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Colón Pérez J, Villarino Fernández RA, Domínguez Lago A, Treviño Castellano MM, Pérez del Molino Bernal ML, Sánchez Poza S, Torres-Sangiao E. Addressing Sexually Transmitted Infections Due to Neisseria gonorrhoeae in the Present and Future. Microorganisms 2024; 12:884. [PMID: 38792714 PMCID: PMC11124187 DOI: 10.3390/microorganisms12050884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024] Open
Abstract
It was in the 1800s when the first public publications about the infection and treatment of gonorrhoea were released. However, the first prevention programmes were only published a hundred years later. In the 1940s, the concept of vaccination was introduced into clinical prevention programmes to address early sulphonamide resistance. Since then, tons of publications on Neisseria gonorrhoeae are undisputed, around 30,000 publications today. Currently, the situation seems to be just as it was in the last century, nothing has changed or improved. So, what are we doing wrong? And more importantly, what might we do? The review presented here aims to review the current situation regarding the resistance mechanisms, prevention programmes, treatments, and vaccines, with the challenge of better understanding this special pathogen. The authors have reviewed the last five years of advancements, knowledge, and perspectives for addressing the Neisseria gonorrhoeae issue, focusing on new therapeutic alternatives.
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Affiliation(s)
- Julia Colón Pérez
- Servicio de Microbiología y Parasitología Clínica, Complexo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain; (J.C.P.); (A.D.L.); (M.M.T.C.); (M.L.P.d.M.B.)
- Grupo Microbiología, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Rosa-Antía Villarino Fernández
- Departamento de Microbiología, Facultad de Farmacia, Universidad de Santiago de Compostela, 15782 Santiago de Compostela, Spain;
| | - Adrián Domínguez Lago
- Servicio de Microbiología y Parasitología Clínica, Complexo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain; (J.C.P.); (A.D.L.); (M.M.T.C.); (M.L.P.d.M.B.)
- Grupo Microbiología, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - María Mercedes Treviño Castellano
- Servicio de Microbiología y Parasitología Clínica, Complexo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain; (J.C.P.); (A.D.L.); (M.M.T.C.); (M.L.P.d.M.B.)
- Grupo Microbiología, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - María Luisa Pérez del Molino Bernal
- Servicio de Microbiología y Parasitología Clínica, Complexo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain; (J.C.P.); (A.D.L.); (M.M.T.C.); (M.L.P.d.M.B.)
- Grupo Microbiología, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Sandra Sánchez Poza
- Departamento de Microbiología, Facultad de Farmacia, Universidad de Santiago de Compostela, 15782 Santiago de Compostela, Spain;
| | - Eva Torres-Sangiao
- Servicio de Microbiología y Parasitología Clínica, Complexo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain; (J.C.P.); (A.D.L.); (M.M.T.C.); (M.L.P.d.M.B.)
- Grupo Microbiología, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
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Vanbaelen T, Florence E, Van Dijck C, Tsoumanis A, Laumen JGE, Santhini Manoharan-Basil S, Abdellati S, De Block T, De Baetselier I, Van den Bossche D, Van Herrewege Y, Rotsaert A, Kenyon C. Effect on the Resistome of Dual vs Monotherapy for the Treatment of Neisseria gonorrhoeae: Results From a Randomized Controlled Trial (ResistAZM Trial). Open Forum Infect Dis 2023; 10:ofad462. [PMID: 37854109 PMCID: PMC10580146 DOI: 10.1093/ofid/ofad462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/07/2023] [Indexed: 10/20/2023] Open
Abstract
Background No randomized controlled trial (RCT) has compared the impact on the resistome of ceftriaxone (CRO) plus azithromycin (AZM) vs CRO for the treatment of Neisseria gonorrhoea (NG). Methods This was an open-label, single-center, RCT comparing the effect on the resistome of CRO plus AZM vs CRO for the treatment of NG. Men who have sex with men (MSM) with genital, anorectal, or pharyngeal NG infection were randomized into the CRO/AZM and CRO arms. Oral rinse and anorectal samples were taken for culture and resistome profiling at 2 visits (baseline and day 14). The primary outcome was the ratio of mean macrolide resistance determinants in anorectal samples from day 14 between arms. Results Twenty individuals were randomized into the CRO/AZM arm and 22 into the CRO arm. We found no significant difference in the mean macrolide resistance determinants in the day 14 anorectal samples between arms (ratio, 1.05; 95% CI, 0.55-1.83; P = .102). The prevalence of baseline macrolide resistance was high (CRO/AZM arm = 95.00%; CRO arm = 90.91%). Conclusions We could not demonstrate a significant effect of dual CRO/AZM therapy on the resistome compared with CRO alone, likely due to a high baseline resistance to AZM. Interventions to prevent the emergence of antimicrobial resistance in MSM are needed.
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Affiliation(s)
- Thibaut Vanbaelen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Eric Florence
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of General Internal Medicine, Infectious Diseases and Tropical Medicine, University Hospital of Antwerp, Antwerp, Belgium
| | - Christophe Van Dijck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Achilleas Tsoumanis
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | | | - Saïd Abdellati
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Tessa De Block
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Irith De Baetselier
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Yven Van Herrewege
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Anke Rotsaert
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Chris Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Van Dijck C, Kenyon C. No evidence of reduced cephalosporin susceptibility of circulating strains of Neisseria gonorrhoeae in the Netherlands despite nearly a decade of recommending ceftriaxone monotherapy. Sex Transm Infect 2022; 99:213-214. [PMID: 36601743 DOI: 10.1136/sextrans-2022-055603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 11/12/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Christophe Van Dijck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium .,Laboratory of Medical Microbiology, University of Antwerp, Antwerpen, Belgium
| | - Chris Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium.,Department of Medicine, University of Cape Town, Cape Town, South Africa
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Kong FYS, Lo FWY, Hocking JS. Treatment efficacy for rectal Neisseria gonorrhoeae: a systematic review and meta-analysis of randomized controlled trials-authors' response. J Antimicrob Chemother 2022; 77:2576-2577. [PMID: 35815679 DOI: 10.1093/jac/dkac227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Fabian Yuh Shiong Kong
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Fiona Wing Yu Lo
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Jane Simone Hocking
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Hsu YP, Chen LF, Chen FL, Liu YK. Comment on: Treatment efficacy for rectal Neisseria gonorrhoeae: a systematic review and meta-analysis of randomized controlled trials. J Antimicrob Chemother 2022; 77:2574-2576. [PMID: 35733335 DOI: 10.1093/jac/dkac194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Yuan Pin Hsu
- Emergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Liang Fu Chen
- Emergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Fu Lun Chen
- Department of Internal Medicine, Division of Infectious Diseases, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ying Kuo Liu
- Emergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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