World Health Organization Global Gonococcal Antimicrobial Surveillance Program (WHO GASP): review of new data and evidence to inform international collaborative actions and research efforts
Magnus Unemo,Monica M Lahra,Michelle J Cole,P Galarza,Francis Ndowa,Irene Martin,Jo-Anne R. Dillon,Pilar Ramon-Pardo,Gail Bolan,Teodora Wi +9 more
TLDR
The World Health Organization GASP data from 67 countries in 2015-16 is described, confirmed gonorrhoea treatment failures with ceftriaxone with or without azithromycin or doxycycline, and international collaborative actions and research efforts essential for the effective management and control of gonor rhoea are described.Abstract:
Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a serious public health problem, compromising the management and control of gonorrhoea globally. Resistance in N. gonorrhoeae to ceftriaxone, the last option for first-line empirical monotherapy of gonorrhoea, has been reported from many countries globally, and sporadic failures to cure especially pharyngeal gonorrhoea with ceftriaxone monotherapy and dual antimicrobial therapies (ceftriaxone plus azithromycin or doxycycline) have been confirmed in several countries. In 2018, the first gonococcal isolates with ceftriaxone resistance plus high-level azithromycin resistance were identified in England and Australia. The World Health Organization (WHO) Global Gonococcal Antimicrobial Surveillance Program (GASP) is essential to monitor AMR trends, identify emerging AMR and provide evidence for refinements of treatment guidelines and public health policy globally. Herein we describe the WHO GASP data from 67 countries in 2015–16, confirmed gonorrhoea treatment failures with ceftriaxone with or without azithromycin or doxycycline, and international collaborative actions and research efforts essential for the effective management and control of gonorrhoea. In most countries, resistance to ciprofloxacin is exceedingly high, azithromycin resistance is present and decreased susceptibility or resistance to ceftriaxone has emerged. Enhanced global collaborative actions are crucial for the control of gonorrhoea, including improved prevention, early diagnosis, treatment of index patient and partner (including test-of-cure), improved and expanded AMR surveillance (including surveillance of antimicrobial use and treatment failures), increased knowledge of correct antimicrobial use and the pharmacokinetics and pharmacodynamics of antimicrobials and effective drug regulations and prescription policies (including antimicrobial stewardship). Ultimately, rapid, accurate and affordable point-of-care diagnostic tests (ideally also predicting AMR and/or susceptibility), new therapeutic antimicrobials and, the only sustainable solution, gonococcal vaccine(s) are imperative.read more
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WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study
Magnus Unemo,Monica M Lahra,Martina Escher,Sergey Eremin,Michelle J Cole,P Galarza,Francis Ndowa,Irene Martin,Jo-Anne R. Dillon,Marcelo Galas,Pilar Ramon-Pardo,Hillard Weinstock,Teodora Wi +12 more
TL;DR: In this paper, the authors describe the 2017-2018 data from the global gonococcal AMR surveillance, and discuss priorities essential for the effective management and control of gonorrhoea.
Journal ArticleDOI
Genomic evolution of Neisseria gonorrhoeae since the preantibiotic era (1928–2013): antimicrobial use/misuse selects for resistance and drives evolution
Daniel Golparian,Simon R. Harris,Leonor Sánchez-Busó,Leonor Sánchez-Busó,Steen Hoffmann,William M. Shafer,William M. Shafer,Stephen D. Bentley,Jørgen Skov Jensen,Magnus Unemo +9 more
TL;DR: The genomic evolution of gonococci and their AMR, related to the introduction of antimicrobial therapies, is described, examining isolates from 1928 (preantibiotic era) to 2013 in Denmark, which is, to this knowledge, the oldest gonococcal collection globally.
