Antimicrobial Resistance in Neisseria gonorrhoeae in the 21st Century: Past, Evolution, and Future
Top Cited Papers
Open Access
- 1 July 2014
- journal article
- review article
- Published by American Society for Microbiology in Clinical Microbiology Reviews
- Vol. 27 (3), 587-613
- https://doi.org/10.1128/cmr.00010-14
Abstract
SUMMARY 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.Keywords
This publication has 151 references indexed in Scilit:
- Impact of Fluoroquinolone Resistance Mutations on Gonococcal Fitness and In Vivo Selection for Compensatory MutationsThe Journal of Infectious Diseases, 2012
- A Highly Conserved Interaction Involving the Middle Residue of the SXN Active-Site Motif Is Crucial for Function of Class B Penicillin-Binding Proteins: Mutational and Computational Analysis of PBP 2 from N. gonorrhoeaeBiochemistry, 2012
- Molecular and Structural Analysis of Mosaic Variants of Penicillin-Binding Protein 2 Conferring Decreased Susceptibility to Expanded-Spectrum Cephalosporins in Neisseria gonorrhoeae: Role of Epistatic MutationsBiochemistry, 2010
- One-step PCR for the identification of multiple antimicrobial resistance in Neisseria gonorrhoeaeJournal of Microbiological Methods, 2009
- Crystal Structures of Penicillin-binding Protein 2 from Penicillin-susceptible and -resistant Strains of Neisseria gonorrhoeae Reveal an Unexpectedly Subtle Mechanism for Antibiotic ResistanceOnline Journal of Public Health Informatics, 2009
- In vitro activities of tigecycline against clinical isolates from Shanghai, ChinaDiagnostic Microbiology and Infectious Disease, 2004
- Hybrid penicillin-binding proteins in penicillin-resistant strains of Neisseria gonorrhoeaeNature, 1988
- Effect of Spectinomycin Use on the Prevalence of Spectinomycin-Resistant and of Penicillinase-ProducingNeisseria GonorrhoeaeThe New England Journal of Medicine, 1987
- A Community-Based Outbreak of Infection with Penicillin-ResistantNeisseria gonorrhoeaeNot Producing Penicillinase (Chromosomally Mediated Resistance)The New England Journal of Medicine, 1985
- Intraspecific and Intergeneric Mobilization of Non-conjugative Resistance Plasmids by a 24-5 Megadalton Conjugative Plasmid of Neisseria gonorrhoeaeMicrobiology, 1981