Monitoring antimicrobial resistance in<i>Neisseria gonorrhoeae</i>in selected countries of the WHO South-East Asia Region between 2009 and 2012: a retrospective analysis

Bala, Manju; Kakran, Monika; Singh, Vikram; Sood, Seema; Ramesh, V.

doi:10.1136/sextrans-2012-050904

Cited by 61 publications

(62 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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%

See 2 more Smart Citations

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: The Antimicrobial Eramentioning

confidence: 99%

Section: Figmentioning

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

show abstract

“…However, N. gonorrhoeae isolates that were resistant to ciprofloxacin arose quickly, and treatment guidelines needed to be amended, as the effective treatment of infections was being compromised. Indeed, the global burden of ciprofloxacinresistant N. gonorrhoeae isolates is now significant and is between 35% and Ͼ95% in many countries (3)(4)(5)(6)(7)(8)(9)(10), although the level in the United States is slightly lower, at 15% (11). Ciprofloxacin resistance in N. gonorrhoeae, like that in other species, is typically manifested by point mutations in the quinolone resistance-determining region (QRDR) of the A subunits of the type II topoisomerases (GyrA and ParC) (5,(12)(13)(14).…”

mentioning

confidence: 99%

“…However, organisms with decreased susceptibilities to these cephalosporins are now emerging, with several reports of high-level resistance to these drugs (5,(17)(18)(19), essentially removing the last option for empirical therapy. Furthermore, even though drugs like ciprofloxacin are no longer widely used to treat gonorrhea, resistance to this drug persists in these multidrug-resistant pathogens and has resulted in patients having fewer effective treatment options (3)(4)(5)(6)(7)(8)(9)(10). Taken together, this has created an urgent need for the discovery and development of novel first-in-class oral agents that can successfully treat infections caused by N. gonorrhoeae carrying preexisting resistance caused by long-term fluoroquinolone and cephalosporin usage.…”

mentioning

confidence: 99%

Characterization of the Novel DNA Gyrase Inhibitor AZD0914: Low Resistance Potential and Lack of Cross-Resistance in Neisseria gonorrhoeae

Alm

Lahiri

Kutschke

et al. 2015

Antimicrob Agents Chemother

125

View full text Add to dashboard Cite

cThe unmet medical need for novel intervention strategies to treat Neisseria gonorrhoeae infections is significant and increasing, as rapidly emerging resistance in this pathogen is threatening to eliminate the currently available treatment options. AZD0914 is a novel bacterial gyrase inhibitor that possesses potent in vitro activities against isolates with high-level resistance to ciprofloxacin and extended-spectrum cephalosporins, and it is currently in clinical development for the treatment of N. gonorrhoeae infections. The propensity to develop resistance against AZD0914 was examined in N. gonorrhoeae and found to be extremely low, a finding supported by similar studies with Staphylococcus aureus. The genetic characterization of both first-step and second-step mutants that exhibited decreased susceptibilities to AZD0914 identified substitutions in the conserved GyrB TOPRIM domain, confirming DNA gyrase as the primary target of AZD0914 and providing differentiation from fluoroquinolones. The analysis of available bacterial gyrase and topoisomerase IV structures, including those bound to fluoroquinolone and nonfluoroquinolone inhibitors, has allowed the rationalization of the lack of cross-resistance that AZD0914 shares with fluoroquinolones. Microbiological susceptibility data also indicate that the topoisomerase inhibition mechanisms are subtly different between N. gonorrhoeae and other bacterial species. Taken together, these data support the progression of AZD0914 as a novel treatment option for the oral treatment of N. gonorrhoeae infections.

show abstract

Multiresistant Neisseria gonorrhoeae: a new threat in second decade of the XXI century

Młynarczyk-Bonikowska

Majewska

Malejczyk

et al. 2019

Med Microbiol Immunol

View full text Add to dashboard Cite

Neisseria gonorrhoeae is an etiologic agent of gonorrhoea, one of the most common sexually transmitted diseases caused by bacteria. For many years, infections caused by N. gonorrhoeae were considered to be relatively easy to treat; however, resistance has emerged successively to all therapeutic agents used in treatment of the disease, e.g., penicillin, ciprofloxacin or azithromycin. Currently, the global problem is the emergence and a threat of spread of N. gonorrhoeae strains resistant to extended-spectrum cephalosporins (ESC), such as injectable ceftriaxone and oral-used cefixime. Especially, dangerous are multi-resistant strains resistant simultaneously to ESC and azithromycin. Three strains with high-level resistance to azithromycin and resistant to ESC were first time isolated in 2018. Moreover, in 2018, the first ESBL was described in N. gonorrhoeae and that makes the threat of appearing the ESBL mechanism of resistance in N. gonorrhoeae more real, even though the strain was sensitive to ceftriaxone. Molecular typing revealed that variants resistant to ESC occurred also among strains belonging to epidemic clonal complex CC1 (genogroup G1407) distinguished in NG-MAST typing system. The G1407 genogroup, in particular the ST1407 sequence type, is currently dominant in most European countries. The presence of different mechanisms of drug resistance significantly affects clinical practice and force changes in treatment regimens and introduction of new drugs.

show abstract

Monitoring antimicrobial resistance inNeisseria gonorrhoeaein selected countries of the WHO South-East Asia Region between 2009 and 2012: a retrospective analysis

Cited by 61 publications

References 17 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

Characterization of the Novel DNA Gyrase Inhibitor AZD0914: Low Resistance Potential and Lack of Cross-Resistance in Neisseria gonorrhoeae

Multiresistant Neisseria gonorrhoeae: a new threat in second decade of the XXI century

Contact Info

Product

Resources

About