Will targeting oropharyngeal gonorrhoea delay the further emergence of drug-resistant Neisseria gonorrhoeae strains?
Gonorrhoea is an important sexually transmitted infection associated with serious complications and enhanced HIV transmission. Oropharyngeal infections are often asymptomatic and will only be detected by screening. Gonococcal culture has low sensitivity (
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| Veröffentlicht in: | Sexually transmitted infections 2015-06, Vol.91 (4), p.234-237 |
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| description | Gonorrhoea is an important sexually transmitted infection associated with serious complications and enhanced HIV transmission. Oropharyngeal infections are often asymptomatic and will only be detected by screening. Gonococcal culture has low sensitivity ( |
| doi_str_mv | 10.1136/sextrans-2014-051731 |
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Oropharyngeal infections are often asymptomatic and will only be detected by screening. Gonococcal culture has low sensitivity (<50%) for detecting oropharyngeal gonorrhoea, and, although not yet approved commercially, nucleic acid amplification tests (NAAT) are the assay of choice. Screening for oropharyngeal gonorrhoea should be performed in high-risk populations, such as men-who-have-sex-with-men(MSM). NAATs have a poor positive predictive value when used in low-prevalence populations. Gonococci have repeatedly thwarted gonorrhoea control efforts since the first antimicrobial agents were introduced. The oropharyngeal niche provides an enabling environment for horizontal transfer of genetic material from commensal Neisseria and other bacterial species to Neisseria gonorrhoeae. This has been the mechanism responsible for the generation of mosaic penA genes, which are responsible for most of the observed cases of resistance to extended-spectrum cephalosporins (ESC). As antimicrobial-resistant gonorrhoea is now an urgent public health threat, requiring improved antibiotic stewardship, laboratory-guided recycling of older antibiotics may help reduce ESC use. Future trials of antimicrobial agents for gonorrhoea should be powered to test their efficacy at the oropharynx as this is the anatomical site where treatment failure is most likely to occur. It remains to be determined whether a combination of frequent screening of high-risk individuals and/or laboratory-directed fluoroquinolone therapy of oropharyngeal gonorrhoea will delay the further emergence of drug-resistant N. gonorrhoeae strains.</description><identifier>ISSN: 1368-4973</identifier><identifier>EISSN: 1472-3263</identifier><identifier>DOI: 10.1136/sextrans-2014-051731</identifier><identifier>PMID: 25911525</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Anti-Bacterial Agents - therapeutic use ; Antimicrobial agents ; Condoms ; Deoxyribonucleic acid ; DNA ; Drug resistance ; Drug Resistance, Bacterial ; Female ; Fluoroquinolones - therapeutic use ; Genes, Bacterial ; Genotype ; Gonorrhea ; Gonorrhea - drug therapy ; Gonorrhea - prevention & control ; HIV ; Human immunodeficiency virus ; Humans ; Infections ; Lentivirus ; Male ; Microbial Sensitivity Tests ; Mouth Mucosa - microbiology ; Mucositis - drug therapy ; Mucositis - microbiology ; Mucositis - prevention & control ; Neisseria gonorrhoeae ; Neisseria gonorrhoeae - drug effects ; Neisseria gonorrhoeae - pathogenicity ; Nucleic Acid Amplification Techniques ; Pharyngitis - drug therapy ; Pharyngitis - microbiology ; Pharyngitis - prevention & control ; Prevalence ; Public Health ; Sex industry ; Sexual Behavior ; Sexually transmitted diseases ; STD</subject><ispartof>Sexually transmitted infections, 2015-06, Vol.91 (4), p.234-237</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b408t-2f7a1df52d7abcb6f62bdc26c8206950e03c4949fd7bafdace03950c17a780433</citedby><cites>FETCH-LOGICAL-b408t-2f7a1df52d7abcb6f62bdc26c8206950e03c4949fd7bafdace03950c17a780433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://sti.bmj.com/content/91/4/234.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://sti.bmj.com/content/91/4/234.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,3196,23571,27924,27925,77600,77631</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25911525$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lewis, D A</creatorcontrib><title>Will targeting oropharyngeal gonorrhoea delay the further emergence of drug-resistant Neisseria gonorrhoeae strains?