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DE, Bitet. "Neisseria Gonorrheae: A Cause of Male Infertility". Open Access Journal of Microbiology & Biotechnology 6, nr 1 (2021): 1–7. http://dx.doi.org/10.23880/oajmb-16000183.
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Background: Gonorrhoea is a sexually transmitted infection that is commonly related to male infertility. The infection affects sperm transport through the urinary tract and subsequent damage of the testicular tubes. The infection also impair sperm production as the infection is rarely asymptomatic and can be difficult to diagnose, it is possible that its contribution to male infertility is underestimated. Infection of the genitals results in a purulent (pus-like) discharge from the genitals which may be foul smelling, inflammation, redness, swelling, dysuria, and a burning sensation during urination. As with Chlamydia, it is possible to have a Gonorrhea infection without noticeable symptoms, and which can cause permanent scarring and blockage in the sperm production duct. Gonorrhoea is a bacterial infection and is treatable with antibiotics. Laboratory studies reveal that N. gonorrhoeae infection can impair motility, viability and spermatogenesis; increase anti-sperm antibodies are associated with a decrease in semen parameters as a result of the production of anti-sperm antibodies in the genital tract. Aim: The study aimed at reviewing the possible role of gonorrhoea in male infertility. Method: Research publications such as Pubmed, Scopus, Medline etc. Results: over 115 journals of international repute were obtained, out of which 50 were found to be closely relevant such as; the implication of N. gonorrheae in male infertility, complication of N. gonorrhea infection, N. gonorrhea e and male infertility and were reviewed. Conclusion: N. gonorrhoae was found implicative in male infertility and the need for comprehensive modern laboratory methods for the diagnosis of the infection and also to included routine laboratory tests.
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Pham, Cau D., Kevin Pettus, Evelyn E. Nash, Hsi Liu, Sancta B. St. Cyr, Karen Schlanger, John Papp i in. "Utility of MALDI-TOF MS for differentiation of Neisseria gonorrhoeae isolates with dissimilar azithromycin susceptibility profiles". Journal of Antimicrobial Chemotherapy 75, nr 11 (31.07.2020): 3202–8. http://dx.doi.org/10.1093/jac/dkaa303.
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Abstract Background Antibiotic-resistant gonorrhoea has been a chronic public health burden since the mid-1930s. Recent emergence of isolates resistant to the current recommended antibiotics for gonorrhoea further magnifies the threat of untreatable gonorrhoea. The lack of new, effective antibiotics highlights the need for better understanding of the population structure of Neisseria gonorrhoeae in order to provide greater insight on how to curtail the spread of antimicrobial-resistant N. gonorrhoeae. Objectives To explore a potential application of MALDI-TOF MS to differentiate N. gonorrhoeae displaying different levels of susceptibility to the antibiotic azithromycin. Methods We conducted MALDI-TOF MS using the Bruker Biotyper on 392 N. gonorrhoeae isolates collected through the Gonococcal Isolate Surveillance Project (GISP) and/or the Strengthening the United States Response to Resistant Gonorrhea (SURRG) project. The MALDI-TOF MS spectra were visually analysed to assess the presence of distinctive peak(s). Statistical analysis was performed to assess the relationship between gonococcal isolates with the distinct protein peak and antibiotic susceptibility. Results In this study, we were able to differentiate N. gonorrhoeae isolates into two distinct subpopulations using MALDI-TOF MS. Isolates were distinguished by the presence or absence of a spectral peak at 11 300 Da. Notably, these two groups exhibited different levels of susceptibility to azithromycin. Conclusions We have shown that in addition to its ability to identify N. gonorrhoeae, MALDI-TOF MS could also be used to differentiate gonococcal isolates with different levels of susceptibility to azithromycin.
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Chen, Xiang-Sheng, Yue-Ping Yin, Guo-Jun Liang, Xiang-Dong Gong, Hua-Sheng Li, Mei-Qin Shi i Yan-Hua Yu. "Co-infection with genital gonorrhoea and genital chlamydia in female sex workers in Yunnan, China". International Journal of STD & AIDS 17, nr 5 (1.05.2006): 329–32. http://dx.doi.org/10.1258/095646206776790088.
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An observational study on prevalence of co-infection with gonorrhoea and chlamydia was conducted among female sex workers (FSWs) in Kunming, China. A total of 505 FSWs participated in the study. All eligible participants gave informed consent. Demographic, behavioural and clinical information of the participants was gathered by direct structured interviews. Tampon swabs were collected to test for Chlamydia trachomatis and Nesseria gonorrhoeae. One-hundred and twenty-four (24.6%) FSWs were co-infected with these two pathogens. Of the 191 FSWs with gonorrhea, 124 (64.9%, 95% confidence interval [CI] = 57.9–71.3%) were co-infected with chlamydia which was significantly higher than the proportion (41.9%, 95% CI = 36.4–47.6%) co-infected with gonorrhoea among 296 FSWs with chlamydia ( P < 0.001). Only 47 of 191 (24.6%) FSWs with gonococcal infection and 28 of 124 (22.6%) with co-infection with gonorrhoea and chlamydia reported vaginal discharge. The results of the study justify the recommendation in the national sexually transmitted disease (STD) guidelines that patients infected with gonorrhoea also be treated routinely with an anti-chlamydial regimen. However, a periodic mass treatment may be considered in some circumstances in STD control programmes to rapidly reduce the infections in this population.
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Balachandran, T., A. P. Roberts, B. A. Evans i B. S. Azadian. "Single-Dose Therapy of Anogenital and Pharyngeal Gonorrhoea with Ciprofloxacin". International Journal of STD & AIDS 3, nr 1 (styczeń 1992): 49–51. http://dx.doi.org/10.1177/095646249200300112.
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A single dose of ciprofloxacin, 250 mg by mouth, was used in an open study to treat pharyngeal or rectal gonorrhoea or both in 64 patients (32 men and 32 women). The study also included 151 men with urethral gonorrhoea and 53 women with cervical or urethral gonorrhoea. Ciprofloxacin cured 63 (98%) patients with pharyngeal or rectal gonorrhoea (including 5 patients with penicillinase-producing Neisseria gonorrhoeae; PPNG), 147 (97%) men with urethral gonorrhoea (including 8 with PPNG) and 52 (98%) women with cervical or urethral gonorrhoea. All the isolates of N. gonorrhoeae were sensitive to 0.03 mg/l of ciprofloxacin. Five of the 6 patients with treatment failure were subsequently cured by a single oral dose of ciprofloxacin 250 mg. None of the patients reported an adverse reaction. Ciprofloxacin 250 mg as a single oral dose is effective and safe in treating patients with pharyngeal or rectal gonorrhoea, including those with PPNG strains.
