surveillance of antimicrobial susceptibilities among N. gonorrhoeae strains will be increasingly critical to inform gonorrhea treatment recommendations.N. gonorrhoeae can infect the urogenital tract, rectum, and pharynx through sexual contact, and infection at extragenital sites may facilitate the acquisition or development of resistance mutations. Rectal infection and exposure to fecal lipids provide selective pressure for mutations such as those in the mtr locus, which confer resistance to hydrophobic molecules and drugs (13-16). Pharyngeal infection supplies the opportunity for genetic reassortment between N. gonorrhoeae and other Neisseria species that colonize the pharynx (17, 18). Specifically, the mosaic penA allele, a key genetic determinant associated with decreased cephalosporin susceptibility, appears to have evolved through recombination with penA genes from commensal Neisseria species (18)(19)(20). In addition, pharyngeal infections are more difficult to eradicate than urogenital or rectal infections (21,22) and are typically asymptomatic, which may provide an optimal setting for selection of resistance mutations. It is notable that the first identified N. gonorrhoeae strain with high-level resistance to ceftriaxone was isolated from the pharynx (8). Furthermore, high rates of resistance and elevated MICs are frequently observed among gay men, bisexual men, and other men who have sex with men (MSM) (7, 23), among whom extragenital infections are common (24-26).Globally, surveillance for N. gonorrhoeae antimicrobial susceptibilities is conducted mostly with urogenital isolates (5, 6, 27), and there are few published data comparing the susceptibilities of urogenital, rectal, and pharyngeal isolates. Although some reports

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confidence: 99%

Comparison of Antimicrobial Susceptibilities of Pharyngeal, Rectal, and Urethral Neisseria gonorrhoeae Isolates among Men Who Have Sex with Men

Kidd

Zaidi

Asbel

et al. 2015

Antimicrob Agents Chemother

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“…Отмечено, что среди мужчин про-цент штаммов со сниженными показателями чув-ствительности к цефиксиму и цефродоксину выше, чем в популяциях с необозначенной гендерной при-надлежностью или у женщин [39,[66][67][68][69][70]. Отмечен высокий риск появления штаммов N. gonorrhoeae, не чувствительных к цефиксиму и цефродоксину, сре-ди МСМ [71].…”

Section: современные подходы к эпидемиологическому наблюдению над расunclassified

Modern aspects of epidemiological surveillance of gonococcal infection spread

Frigo¹

2015

Klin. dermatol. venerol.

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“…Antimicrobial resistance can lead to ineffective treatment and ongoing transmission of the uncured infection. A study conducted in the USA reported higher antibiotic resistance among men who have sex with men (MSM) (19). Higher gonorrhea antimicrobial resistance may have contributed to the rate increase in Canadian men.…”

Section: Geographic Distributionmentioning

confidence: 99%