</title><title>Sexually transmitted infections</title><addtitle>Sex Transm Infect</addtitle><description>Gonorrhoea is an important sexually transmitted infection associated with serious complications and enhanced HIV transmission. Oropharyngeal infections are often asymptomatic and will only be detected by screening. Gonococcal culture has low sensitivity (<50%) for detecting oropharyngeal gonorrhoea, and, although not yet approved commercially, nucleic acid amplification tests (NAAT) are the assay of choice. Screening for oropharyngeal gonorrhoea should be performed in high-risk populations, such as men-who-have-sex-with-men(MSM). NAATs have a poor positive predictive value when used in low-prevalence populations. Gonococci have repeatedly thwarted gonorrhoea control efforts since the first antimicrobial agents were introduced. The oropharyngeal niche provides an enabling environment for horizontal transfer of genetic material from commensal Neisseria and other bacterial species to Neisseria gonorrhoeae. This has been the mechanism responsible for the generation of mosaic penA genes, which are responsible for most of the observed cases of resistance to extended-spectrum cephalosporins (ESC). As antimicrobial-resistant gonorrhoea is now an urgent public health threat, requiring improved antibiotic stewardship, laboratory-guided recycling of older antibiotics may help reduce ESC use. Future trials of antimicrobial agents for gonorrhoea should be powered to test their efficacy at the oropharynx as this is the anatomical site where treatment failure is most likely to occur. It remains to be determined whether a combination of frequent screening of high-risk individuals and/or laboratory-directed fluoroquinolone therapy of oropharyngeal gonorrhoea will delay the further emergence of drug-resistant N. gonorrhoeae strains.</description><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antimicrobial agents</subject><subject>Condoms</subject><subject>Deoxyribonucleic acid</subject><subject>DNA</subject><subject>Drug resistance</subject><subject>Drug Resistance, Bacterial</subject><subject>Female</subject><subject>Fluoroquinolones - therapeutic use</subject><subject>Genes, Bacterial</subject><subject>Genotype</subject><subject>Gonorrhea</subject><subject>Gonorrhea - drug therapy</subject><subject>Gonorrhea - prevention & control</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infections</subject><subject>Lentivirus</subject><subject>Male</subject><subject>Microbial Sensitivity Tests</subject><subject>Mouth Mucosa - microbiology</subject><subject>Mucositis - drug therapy</subject><subject>Mucositis - microbiology</subject><subject>Mucositis - prevention & control</subject><subject>Neisseria gonorrhoeae</subject><subject>Neisseria gonorrhoeae - drug effects</subject><subject>Neisseria gonorrhoeae - pathogenicity</subject><subject>Nucleic Acid Amplification Techniques</subject><subject>Pharyngitis - drug therapy</subject><subject>Pharyngitis - microbiology</subject><subject>Pharyngitis - prevention & control</subject><subject>Prevalence</subject><subject>Public Health</subject><subject>Sex industry</subject><subject>Sexual Behavior</subject><subject>Sexually transmitted diseases</subject><subject>STD</subject><issn>1368-4973</issn><issn>1472-3263</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkU1LHTEUhkOpVGv7D6QEunEzmq9JJisRqW1B7Kaly5DJnMydy0xym2Sg_nsjV6V0o6sTDs_7kuRB6ISSM0q5PM_wtyQbcsMIFQ1pqeL0DTqiQrGGM8nf1jOXXSO04ofofc5bQohUrX6HDlmrKW1Ze4TK72mecbFphDKFEccUdxub7sIIdsZjDDGlTQSLB5jtHS4bwH5NdSQMC9RUcICjx0NaxyZBnnKxoeBbmHKGNNl_KgDneuEp5IsP6MDbOcPHx3mMfl1_-Xn1rbn58fX71eVN0wvSlYZ5ZengWzYo27teesn6wTHpOkakbgkQ7oQW2g-qt36wri7q2lFlVUcE58fodN-7S_HPCrmYZcoO5tkGiGs2tGNKM9lx8jIqtWKU6Y5V9PN_6DauKdSHGEY7pSWXXFRK7CmXYs4JvNmlaak_aygxDwLNk0DzINDsBdbYp8fytV9geA49GavA-R7ol-3rKu8BGqCqUw</recordid><startdate>20150601</startdate><enddate>20150601</enddate><creator>Lewis, D A</creator><general>BMJ Publishing Group LTD</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>7QL</scope><scope>C1K</scope></search><sort><creationdate>20150601</creationdate><title>Will targeting oropharyngeal gonorrhoea delay the further emergence of drug-resistant Neisseria gonorrhoeae strains?