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Martins, José Luis Rodrigues, Emerith Mayra Hungria Pinto, Salomão Antonio Oliveira, Fernanda Almeida Costa Gomes i Osmar Nascimento Silva. "Treatment of Sexually Transmitted Infections (STIs) Caused by Neisseria gonorrhoeae and the Global Shortage of Antibiotics". Venereology 1, nr 3 (24.10.2022): 235–44. http://dx.doi.org/10.3390/venereology1030017.
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The gonorrhoea caused by the bacterium Neisseria gonorrhoeae remains a major global public health problem with high morbidity. Gonorrhoea can affect both women and men, being more prevalent in sexually active young individuals. Even after infection from N. gonorrhoeae, many patients may remain asymptomatic, making the diagnosis and adequate treatment of the disease difficult. The treatment and control of gonorrhoea have been difficult in recent years in most populations, being an example of how behavioural, social, and demographic factors can influence the epidemiology of an infectious disease. The emergence of strains of N. gonorrhoeae resistant to multiple antimicrobials, especially to extended-spectrum cephalosporins, indicates that gonorrhoea has the potential to become untreatable in the current reality of treatment options, especially in places that have a high prevalence of gonococcal infections. The loss of available and effective treatment options can lead to significant increases in new cases of the disease, as well as increased morbidity and mortality. This review provides an overview of current therapeutic options for gonorrhoea, as well as ongoing experimental studies and clinical trials with new antigonococcal agents.
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Semchenko, Evgeny A., Xiaofan Chen, Caroline Thng, Maree O'Sullivan i Kate L. Seib. "Gonorrhoea: past, present and future". Microbiology Australia 41, nr 4 (2020): 205. http://dx.doi.org/10.1071/ma20055.
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The sexually transmitted infection (STI) gonorrhoea is an ancient human disease caused by the Gram-negative bacterial pathogen Neisseria gonorrhoeae. Despite decades of research focused on preventing, diagnosing, and treating gonorrhoea, it remains a major global health concern due to its high prevalence, high rates of asymptomatic cases, the severe sequelae that can result from untreated infections, and the increasing difficulty in treating infections caused by multi-drug resistant strains of N. gonorrhoeae. It is estimated that there are more than 87 million cases of gonorrhoea worldwide each year, and the WHO, CDC and Australian National Antimicrobial Resistance (AMR) Strategy have prioritised N. gonorrhoeae as an urgent public health threat for which new therapeutics and a vaccine are needed.
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Rahimi, Frashta, Namraj Goire, Rebecca Guy, John M. Kaldor, James Ward, Michael D. Nissen, Theo P. Sloots i David M. Whiley. "Direct urine polymerase chain reaction for chlamydia and gonorrhoea: a simple means of bringing high-throughput rapid testing to remote settings?" Sexual Health 10, nr 4 (2013): 299. http://dx.doi.org/10.1071/sh12108.
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Background Rapid point-of-care tests (POCTs) for chlamydia (Chlamydia trachomatis) and gonorrhoea (Neisseria gonorrhoeae) have the potential to confer health benefits in certain populations even at moderate sensitivities; however, suitable POCTs for these organisms are currently lacking. Methods: In this study, we investigated the use of direct urine polymerase chain reaction (PCR), with the view of implementing a simplified PCR strategy for high-throughput chlamydia and gonorrhoea screening in remote settings. Briefly, a simple dilution of the urine was performed before adding it directly to a real-time PCR reaction. The method was evaluated using 134 stored urine specimens that had been submitted for chlamydia and gonorrhoea testing and had been tested using a commercial C. trachomatis and N. gonorrhoeae PCR method. These included samples that were PCR-positive for chlamydia (n = 87), gonorrhoea (n = 16) or both (n = 2). Direct urine testing was conducted using previously described in-house real-time PCR methods for C. trachomatis and N. gonorrhoeae as well as for recognised N.gonorrhoeae antimicrobial resistance mechanisms. Results: The overall sensitivities and specificities of the direct urine PCR were 78% and 100% for chlamydia, and 83% and 100% for gonorrhoea. N.gonorrhoeae penicillin and quinolone resistance mechanisms were characterised in 14 of the 18 N. gonorrhoeae-positive samples. Conclusions: The results of this study show that the simplified PCR strategy may be a feasible approach for rapid screening and improving chlamydia and gonorrhoea treatment in remote settings.
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Templeton, David J., Niveditha Manokaran i Catherine C. O'Connor. "Prevalence and predictors of chlamydia co-infection among patients infected with gonorrhoea at a sexual health clinic in Sydney". Sexual Health 9, nr 4 (2012): 392. http://dx.doi.org/10.1071/sh11146.
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Anogenital gonorrhoea (Neisseria gonorrhoeae) is commonly diagnosed at sexual health clinics by on-site microscopy. Whether to add anti-chlamydial therapy in such situations is unclear. The medical records of all patients diagnosed with gonorrhoea between May 2005 and April 2010 at RPA Sexual Health were reviewed. Of 165 patients with anogenital gonorrhoea, 27 (16.4%, 95% confidence interval (CI) 11.1–22.9%) were co-infected with chlamydia (Chlamydia trachomatis). Compared with those only infected with anogenital gonorrhoea, there was no correlation of anogenital gonorrhoea–chlamydia co-infection with any demographic, behavioural or clinical variables examined. Anti-chlamydial therapy should be considered for all patients with gram stain diagnosed anogenital gonorrhoea at the initial clinic visit.
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Abraha, Million, Dianne Egli-Gany i Nicola Low. "Epidemiological, behavioural, and clinical factors associated with antimicrobial-resistant gonorrhoea: a review". F1000Research 7 (27.03.2018): 400. http://dx.doi.org/10.12688/f1000research.13600.1.
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Antimicrobial-resistant Neisseria gonorrhoeae is a global public health problem in the 21st century. N. gonorrhoeae has developed resistance to all classes of antibiotics used for empirical treatment, and clinical treatment failure caused by extensively resistant strains has been reported. Identifying specific factors associated with an increased risk of antimicrobial-resistant N. gonorrhoeae might help to develop strategies to improve antimicrobial stewardship. In this review, we describe the findings of 24 studies, published between 1989 and 2017, that examined epidemiological, behavioural, and clinical factors and their associations with a range of antimicrobial agents used to treat gonorrhoea. Antimicrobial-resistant N. gonorrhoeae is more common in older than younger adults and in men who have sex with men compared with heterosexual men and women. Antimicrobial-resistant N. gonorrhoeae is less common in some black minority and Aboriginal ethnic groups than in the majority white population in high-income countries. The factors associated with antimicrobial-resistant gonorrhoea are not necessarily those associated with a higher risk of gonorrhoea.
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Tabize Olivier, Mutendela, Freddy Munyololo Muganza, Leshweni Jeremia Shai i Stanley Sechene Gololo. "Rutin Inhibits F, G, N and O gonorrhea strains, 2008 WHO N-gonorrhea Reference strains, in vitro". Interdisciplinary Research Journal and Archives 1 (16.12.2020): 41–49. http://dx.doi.org/10.36966/irjar2020.13.
