International travels and transmission of multidrug resistant Neisseria gonorrhoeae in Europe: A systematic review

Cruz, María de las Mercedes Vicente de la; Giesen, Christine; Díaz‐Menéndez, Marta

doi:10.1016/j.tmaid.2022.102401

Cited by 2 publications

(3 citation statements)

References 35 publications

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“… 94 , 95 A review conducted by Vicente et al . 22 identified Southeast Asia as the geographical hotspot for the emergence and acquisition of drug-resistant gonorrhoea. The first global reports of multi-drug resistant STIs, notably gonorrhoea, were identified in Australia and the UK among travellers returning from Southeast Asia.…”

Section: Discussionmentioning

confidence: 99%

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A systematic review and meta-analysis of sexually transmitted infections and blood-borne viruses in travellers

Shiferaw,

Martin,

Dean

et al. 2024

Journal of Travel Medicine

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Background Sexually transmitted infections (STIs) and blood-borne viruses (BBVs) impose a global health and economic burden. International travellers facilitate the spread of infectious diseases, including STIs. Hence, this review assessed the prevalence/proportionate morbidity of travellers with STIs and sexually transmitted BBVs, and factors associated with the infection in this population. Methods PubMed, Scopus, Web of Science, CINHAL, Embase, and Cochrane Library were searched from inception of the databases until November 2022. Published analytical observational studies reporting the prevalence/proportionate morbidity of travellers with STIs and factors associated with STIs by type of traveller (i.e. tourists, business travellers, students, visiting friends or relatives [VFRs], international truck drivers, backpackers, expatriates, and men who have sex with men [MSM]) were included. The selection of articles, data extraction, and risk of bias assessment were conducted by two independent reviewers. Meta-analyses were conducted for each STI by clinical presentation and type of traveller. Results Thirty-two studies (n = 387 731 travellers) were included, 19 evaluated the proportionate morbidity of STIs among symptomatic travellers, while 13 examined the prevalence of STIs in asymptomatic travellers. The highest proportionate morbidity was found among VFRs (syphilis, 1.67%; 95%CI:1.03–2.81%), backpackers (chlamydia trachomatis, 6.58%; 95%CI: 5.96–7.25%), and MSM (HIV [2.50%;95%CI:0.44–12.88%], gonorrhoea [4.17%;95%CI:1.1.5–13.98%], lymphogranuloma venereum [4.17%;95%CI:1.1.5–13.98%], and HAV [20.0%; 95% CI: 14.99–26.17%]). The highest prevalence of STIs among asymptomatic were found in MSM (HIV [25.94%;95%CI:22.21–30.05%] and HBV [24.90%; 95%CI:21.23–28.96%]) and backpackers (chlamydia trachomatis, 3.92%;95% CI:2.72–5.32%). Short duration of the trip (<1 month), not having pre-travel consultation, travelling to Southeast Asia, and being unvaccinated for HBV were identified as risk factors for STIs. Conclusion Strategies to prevent STIs and sexually transmitted BBVs should be discussed at pretravel consultations and recommendations should be prioritized in high-risk groups of travellers, such as backpackers, VFRs, and MSMs. Additionally, healthcare providers should tailor recommendations for safe sex practices to individual travellers’ unique needs.

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Section: Discussionmentioning

confidence: 99%

“…resistance to azithromycin (18.6%) and decreased susceptibility to ceftriaxone (10.8%)], 20 among travellers visiting Southeast Asia. 21 , 22 …”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta-analysis of sexually transmitted infections and blood-borne viruses in travellers

Shiferaw,

Martin,

Dean

et al. 2024

Journal of Travel Medicine

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“…Between 2013 and 2019, diagnoses of gonorrhea in England rose by 128% to 70,922, the largest annual number ever reported [ 5 ]. The increase in international travel in the recent years may be contributing to the spread of gonorrhea [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Gepotidacin as Treatment of Uncomplicated Urogenital Gonorrhea (EAGLE-1): Design of a Randomized, Comparator-Controlled, Phase 3 Study

Perry,

Scangarella-Oman,

Millns

et al. 2023

Infect Dis Ther

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Introduction Gonorrhea, caused by Neisseria gonorrhoeae (NG), is the second most common bacterial sexually transmitted infection (STI). Rates of antimicrobial resistance to standard care are increasing worldwide, with many antibiotic classes now ineffective against NG. Gepotidacin is a first-in-class, bactericidal, triazaacenaphthylene antibiotic that inhibits bacterial DNA replication by inhibition of two enzymes, where a single target-specific mutation does not significantly impact susceptibility. Gepotidacin confers activity against NG, including most strains resistant to marketed antibiotics. Here, we describe the design of a phase 3 clinical trial (EAGLE-1; NCT04010539) evaluating gepotidacin for the treatment of uncomplicated urogenital gonorrhea. Methods This phase 3, randomized, multicenter, sponsor-blinded, noninferiority study across six countries is comparing the efficacy of gepotidacin with ceftriaxone plus azithromycin in 400 patients with uncomplicated urogenital gonorrhea (microbiological intent-to-treat population) and assessing the safety of gepotidacin in approximately 600 patients (intent-to-treat population). Eligible participants 12 years of age or older with clinical suspicion of urogenital gonococcal infection and a NG-positive urogenital sample and/or purulent discharge are randomized 1:1 to receive oral gepotidacin (2 × 3000 mg 10–12 h apart) or ceftriaxone (500 mg, intramuscular) plus azithromycin (1 g, oral). The primary endpoint is culture-confirmed bacterial eradication of NG from the urogenital site at the test-of-cure (days 4–8) visit. Planned Outcomes This trial was designed in accordance with US Food and Drug Administration (2015) and European Medicines Agency (2011) guidance, particularly the primary endpoint and microbiological evaluability requirements. This study will help characterize the risk–benefit profile of gepotidacin for treating uncomplicated urogenital gonorrhea. Gepotidacin is an important potential treatment for gonorrhea to help address the urgent unmet need of multidrug resistance and the increasingly limited number of oral treatment options. Trial Registration ClinicalTrials.gov identifier, NCT04010539. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-023-00862-6.

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International travels and transmission of multidrug resistant Neisseria gonorrhoeae in Europe: A systematic review

Cited by 2 publications

References 35 publications

A systematic review and meta-analysis of sexually transmitted infections and blood-borne viruses in travellers

A systematic review and meta-analysis of sexually transmitted infections and blood-borne viruses in travellers

Efficacy and Safety of Gepotidacin as Treatment of Uncomplicated Urogenital Gonorrhea (EAGLE-1): Design of a Randomized, Comparator-Controlled, Phase 3 Study

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