</title><author>Lewis, D A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b408t-2f7a1df52d7abcb6f62bdc26c8206950e03c4949fd7bafdace03950c17a780433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antimicrobial agents</topic><topic>Condoms</topic><topic>Deoxyribonucleic acid</topic><topic>DNA</topic><topic>Drug resistance</topic><topic>Drug Resistance, Bacterial</topic><topic>Female</topic><topic>Fluoroquinolones - therapeutic use</topic><topic>Genes, Bacterial</topic><topic>Genotype</topic><topic>Gonorrhea</topic><topic>Gonorrhea - drug therapy</topic><topic>Gonorrhea - prevention & control</topic><topic>HIV</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Infections</topic><topic>Lentivirus</topic><topic>Male</topic><topic>Microbial Sensitivity Tests</topic><topic>Mouth Mucosa - microbiology</topic><topic>Mucositis - drug therapy</topic><topic>Mucositis - microbiology</topic><topic>Mucositis - prevention & control</topic><topic>Neisseria gonorrhoeae</topic><topic>Neisseria gonorrhoeae - drug effects</topic><topic>Neisseria gonorrhoeae - pathogenicity</topic><topic>Nucleic Acid Amplification Techniques</topic><topic>Pharyngitis - drug therapy</topic><topic>Pharyngitis - microbiology</topic><topic>Pharyngitis - prevention & control</topic><topic>Prevalence</topic><topic>Public Health</topic><topic>Sex industry</topic><topic>Sexual Behavior</topic><topic>Sexually transmitted diseases</topic><topic>STD</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lewis, D A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Sexually transmitted infections</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lewis, D A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Will targeting oropharyngeal gonorrhoea delay the further emergence of drug-resistant Neisseria gonorrhoeae strains?</atitle><jtitle>Sexually transmitted infections</jtitle><addtitle>Sex Transm Infect</addtitle><date>2015-06-01</date><risdate>2015</risdate><volume>91</volume><issue>4</issue><spage>234</spage><epage>237</epage><pages>234-237</pages><issn>1368-4973</issn><eissn>1472-3263</eissn><abstract>Gonorrhoea is an important sexually transmitted infection associated with serious complications and enhanced HIV transmission. Oropharyngeal infections are often asymptomatic and will only be detected by screening. Gonococcal culture has low sensitivity (<50%) for detecting oropharyngeal gonorrhoea, and, although not yet approved commercially, nucleic acid amplification tests (NAAT) are the assay of choice. Screening for oropharyngeal gonorrhoea should be performed in high-risk populations, such as men-who-have-sex-with-men(MSM). NAATs have a poor positive predictive value when used in low-prevalence populations. Gonococci have repeatedly thwarted gonorrhoea control efforts since the first antimicrobial agents were introduced. The oropharyngeal niche provides an enabling environment for horizontal transfer of genetic material from commensal Neisseria and other bacterial species to Neisseria gonorrhoeae. This has been the mechanism responsible for the generation of mosaic penA genes, which are responsible for most of the observed cases of resistance to extended-spectrum cephalosporins (ESC). As antimicrobial-resistant gonorrhoea is now an urgent public health threat, requiring improved antibiotic stewardship, laboratory-guided recycling of older antibiotics may help reduce ESC use. Future trials of antimicrobial agents for gonorrhoea should be powered to test their efficacy at the oropharynx as this is the anatomical site where treatment failure is most likely to occur. It remains to be determined whether a combination of frequent screening of high-risk individuals and/or laboratory-directed fluoroquinolone therapy of oropharyngeal gonorrhoea will delay the further emergence of drug-resistant N. gonorrhoeae strains.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>25911525</pmid><doi>10.1136/sextrans-2014-051731</doi><tpages>4</tpages></addata></record> |
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| ispartof | Sexually transmitted infections, 2015-06, Vol.91 (4), p.234-237 |
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| subjects | Anti-Bacterial Agents - therapeutic use Antimicrobial agents Condoms Deoxyribonucleic acid DNA Drug resistance Drug Resistance, Bacterial Female Fluoroquinolones - therapeutic use Genes, Bacterial Genotype Gonorrhea Gonorrhea - drug therapy Gonorrhea - prevention & control HIV Human immunodeficiency virus Humans Infections Lentivirus Male Microbial Sensitivity Tests Mouth Mucosa - microbiology Mucositis - drug therapy Mucositis - microbiology Mucositis - prevention & control Neisseria gonorrhoeae Neisseria gonorrhoeae - drug effects Neisseria gonorrhoeae - pathogenicity Nucleic Acid Amplification Techniques Pharyngitis - drug therapy Pharyngitis - microbiology Pharyngitis - prevention & control Prevalence Public Health Sex industry Sexual Behavior Sexually transmitted diseases STD |
| title | Will targeting oropharyngeal gonorrhoea delay the further emergence of drug-resistant Neisseria gonorrhoeae strains? |
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