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Rutin was isolated from methanol extract of the aerial part of Asparagus suaveolens using precipitation method. South Africans use Asparagus suaveolens to treat gonorrhea infections. The obtained Nuclear Magnetic Resonance (NMR) and Liquid Chromatography-Mass Spectroscopy (LC-MS) data and visiting the published data on the isolation of rutin confirmed the structure. The 2008 WHO Neisseria gonorrhea reference strains were used to evaluate microbial activity of rutin against the gonorrhea strains. Rutin found to be bacteriostatic against WHO 2008 Neisseria gonorrhoea F, G, N and O strains with the minimum inhibition concentration of 0.40, 0.65, 0.22 and 0.65 mg/ml, respectively. In addition, rutin fare better than the reference drugs and bactericidal against K, L, M, and P strains. These results support the traditional use of Asparagus suaveolens against gonorrhea infections by South African indigenous people. To our knowledge, this is the first study indicating the activity of rutin against N.gonorrhea strains. Résumé: La rutine a été isolée à partir d'un extrait au méthanol de la partie aérienne d'Asparagus suaveolens en utilisant la méthode de précipitation. Les SudAfricains utilisent Asparagus suaveolens pour traiter les infections gonorrhées. Les données obtenues par résonance magnétique nucléaire (RMN) et par chromatographie liquide-spectroscopie de masse (LCMS) et la consultation des données publiées sur l'isolement de la rutine ont confirmé la structure. Les souches de référence OMS de Neisseria gonorrhea de 2008 ont été utilisées pour évaluer l'activité microbienne de la rutine contre les souches de gonorrhée. La rutine s'est révélée bactériostatique contre les souches de Neisseria gonorrhea F, G, N et O de l'OMS 2008 avec une concentration minimale d'inhibition de 0,40, 0,65, 0,22 et 0,65 mg/ml, respectivement. De plus, la rutine se porte mieux que les médicaments de référence et bactéricide contre les souches K, L, M et P. Ces résultats soutiennent l'utilisation traditionnelle d'Asparagus suaveolens contre les infections gonorrhées par les populations autochtones sud-africaines. À notre connaissance, il s'agit de la première étude indiquant l'activité de la rutine contre les souches de N. gonorrhée.
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McMillan, A., H. Young i A. Moyes. "Rectal Gonorrhoea in Homosexual Men: Source of Infection". International Journal of STD & AIDS 11, nr 5 (maj 2000): 284–87. http://dx.doi.org/10.1177/095646240001100502.
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The objective of this retrospective study was to determine the possible source of infection in homosexual men with rectal gonorrhoea: the probable source of rectal gonorrhoea was identified in 46/155 cases. Although the urethra was the site of infection in 33 (72%) of these contacts, only pharyngeal gonorrhoea was identified in 9 (20%) men. In 25/26 cases, there was concordance in the auxo/serotypes of Neisseria gonorrhoeae between contacts with urethral gonorrhoea and the index men with rectal gonorrhoea. Eleven out of 12 pharyngeal isolates were of the same auxo/serotype as the index cases. This study supports the hypothesis that rectal gonorrhoea in homosexual men can be acquired from the oropharynx. Because infection at this site is an independent risk factor for acquisition of HIV, screening for rectal and pharyngeal gonorrhoea should be offered to men who have sex with men, even when there is no history of unprotected receptive anal intercourse.
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Horner, P. J., R. J. Coker, A. Turner, M. S. Shafi i S. M. Murphy. "Gonorrhoea: Signs, Symptoms and Serogroups". International Journal of STD & AIDS 3, nr 6 (listopad 1992): 430–33. http://dx.doi.org/10.1177/095646249200300606.
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Over 19 weeks, 104 male patients attending a genitourinary medicine clinic with gonococcal urethritis were asked to complete a questionnaire detailing symptoms. Sixty-seven questionnaires were duly completed. The examining nurse documented signs. Ninety-one isolates of Neisseria gonorrhoeae were serogrouped and auxotyped, 55 of these were from patients who had completed a questionnaire. Patients presented earlier if they had a past history of gonorrhoea ( p=0.02). The serogroup of N. gonorrhoeae did not influence the amount of discharge, the presence of meatal inflammation, dysuria or penile tip irritation or the delay in presentation after appearance of discharge. Auxotype AHU was not associated with asymptomatic gonorrhoea.
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Lewis, David A. "New treatment options for Neisseria gonorrhoeae in the era of emerging antimicrobial resistance". Sexual Health 16, nr 5 (2019): 449. http://dx.doi.org/10.1071/sh19034.
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Neisseria gonorrhoeae, the causative agent of gonorrhoea, has rapidly evolved from an exquisitely susceptible pathogen into a ‘superbug’ with the capacity to exhibit an extensively drug resistant (XDR) phenotype. The threat of untreatable gonorrhoea now looms on the horizon while the arsenal of effective antimicrobial agents diminishes with time. Ceftriaxone remains the mainstay of first-line therapy as a single agent or as the backbone of a dual therapy regimen. The implementation of new assays to facilitate ‘precision’ treatment, based on the prediction of N. gonorrhoeae susceptibility to old anti-gonococcal drugs, may enable sparing use of ceftriaxone in those countries that can afford this technology. A few existing drugs, such as ertapenem, can be repositioned to help manage multi-drug resistant and XDR gonorrhoea. Recent clinical trials involving solithromycin and delafloxacin have generated disappointing results in that both agents failed to show non-inferiority to conventional ceftriaxone-based regimens. At present, zoliflodacin and gepotidacin appear to be the most promising antimicrobial agents in clinical development. Both drugs performed well in eradicating urogenital gonorrhoea in recent Phase 2 trials; however, treatment failures were reported at the oropharyngeal site, which is an important site of infection in men who have sex with men and sex workers. Given this observation, it is unlikely that either of these new agents could be promoted for monotherapy of gonorrhoea. The pre-clinical pipeline remains relatively empty of agents likely to progress to clinical development for gonorrhoea treatment and increased investment into gonorrhoea-specific drug discovery is recommended.
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Read, Tim R. H., Marcus Y. Chen, Catriona S. Bradshaw, Sriyakantha Beneragama i Christopher K. Fairley. "Do all women attending urban sexual health services need testing for gonorrhoea?" Sexual Health 2, nr 4 (2005): 259. http://dx.doi.org/10.1071/sh05029.
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Asymptomatic women are often screened for gonorrhoea at Australian sexual health centres. The medical records of all women diagnosed with gonorrhoea at the Melbourne Sexual Health Centre (MSHC) between January 2002 and December 2003 were audited and the database was examined for risk factors in all women tested in 2003. Fifteen cases of gonorrhoea were identified among women at MSHC, all had symptoms or an identifiable risk factor. Asymptomatic women without risk factors may not require screening for Neisseria gonorrhoeae in low prevalence populations.
