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Recent advances in the development and use of molecular tests to predict antimicrobial resistance in Neisseria gonorrhoeae
Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Örebro University, School of Medical Sciences. WHO Collaborating Centre for Gonorrhoea, Örebro University Hospital, Örebro, Sweden.
WHO Collaborating Centre for Gonorrhoea, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0003-1710-2081
2017 (English)In: Expert Review of Molecular Diagnostics, ISSN 1473-7159, E-ISSN 1744-8352, Vol. 17, no 9, p. 845-859Article in journal (Refereed) Published
Abstract [en]

Introduction: The number of genetic tests, mostly real-time PCRs, to detect antimicrobial resistance (AMR) determinants and predict AMR in Neisseria gonorrhoeae is increasing. Several of these assays are promising, but there are important shortcomings and few assays have been adequately validated and quality assured.

Areas covered: Recent advances, focusing on publications since 2012, in the development and use of molecular tests to predict gonococcal AMR for surveillance and for clinical use, advantages and disadvantages of these tests and of molecular AMR prediction compared with phenotypic AMR testing, and future perspectives for effective use of molecular AMR tests for different purposes.

Expert commentary: Several challenges for direct testing of clinical, especially extra-genital, specimens remain. The choice of molecular assay needs to consider the assay target, quality controls, sample types, limitations intrinsic to molecular technologies, and specific to the chosen methodology, and the intended use of the test. Improved molecular- and particularly genome-sequencing-based methods will supplement AMR testing for surveillance purposes, and translate into point-of-care tests that will lead to personalized treatments, while sparing the last available empiric treatment option (ceftriaxone). However, genetic AMR prediction will never completely replace phenotypic AMR testing, which detects also AMR due to unknown AMR determinants.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2017. Vol. 17, no 9, p. 845-859
Keywords [en]
Neisseria gonorrhoeae; antimicrobial resistance; molecular testing; NAAT; ceftriaxone; ciprofloxacin; azithromycin; penA; gyrA; 23S rRNA
National Category
Biomedical Laboratory Science/Technology Infectious Medicine
Identifiers
URN: urn:nbn:se:oru:diva-61749DOI: 10.1080/14737159.2017.1360137ISI: 000422748900006PubMedID: 28741392Scopus ID: 2-s2.0-85027341096OAI: oai:DiVA.org:oru-61749DiVA, id: diva2:1153844
Available from: 2017-10-31 Created: 2017-10-31 Last updated: 2018-08-07Bibliographically approved

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Golparian, DanielUnemo, Magnus

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