LITERATURE UPDATE
Neisseria gonorrhoeae: an STI that has developed resistance mechanisms to antimicrobials
Last year, over 85,000 gonorrhoea diagnoses were reported in England, the highest number since records began in 1918. Here, Pathology in Practice Science Editor Brian Nation compiles a selection of current research interest focusing on AMR in this sexually transmitted infection.
Neisseria gonorrhoeae Antimicrobial Resistance: The Future of Antibiotic Therapy
Raccagni AR, Ranzenigo M, Bruzzesi E, Maci C, Castagna A, Nozza S. J Clin Med. 2023 Dec 18; 12 (24): 7767. doi: 10.3390/ jcm12247767.
The growing threat of antibiotic- resistant Neisseria gonorrhoeae, which causes gonorrhoea, presents a current public health challenge. Over the years, the pathogen has developed resistance to different antibiotics, leaving few effective treatment options. High-level resistance to key drugs, including ceftriaxone, has become a concerning reality.
This article primarily focuses on the
treatment of gonorrhoea and the current clinical trials aimed at providing new antibiotic treatment options. The authors explore ongoing efforts to assess new antibiotics, including zoliflodacin and gepotidacin. These drugs offer new effective treatment options, but their rapid availability remains uncertain. In addition, the authors delve into two ongoing clinical trials: one evaluating the efficacy and safety of gepotidacin compared to the standard ceftriaxone- azithromycin combination, and the other assessing the non-inferiority of zoliflodacin versus the combination therapy of ceftriaxone-azithromycin. These trials represent crucial steps in the search for alternative treatments for uncomplicated gonorrhoea. Notably, gonorrhoea has been included in the WHO Priority Pathogens List for Research and Development of New Antibiotics.
In conclusion, the urgent need for innovative treatment strategies is underscored by the rising threat of antibiotic resistance in N. gonorrhoeae;
collaboration among researchers, industries, and healthcare authorities is therefore essential.
Emerging threat of antimicrobial resistance in Neisseria gonorrhoeae: pathogenesis, treatment challenges, and potential for vaccine development Omeershffudin UNM, Kumar S. Arch Microbiol. 2023 Sep 9; 205 (10): 330. doi: 10.1007/s00203-023-03663-0.
The continuous rise of antimicrobial resistance (AMR) is a serious concern as it endangers the effectiveness of healthcare interventions that rely on antibiotics in the long run. The increasing resistance of Neisseria gonorrhoeae, the bacteria responsible for causing gonorrhoea, to commonly used antimicrobial drugs, is a major concern. This has now become a
critical global health crisis. In the coming years, there is a risk of a hidden epidemic caused by the emergence of gonococcal AMR. This will worsen the global situation. Infections caused by N. gonorrhoeae were once considered easily treatable. However, over time, they have become increasingly resistant to commonly used therapeutic medications, such as penicillin, ciprofloxacin and azithromycin. As a result, this pathogen is developing into a true “superbug,” which means that ceftriaxone is now the only available option for initial empirical treatment. Effective management strategies are urgently needed to prevent severe consequences, such as infertility and pelvic inflammatory disease, which can result from delayed intervention.
Histopathology of an acute case of gonococcal urethritis (Gram staining).
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CDC/Joe Millar Wikimedia Commons
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