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Xu, Xianglong, Eric P. F. Chow, Jason J. Ong, Mingwang Shen, Chongjian Wang, Jane S. Hocking, Christopher K. Fairley i Lei Zhang. "Modelling the potential role of saliva use during masturbation in the transmission of". Sexual Health 18, nr 6 (17.12.2021): 466–74. http://dx.doi.org/10.1071/sh21138.
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Background Neisseria gonorrhoeae can be cultured from saliva in men with pharyngeal gonorrhoea and could theoretically be transmitted from the pharynx to the urethra when saliva is used as a lubricant for masturbation. In this work, we proposed that saliva use during masturbation may be a potential transmission route of gonorrhoea. Methods We analysed the transmission of Neisseria gonorrhoeae at the oropharynx, urethra and anorectum with mathematical models among men who have sex with men using data from six different studies. Model 1 included transmission routes (oral sex, anal sex, rimming, kissing, and three sequential sex practices). In Model 2, we added saliva use during solo masturbation and mutual masturbation to model 1. Results Model 2 could replicate single site infection at the oropharynx, urethra and anorectum and multi-site infection across six different datasets. However, the calibration of Model 2 was not significantly different from Model 1 across four datasets. Model 2 generated an incidence of gonorrhoea from masturbation of between 5.2% (95% CI: 3.2–10.1) to 10.6% (95% CI: 5.8–17.3) across six data sets. Model 2 also estimated that about one in four cases of urethral gonorrhoea might arise from solo masturbation and mutual masturbation. Conclusions Our models raise the possibility that saliva use during masturbation may play a role in transmitting gonorrhoea. This is an important area to explore because it contributes to the knowledge base about gonorrhoea transmission.
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Somayaji, R., C. Naugler, M. Guo i D. Church. "Examining Chlamydia trachomatis and Neisseria gonorrhoeae rates between 2010 and 2015: a population-based observational study". International Journal of STD & AIDS 28, nr 8 (5.10.2016): 822–28. http://dx.doi.org/10.1177/0956462416674427.
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Bacterial sexually transmitted infections including Chlamydia trachomatis and Neisseria gonorrhoeae remain an important public health concern. We aimed to assess the population-based incidence of C. trachomatis and N. gonorrhoeae in an age-standardized cohort over time. A retrospective study of a large Canadian health region was undertaken between 2010 and 2015 using linked census and digital laboratory data. C. trachomatis and N. gonorrhoeae tests were linked to patient data. Sex and age-standardized incidence rates (IR) and ratios (IRR) were calculated for cases and testing rates. The annual mean population was 1,150,556 individuals (50.1% female). A total of 15,109 cases of chlamydia and 981 cases of gonorrhoea occurred. The overall IR for chlamydia ranged from 18.81 to 25.63 cases per 10,000 person-years. The IRR was 1.27 (95% CI 1.20–1.34, p < 0.001) for the comparison of 2015 and 2010 rates. For gonorrhoea, overall rates ranged from 0.92 to 1.86 cases per 10,000 person-years. The IRR for gonorrhoea was 2.02 (95% CI 1.56–2.59, p < 0.001) for 2015 and 2010 rates. In our large population-based study spanning six years, we observed increasing rates of C. trachomatis and N. gonorrhoeae with low testing rates.
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Qian, Sue, Rosalind Foster, Christopher Bourne, Tobias Vickers, Ruthy McIver i Anna McNulty. "Neisseria gonorrhoeae positivity in clients presenting as asymptomatic contacts of gonorrhoea at a sexual health centre". Sexual Health 17, nr 2 (2020): 187. http://dx.doi.org/10.1071/sh19091.
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Background Previous guidelines at the Sydney Sexual Health Centre (SSHC) recommended empirical antibiotic treatment for asymptomatic contacts of Neisseria gonorrhoeae at the time of testing. With increasing concerns around gonorrhoea antibiotic resistance, it has been suggested that asymptomatic contacts should only be treated based on test results. Methods: This retrospective study of data from the SSHC electronic medical record included a total of 295 gonorrhoea contacts from 1 January 2018 to 30 June 2018. The primary outcome was the proportion of asymptomatic gonorrhoea contacts with a positive gonorrhoea result from any anatomical site. Statistically significant differences in gonorrhoea positivity according to gender, sexual preference, use of PrEP, sex worker status, country of birth, preferred language and number of partners, were calculated using Fisher’s exact test. Results: The overall proportion of asymptomatic gonorrhoea contacts with a positive gonorrhoea result was 27.1% (95% CI: 22.1–32.6%). The proportion of gonorrhoea positivity was significantly higher in females compared to males (52.0% vs 25.7%, P < 0.01), gay and bisexual men compared to heterosexual men (28.7% vs 0%, P < 0.01) and non-users of PrEP compared to PrEP users (31.2% vs 12.5%, P < 0.05). No statistically significant differences in gonorrhoea positivity were found in subgroups divided by sex worker status, country of birth, preferred language and number of partners. Conclusion: The relatively low gonorrhoea positivity rate (27.1%) in asymptomatic gonorrhoea contacts at the SSHC between January and June 2018 supports guideline changes to no longer provide empirical antibiotic treatment to asymptomatic contacts.
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Semchenko, Evgeny A., Aimee Tan, Ray Borrow i Kate L. Seib. "The Serogroup B Meningococcal Vaccine Bexsero Elicits Antibodies to Neisseria gonorrhoeae". Clinical Infectious Diseases 69, nr 7 (14.12.2018): 1101–11. http://dx.doi.org/10.1093/cid/ciy1061.
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Abstract Background Neisseria gonorrhoeae and Neisseria meningitidis are closely-related bacteria that cause a significant global burden of disease. Control of gonorrhoea is becoming increasingly difficult, due to widespread antibiotic resistance. While vaccines are routinely used for N. meningitidis, no vaccine is available for N. gonorrhoeae. Recently, the outer membrane vesicle (OMV) meningococcal B vaccine, MeNZB, was reported to be associated with reduced rates of gonorrhoea following a mass vaccination campaign in New Zealand. To probe the basis for this protection, we assessed the cross-reactivity to N. gonorrhoeae of serum raised to the meningococcal vaccine Bexsero, which contains the MeNZB OMV component plus 3 recombinant antigens (Neisseria adhesin A, factor H binding protein [fHbp]-GNA2091, and Neisserial heparin binding antigen [NHBA]-GNA1030). Methods A bioinformatic analysis was performed to assess the similarity of MeNZB OMV and Bexsero antigens to gonococcal proteins. Rabbits were immunized with the OMV component or the 3 recombinant antigens of Bexsero, and Western blots and enzyme-linked immunosorbent assays were used to assess the generation of antibodies recognizing N. gonorrhoeae. Serum from humans immunized with Bexsero was investigated to assess the nature of the anti-gonococcal response. Results There is a high level of sequence identity between MeNZB OMV and Bexsero OMV antigens, and between the antigens and gonococcal proteins. NHBA is the only Bexsero recombinant antigen that is conserved and surfaced exposed in N. gonorrhoeae. Bexsero induces antibodies in humans that recognize gonococcal proteins. Conclusions The anti-gonococcal antibodies induced by MeNZB-like OMV proteins could explain the previously-seen decrease in gonorrhoea following MeNZB vaccination. The high level of human anti-gonococcal NHBA antibodies generated by Bexsero vaccination may provide additional cross-protection against gonorrhoea.
