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Antimicrobial Resistance in Neisseria gonorrhoeae in the 21st Century: Past, Evolution, and Future
Orebro University Hospital. WHO Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, National Reference Laboratory for Pathogenic Neisseria, Dept. of Laboratory Medicine, Microbiology.ORCID iD: 0000-0003-1710-2081
Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, United States; Laboratories of Bacterial Pathogenesis, Veterans Affairs Medical Center, Decatur, GA, United States.
2014 (English)In: Clinical Microbiology Reviews, ISSN 0893-8512, E-ISSN 1098-6618, Vol. 27, no 3, 587-613 p.Article, review/survey (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
American Society for Microbiology , 2014. Vol. 27, no 3, 587-613 p.
National Category
Microbiology in the medical area
Identifiers
URN: urn:nbn:se:oru:diva-56778DOI: 10.1128/CMR.00010-14ISI: 000338833000009PubMedID: 24982323Scopus ID: 2-s2.0-84903598016OAI: oai:DiVA.org:oru-56778DiVA: diva2:1084063
Note

Funding Agencies:

Research Committee of Örebro County

Örebro University Hospital Foundation, Örebro, Sweden

NIH R37 AI021150-29  U19 AI031496  R21 AI103270-01

Medical Research Service of the Department of Veterans Affairs

Available from: 2017-03-23 Created: 2017-03-23 Last updated: 2017-03-23Bibliographically approved

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