Antimicrobial Resistance in Neisseria gonorrhoeae in the 21st Century: Past, Evolution, and Future
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
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.
Microbiology in the medical area
IdentifiersURN: urn:nbn:se:oru:diva-56778DOI: 10.1128/CMR.00010-14ISI: 000338833000009PubMedID: 24982323ScopusID: 2-s2.0-84903598016OAI: oai:DiVA.org:oru-56778DiVA: diva2:1084063
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 Affairs2017-03-232017-03-232017-03-23Bibliographically approved