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Unemo, Magnus, Monica M. Lahra, Michelle Cole, Patricia Galarza, Francis Ndowa, Irene Martin, Jo-Anne R. Dillon, Pilar Ramon-Pardo, Gail Bolan i Teodora Wi. "World Health Organization Global Gonococcal Antimicrobial Surveillance Program (WHO GASP): review of new data and evidence to inform international collaborative actions and research efforts". Sexual Health 16, nr 5 (2019): 412. http://dx.doi.org/10.1071/sh19023.
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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.
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Mabonga, Emily, Rosalind Parkes-Ratanshi, Stefan Riedel, Sheila Nabweyambo, Olive Mbabazi, Chris Taylor, Charlotte Gaydos i Yukari C. Manabe. "Complete ciprofloxacin resistance in gonococcal isolates in an urban Ugandan clinic: findings from a cross-sectional study". International Journal of STD & AIDS 30, nr 3 (4.11.2018): 256–63. http://dx.doi.org/10.1177/0956462418799017.
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Antimicrobial resistance (AMR) to gonorrhoea is a threat to global health security. There have been concerns expressed that countries with high rates of disease have poor surveillance. The objectives of the study were to determine the AMR patterns of Neisseria gonorrhoeae clinical isolates to antimicrobial agents in patients with HIV or high risk of HIV acquisition, to compare the concordance of disk diffusion and agar dilution as methods for determining AMR to N. gonorrhoeae, and to describe methodological challenges to carrying out AMR testing. The study was conducted at an HIV outpatient service for at-risk populations and an outreach clinic for commercial sex workers in Kampala. Patients were offered a sexually transmitted infection screen using a polymerase chain reaction (PCR)-based assay. Samples positive for gonorrhoea were cultured. Antimicrobial susceptibility testing was performed using disk diffusion and isolates were sent to a reference laboratory for agar dilution direct susceptibility testing. Five hundred and seventy-five patients were screened. There were 33 (5.7%) patients with gonorrhoea detected by PCR. Of the 16 viable N. gonorrhoeae isolates, 100% were resistant to ciprofloxacin and tetracycline by disk diffusion and 31% exhibited reduced susceptibility to ceftriaxone and cefixime. By agar dilution, 100% of isolates were resistant to ciprofloxacin and all isolates were susceptible to ceftriaxone and cefixime. There was concordance between disk diffusion and agar dilution for ciprofloxacin and tetracycline resistance and a significant discordance for third-generation cephalosporins. More than half the women with gonorrhoea were asymptomatic and represent a potential reservoir for ongoing transmission. AMR testing of N. gonorrhoeae isolates is needed to ensure optimal treatment and prevention of antibiotic resistance progression.
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Hansen, Lisa, Tom Wong i Maureen Perrin. "Gonorrhoea resurgence in Canada". International Journal of STD & AIDS 14, nr 11 (1.11.2003): 727–31. http://dx.doi.org/10.1258/09564620360719741.
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After several years of decline, reported gonorrhoea rates in Canada have recently increased substantially. National goals for gonorrhoea control were developed in 1997, but it appears that reliance on secular trends is insufficient to attain the goal of eliminating locally transmitted infection by Neisseria gonorrhoeae by 2010. We have examined disease surveillance reports from 1994 to 2001 inclusive to assess demographic and epidemiologic trends in reported cases of gonococcal infection. Since 1997, reported cases have increased by 53% among men and 33% among women. The largest proportion of cases in women is in those aged 15-24; the most dramatic increase in males has been among those aged 30-39. Reasons for the resurgence remain unclear, but disease reports indicate that renewed attention to enhanced surveillance and targeted prevention are essential for gonorrhoea control in Canada.
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Lopez, Kelsey M., Jeffrey A. Hobden i Isiah M. Warner. "Octenidine/carbenicillin GUMBOS as potential treatment for oropharyngeal gonorrhoea". Journal of Antimicrobial Chemotherapy 75, nr 12 (24.08.2020): 3576–81. http://dx.doi.org/10.1093/jac/dkaa346.
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Abstract Background Reducing Neisseria gonorrhoeae colonies in the oropharynx is a viable solution to minimize the transmission of this bacterium amongst individuals. Objectives A strategy involving the electrostatic interaction between a common antiseptic and a discontinued antibiotic (i.e. octenidine and carbenicillin) was evaluated as a potential treatment for gonorrhoea. Octenidine/carbenicillin is a novel group of uniform materials based on organic salts (GUMBOS) with inherent in vitro antibacterial activity that comes from its parent antiseptic and antibacterial ions, octenidine and carbenicillin, respectively. Methods Antibacterial activities for octenidine dihydrochloride, disodium carbenicillin, octenidine/carbenicillin and stoichiometrically equivalent 1:1 octenidine dihydrochloride to disodium carbenicillin were assessed using the Kirby–Bauer disc diffusion assay for N. gonorrhoeae (ATCC 49226) and three clinical isolates. Predictive permeability using the Parallel Artificial Membrane Permeability Assay and cytotoxicity against HeLa cells was also evaluated. Results Additive in vitro antibacterial activities against N. gonorrhoeae were observed in this study, which suggests octenidine/carbenicillin could be a useful agent in reducing N. gonorrhoeae transmission and minimizing gonorrhoea infections. Octenidine/carbenicillin also exhibited bioequivalence to azithromycin and doxycycline, two currently prescribed antibiotics. Likewise, octenidine/carbenicillin had improved predicted permeability compared with octenidine dihydrochloride. Conclusions Antimicrobial GUMBOS synthesized in this study could be used as an adjunctive treatment approach to current drug therapies for oropharyngeal gonorrhoea infection control and prevention.
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Grütter, Anabel E., Tecla Lafranca, Aurelia Pahnita Sigg, Max Mariotti, Gernot Bonkat i Olivier Braissant. "Detection and Drug Susceptibility Testing of Neisseria gonorrhoeae Using Isothermal Microcalorimetry". Microorganisms 9, nr 11 (11.11.2021): 2337. http://dx.doi.org/10.3390/microorganisms9112337.