Journal ArticleDOI
A community-driven resource for genomic epidemiology and antimicrobial resistance prediction of Neisseria gonorrhoeae at Pathogenwatch
Leonor Sánchez-Busó,Corin A. Yeats,Benjamin Taylor,Benjamin Taylor,Richard Goater,Anthony Underwood,Khalil Abudahab,Silvia Argimón,Kevin C. Ma,Tatum D. Mortimer,Daniel Golparian,Michelle J Cole,Yonatan H. Grad,Yonatan H. Grad,Irene Martin,Brian H. Raphael,William M. Shafer,William M. Shafer,Katy Town,Teodora Wi,Simon R. Harris,Magnus Unemo,David M. Aanensen,David M. Aanensen +23 more
TL;DR: In this paper, the authors present a public health-focussed scheme for genomic epidemiology of N. gonorrhoeae at Pathogenwatch ( https://pathogenwatch.watch/ngonorhoeae ), which provides customised bioinformatic pipelines guided by expert opinion.
Journal ArticleDOI
Gonococcal vaccines: Public health value and preferred product characteristics; report of a WHO global stakeholder consultation, January 2019
Sami L Gottlieb,Francis Ndowa,Edward W. Hook,Carolyn D. Deal,Laura H. Bachmann,Laith J. Abu-Raddad,Xiang-Sheng Chen,Ann E. Jerse,Nicola Low,Calman A. MacLennan,Helen Petousis-Harris,Kate L. Seib,Magnus Unemo,Leah R. Vincent,Birgitte K. Giersing +14 more
TL;DR: The main discussion points and conclusions from the January 2019 meeting of experts are described, including the need for vaccines to control N. gonorrhoeae infections with the ultimate goals of preventing adverse sexual and reproductive health outcomes.
Journal ArticleDOI
In Vitro Activity of Lefamulin against Sexually Transmitted Bacterial Pathogens.
TL;DR: The results suggest that lefamulin could be a promising first-line antibiotic for the treatment of STI, particularly in populations with high rates of resistance to standard-of-care antibiotics.
References
More filters
Journal ArticleDOI
Sexually transmitted diseases treatment guidelines, 2015.
Kimberly A. Workowski,Gail Bolan +1 more
TL;DR: These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 30-May 2, 2013.
Journal ArticleDOI
Sexually transmitted diseases treatment guidelines (2015)
Kimberly A. Workowski,Gail Bolan +1 more
TL;DR: In this paper, the authors describe the genitalia of Neisseria gonorrhoeae as a "Neisseria genitalium" and use it to develop Mycoplasma genitalium.
Journal ArticleDOI
Reduction of concentration of HIV-1 in semen after treatment of urethritis: implications for prevention of sexual transmission of HIV-1
Myron S. Cohen,Irving F. Hoffman,Rachel A. Royce,Peter N. Kazembe,John R. Dyer,Celine Costello Daly,Dick Zimba,Pietro Vernazza,Martin Maida,Susan A. Fiscus,Joseph J. Eron +10 more
TL;DR: HIV-1-control programmes, which include detection and treatment of STDs in patients already infected with HIV-1, may help to curb the epidemic and targeting of gonococcal urethritis may be a particularly effective strategy.
Journal ArticleDOI
Antimicrobial Resistance in Neisseria gonorrhoeae in the 21st Century: Past, Evolution, and Future
TL;DR: 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, and future methods for genetic testing for AMR might permit region-specific and tailor-made antimicrobial therapy, the design of novel antimicroBials to circumvent the resistance problems can be undertaken more rationally.
Journal ArticleDOI
Is Neisseria gonorrhoeae Initiating a Future Era of Untreatable Gonorrhea?: Detailed Characterization of the First Strain with High-Level Resistance to Ceftriaxone
Makoto Ohnishi,Daniel Golparian,Ken Shimuta,Takeshi Saika,Shinji Hoshina,Kazuhiro Iwasaku,Shu Ichi Nakayama,Jo Kitawaki,Magnus Unemo +8 more
TL;DR: A detailed characterization of the first Neisseria gonorrhoeae strain, H041, was performed to confirm the finding, examine its antimicrobial resistance (AMR), and elucidate the resistance mechanisms.
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