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Background: Gonorrhea is a frequently encountered sexually transmitted disease that results in urethritis and can further lead to pelvic inflammatory disease, infertility, and possibly disseminated gonococcal infections. Thus, it must be diagnosed promptly and accurately. In addition, drug susceptibility testing should be performed rapidly as well. Unfortunately, Neisseria gonorrhoea is a fastidious microorganism that is difficult to grow and requires culturing in an opaque medium. Methods: Here, we used isothermal microcalorimetry (IMC) to monitor the growth and the antimicrobial susceptibility of N. gonorrhoea. Results: Using IMC, concentrations of N. gonorrhoea between 2000 and 1 CFU·mL−1 were detected within 12 to 33 h. In addition, drug susceptibility could be monitored easily. Conclusions: The use of isothermal microcalorimetry provides an interesting and useful tool to detect and characterize fastidious microbes such as N. gonorrhoea that require media incompatible with optical detection conventionally used in many commercial systems.
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Chigugudhlo, Patronellah Nelly, Evans Chazireni, Ian Takunda Marufu-Dzangare i Simon Dhleleyeniec. "Temporal analysis of gonorrhoea prevalence rate in females aged 15-49 in Chipinge district, Zimbabwe". International Journal of Social Sciences and Humanities Invention 6, nr 1 (30.01.2019): 5214–17. http://dx.doi.org/10.18535/ijsshi/v6i1.01.
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This study was carried out to examine the temporal prevalence of gonorrhoea in females aged 15-49 in Chipinge district in Manicaland province of Zimbabwe. A mixed research design involving secondary data and focus group interviews was used in this study. Interview guides were used to collect primary data. The data collected was organized and was presented graphically. Findings from the study revealed that females aged 15 to 49 experienced high prevalence rate of gonorrhoea but the number of gonorrhoea cases was declining over the years. It emerged from the study that risk behaviours such as promiscuity and premarital sexual intercourse, lack of abstinence or appropriate sexual behaviour, commercial sex as well as long distances travelled to the nearest health facility for prevention and early treatments impact were the factors that lead to high levels of gonorrhoea in the district. Research findings also showed that there was generally high number of cases of gonorrhoea drug resistance in the district. There was however a general decline in cases of gonorrhoea drug resistance in the district over the years.Numerous recommendations were made to reduce or even eliminate the burden of gonorrhea in the district and improve the that livelihoods of people in the region.
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Liang, Jingyao, Ridong Yang, Xiaodong Li, Chao Bi, Xingdong Ye, Xibao Zhang i Wenling Cao. "First four failures of cefathiamidine to treat urogenital gonorrhoea in Guangzhou, China, 2014–15". Sexual Health 14, nr 3 (2017): 289. http://dx.doi.org/10.1071/sh16087.
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Neisseria gonorrhoeae has a remarkable ability to develop resistance to all available therapeutic antimicrobials. This report describes the first four cases of verified failure to treat gonorrhoea using 1000 mg cefathiamidine intramuscularly in Guangzhou, China; for each case, the patient was clinically cured after treatment with 500 mg ceftriaxone intramuscularly. Enhanced monitoring of clinical treatment failures, finding new effective treatments and updating treatment guidelines are all of utmost importance to curb the spread of drug-resistant gonorrhoea.
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Boiko, Iryna, Viorika Akimova, Lyudmyla Mazur, Iryna Savchenko, Ihor Kohut i Inna Krynytska. "The Clinico-Epidemiological Profile of Patients with Gonorrhoea and Challenges in the Management of Neisseria gonorrhoeae Infection in an STI clinic, Ternopil, Ukraine (2013-2018)". Journal of Medicine and Life 13, nr 1 (styczeń 2020): 75–81. http://dx.doi.org/10.25122/jml-2019-0170.
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Gonorrhea is the second most common sexually transmitted infection spreading worldwide and a serious public health problem. How�ever, further data are required to improve the management of gonorrhea. Our aim was to review the features of gonococcal infection and characterize the challenges of its management. A retrospective descriptive study of the medical records of 136 adult patients with gonorrhea that visited Ternopil Regional Sexually Transmitted Infections Clinic (Ukraine) in 2013-2018 was performed. The male-to-female ratio was 6.6:1. Homosexually-acquired gonorrhoea was 3.7%. Also, most patients acquired gonorrhea in Ukraine (98.4%). The mean infectious period lasted 2-16 days, including the incubation period of 1-9 days and the period from the onset of symptoms to the first visit of the clinic of 1-7 days. The probability of N. gonorrhoeae transmission within the frame of the epidemiologic sexual chain was 1:2.4. Concurrent T. vaginalis (39.7%) and C. trachomatis (2.2%) were detected. HIV and syphilis screening rates were 1.6% and 0.7%, respectively. The examining rate of sexual partners was 11%, testing extragenital specimens - 0.7%, screening coverage for HIV - 46.3%, compliance with follow-up visits - 41.9%. Part of patients (16.2%) received monotherapy with clarithromycin, doxycycline, benzylpenicillin, azithromycin, or ofloxacin. The management of N. gonorrhoeae infections was compromised by a low rate of examining sexual partners, females and testing extragenital specimens, screening for HIV, compliance to follow-up visits, access to nucleic acid amplification tests, and receiving questionable or even obsolete antimicrobial treatment. Therefore, more accurate and comprehensive management of gonorrhea is urgently needed in Ukraine.
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Ritchie, Stephen, Rebecca Henley, Jackie Hilton, Rupert Handy, Joan Ingram, Susan Mundt, Mitzi Nisbet, Mark Thomas i Simon Briggs. "Uptake, yield and resource requirements of screening for asymptomatic sexually transmissible infections among HIV-positive people attending a hospital outpatient clinic". Sexual Health 11, nr 1 (2014): 67. http://dx.doi.org/10.1071/sh13167.
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Background We performed a prospective audit of screening for asymptomatic sexually transmissible infections (STIs), during an intensive effort to screen all patients at our hospital-based HIV clinic. We aimed to measure the effectiveness and resource implications of our screening program. Methods: All outpatients who attended during an 8-month period were invited to take part in opt-out screening for chlamydia (Chlamydia trachomatis), gonorrhoea (Neisseria gonorrhoeae) and syphilis. Participants completed a brief questionnaire, were asked about current symptoms of STIs and self-collected specimens for laboratory testing. Results: The majority (535 out of 673, 80%) of the patients who were asked to participate provided specimens for screening. No chlamydia, gonorrhoea or syphilis infections were identified in women (n = 91) or in heterosexual men (n = 76). In contrast, 34 out of 368 (10%) of men who have sex with men tested positive (chlamydia, 25; gonorrhoea, 2; chlamydia and gonorrhoea, 2; syphilis, 5). The laboratory cost of diagnosing each case of rectal chlamydia or gonorrhoea (NZ$664) was substantially lower than the cost of diagnosing each case of urethral infection (NZ$5309). Conclusions: There was high uptake of screening among our clinic population, who preferred screening to be performed at the hospital clinic. The yield of screening men who have sex with men warrants continued annual screening for rectal gonorrhoea and chlamydia and for syphilis.
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Chesson, Harrell W., Kwame Owusu-Edusei, Jami S. Leichliter i Sevgi O. Aral. "Violent crime rates as a proxy for the social determinants of sexually transmissible infection rates: the consistent state-level correlation between violent crime and reported sexually transmissible infections in the United States, 1981–2010". Sexual Health 10, nr 5 (2013): 419. http://dx.doi.org/10.1071/sh13006.
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Background Numerous social determinants of health are associated with violent crime rates and sexually transmissible infection (STI) rates. This report aims to illustrate the potential usefulness of violent crime rates as a proxy for the social determinants of STI rates. Methods: For each year from 1981 to 2010, we assessed the strength of the association between the violent crime rate and the gonorrhoea (Neisseria gonorrhoeae) rate (number of total reported cases per 100 000) at the state level. Specifically, for each year, we calculated Pearson correlation coefficients (and P-values) between two variables (the violent crime rate and the natural log of the gonorrhoea rate) for all 50 states and Washington, DC. For comparison, we also examined the correlation between gonorrhoea rates, and rates of poverty and unemployment. We repeated the analysis using overall syphilis rates instead of overall gonorrhoea rates. Results: The correlation between gonorrhoea and violent crime was significant at the P < 0.001 level for every year from 1981 to 2010. Syphilis rates were also consistently correlated with violent crime rates. In contrast, the P-value for the correlation coefficient exceeded 0.05 in 9 of the 30 years for the association between gonorrhoea and poverty, and in 17 of the 30 years for that between gonorrhoea and unemployment. Conclusions: Because violent crime is associated with many social determinants of STIs and because it is consistently associated with STI rates, violent crime rates can be a useful proxy for the social determinants of health in statistical analyses of STI rates.
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Dubbink, Jan Henk, Stephan P. Verweij, Helen E. Struthers, Sander Ouburg, James A. McIntyre, Servaas A. Morré i Remco PH Peters. "Genital Chlamydia trachomatis and Neisseria gonorrhoeae infections among women in sub-Saharan Africa: A structured review". International Journal of STD & AIDS 29, nr 8 (28.02.2018): 806–24. http://dx.doi.org/10.1177/0956462418758224.
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Chlamydia trachomatis and Neisseria gonorrhoeae constitute major public health problems among women, but the burden of infection in sub-Saharan Africa is poorly documented. We conducted a structured review of the prevalence and incidence of genital, oral and anal C. trachomatis and N. gonorrhoeae infection in women in sub-Saharan Africa. We searched Medline, EMBASE and Web of Science over a 10-year period for studies on epidemiology of genital, oral and anal chlamydial infection and gonorrhoea in women in all countries of sub-Saharan Africa. We assessed geographic and demographic differences in prevalence and incidence of infection; weighted mean prevalence estimates were calculated with a random-effect model. A total of 102 study results were included, with data available for 24/49 of sub-Saharan countries. The weighted prevalence of chlamydial infection was lower among women in community-based studies (3.9%; 95% CI: 2.9–5.1%) than for women recruited at primary healthcare facilities (6.0%; 95% CI: 4.2–8.4%, p < 0.001); the same was observed for gonorrhoea (2.2%; 95% CI: 1.2–4.0% vs. 4.2%; 95% CI: 3.2–5.6%, p < 0.001). Prevalence of Chlamydia among sex workers was 5.5% (95% CI: 4.2–7.3%) and gonorrhoea 7.6% (95% CI: 5.4–11%). Seven studies reported on incidence which varied between 0.75–28 and 2.8–17 per 100 person-years-at-risk for chlamydial infection and gonorrhoea, respectively. Only two studies reported on anal infections and one on oral infection. This overview underscores the considerable incidence and prevalence of genital C. trachomatis and N. gonorrhoeae in women in different settings in sub-Saharan Africa. Better control strategies are warranted to reduce the burden of infection and to prevent long-term complications of these infections.
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Foerster, Sunniva, George Drusano, Daniel Golparian, Michael Neely, Laura J. V. Piddock, Emilie Alirol i Magnus Unemo. "In vitro antimicrobial combination testing of and evolution of resistance to the first-in-class spiropyrimidinetrione zoliflodacin combined with six therapeutically relevant antimicrobials for Neisseria gonorrhoeae". Journal of Antimicrobial Chemotherapy 74, nr 12 (5.09.2019): 3521–29. http://dx.doi.org/10.1093/jac/dkz376.
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Abstract Objectives Resistance in Neisseria gonorrhoeae to all gonorrhoea therapeutic antimicrobials has emerged. Novel therapeutic antimicrobials are imperative and the first-in-class spiropyrimidinetrione zoliflodacin appears promising. Zoliflodacin could be introduced in dual antimicrobial therapies to prevent the emergence and/or spread of resistance. We investigated the in vitro activity of and selection of resistance to zoliflodacin alone and in combination with six gonorrhoea therapeutic antimicrobials against N. gonorrhoeae. Methods The international gonococcal reference strains WHO F (WT) and WHO O, WHO V and WHO X (strains with different AMR profiles) were examined. Zoliflodacin was evaluated alone or combined with ceftriaxone, cefixime, spectinomycin, gentamicin, tetracycline, cethromycin or sitafloxacin in chequerboard assays, time–kill curve analysis and selection-of-resistance studies. Results Zoliflodacin alone or in combination with all six antimicrobials showed rapid growth inhibition against all examined strains. The time–kill curve analysis indicated that tetracycline or cethromycin combined with zoliflodacin can significantly decrease the zoliflodacin kill rate in vitro. The frequency of selected zoliflodacin-resistance mutations was low when evaluated as a single agent and further reduced for all antimicrobial combinations. All resistant mutants contained the GyrB mutations D429N, K450T or K450N, resulting in zoliflodacin MICs of 0.5–4 mg/L. Conclusions Zoliflodacin, alone or in combination with sexually transmitted infection therapeutic antimicrobials, rapidly kills gonococci with infrequent resistance emergence. Zoliflodacin remains promising for gonorrhoea oral monotherapy and as part of dual antimicrobial therapy with low resistance emergence potential. A Phase III trial evaluating efficacy and safety of zoliflodacin for uncomplicated gonorrhoea treatment is planned in 2019.
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Kwong, Jason C., Eric P. F. Chow, Kerrie Stevens, Timothy P. Stinear, Torsten Seemann, Christopher K. Fairley, Marcus Y. Chen i Benjamin P. Howden. "Whole-genome sequencing reveals transmission of gonococcal antibiotic resistance among men who have sex with men: an observational study". Sexually Transmitted Infections 94, nr 2 (15.12.2017): 151–57. http://dx.doi.org/10.1136/sextrans-2017-053287.
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ObjectivesDrug-resistant Neisseria gonorrhoeae are now a global public health threat. Direct transmission of antibiotic-resistant gonococci between individuals has been proposed as a driver for the increased transmission of resistance, but direct evidence of such transmission is limited. Whole-genome sequencing (WGS) has superior resolution to investigate outbreaks and disease transmission compared with traditional molecular typing methods such as multilocus sequence typing (MLST) and N. gonorrhoeae multiantigen sequence (NG-MAST). We therefore aimed to systematically investigate the transmission of N. gonorrhoeae between men in sexual partnerships using WGS to compare isolates and their resistance to antibiotics at a genome level.Methods458 couples from a large prospective cohort of men who have sex with men (MSM) tested for gonorrhoea together between 2005 and 2014 were included, and WGS was conducted on all isolates from couples where both men were culture-positive for N. gonorrhoeae. Resistance-determining sequences were identified from genome assemblies, and comparison of isolates between and within individuals was performed by pairwise single nucleotide polymorphism and pangenome comparisons, and in silico predictions of NG-MAST and MLST.ResultsFor 33 of 34 (97%; 95% CI 85% to 100%) couples where both partners were positive for gonorrhoea, the resistance-determining genes and mutations were identical in isolates from each partner (94 isolates in total). Resistance determinants in isolates from 23 of 23 (100%; 95% CI 86% to 100%) men with multisite infections were also identical within an individual. These partner and within-host isolates were indistinguishable by NG-MAST, MLST and whole genomic comparisons.ConclusionsThese data support the transmission of antibiotic-resistant strains between sexual partners as a key driver of resistance rates in gonorrhoea among MSM. This improved understanding of the transmission dynamics of N. gonorrhoeae between sexual partners will inform treatment and prevention guidelines.
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Davies, P. O., i C. A. Ison. "The role of effective diagnosis for the control of gonorrhoea in high prevalence populations". International Journal of STD & AIDS 9, nr 8 (1.08.1998): 435–43. http://dx.doi.org/10.1258/0956462981922539.
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Gonorrhoea in the UK is now a highly focal problem that is localized to certain inner city areas where it presents a significant public health concern. However, the majority of men and a proportion of women infested with Neisseria gonorrhoeae do not experience symptoms of sufficient intensity to prompt them to seek medical advice and the current strategy of treating symptomatic individuals in specialist clinics with subsequent tracing of sexual partners is therefore failing to control the spread of infection in these areas. One method for addressing this problem would be the extension of effective diagnostic services into the clinical environments most likely to be accessed by these high risk individuals. This paper reviews the scientific literature examining the various methodologies available for the identification of N. gonorrhoeae and assesses their suitability for the diagnosis of gonorrhoea in these alternative clinical settings.
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Gottlieb, Sami L., Ann E. Jerse, Sinead Delany-Moretlwe, Carolyn Deal i Birgitte K. Giersing. "Advancing vaccine development for gonorrhoea and the Global STI Vaccine Roadmap". Sexual Health 16, nr 5 (2019): 426. http://dx.doi.org/10.1071/sh19060.
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Efforts to develop vaccines against Neisseria gonorrhoeae have become increasingly important, given the rising threat of gonococcal antimicrobial resistance (AMR). Recent data suggest vaccines for gonorrhoea are biologically feasible; in particular, epidemiological evidence shows that vaccines against a closely related pathogen, serogroup B Neisseria meningitidis outer membrane vesicle (OMV) vaccines, may reduce gonorrhoea incidence. Vaccine candidates using several approaches are currently in preclinical development, including meningococcal and gonococcal OMV vaccines, a lipooligosaccharide epitope and purified protein subunit vaccines. The Global STI Vaccine Roadmap provides action steps to build on this technical momentum and advance gonococcal vaccine development. Better quantifying the magnitude of gonorrhoea-associated disease burden, for outcomes like infertility, and modelling the predicted role of gonococcal vaccines in addressing AMR will be essential for building a full public health value proposition, which can justify investment and help with decision making about future vaccine policy and programs. Efforts are underway to gain consensus on gonorrhoea vaccine target populations, implementation strategies and other preferred product characteristics that would make these vaccines suitable for use in low- and middle-income, as well as high-income, contexts. Addressing these epidemiological, programmatic and policy considerations in parallel to advancing research and development, including direct assessment of the ability of meningococcal B OMV vaccines to prevent gonorrhoea, can help bring about the development of viable gonococcal vaccines.
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Kenyon, Chris, Jolein Laumen i Sheeba Manoharan-Basil. "Choosing New Therapies for Gonorrhoea: We Need to Consider the Impact on the Pan-Neisseria Genome. A Viewpoint". Antibiotics 10, nr 5 (1.05.2021): 515. http://dx.doi.org/10.3390/antibiotics10050515.
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The development of new gonorrhoea treatment guidelines typically considers the resistance-inducing effect of the treatment only on Neisseria gonorrhoeae. Antimicrobial resistance in N. gonorrhoeae has, however, frequently first emerged in commensal Neisseria species and then been passed on to N. gonorrhoeae via transformation. This creates the rationale for considering the effect of gonococcal therapies on resistance in commensal Neisseria. We illustrate the benefits of this pan-Neisseria strategy by evaluating three contemporary treatment options for N. gonorrhoeae—ceftriaxone plus azithromycin, monotherapy with ceftriaxone and zoliflodacin.
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Wang, Ann Andee, i Elyse Anna Linson. "Septic arthritis in a previously healthy man with pan-negative infectious and rheumatologic work-up". BMJ Case Reports 13, nr 2 (luty 2020): e231823. http://dx.doi.org/10.1136/bcr-2019-231823.
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Neisseria gonorrhoeae is the causative organism in 0.6%–1.2% of septic arthritis cases in North America and Europe, and classically presents as migratory polyarthralgias and tenosynovitis, with later development of septic oligoarthritis. In men, urine gonorrhoea nucleic amplification testing (NAAT) is the preferred diagnostic test, as its sensitivity surpasses that of joint and blood culture in disseminated infections. We present a case of a previously healthy man who presented with septic arthritis of the wrist. He denied any sexual activity in the previous year. Urine gonorrhoea NAAT and cultures were negative. However, N. gonorrhoeae was later identified via 16s PCR of the patient’s synovial fluid, leading to a delayed diagnosis of gonococcal arthritis. In patients with septic arthritis, gonococcal infection should remain on the differential despite reported sexual history and negative urine NAAT. Clinicians should continue to follow cultures and provide antibiotic coverage until a causative organism is identified.
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Manavi, Kaveh, Hugh Young i Dan Clutterbuck. "Sensitivity of microscopy for the rapid diagnosis of gonorrhoea in men and women and the role of gonorrhoea serovars". International Journal of STD & AIDS 14, nr 6 (1.06.2003): 390–94. http://dx.doi.org/10.1258/095646203765371277.
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Auditing the sensitivity of microscopic diagnosis of gonorrhoea is recommended by the current guidelines. A retrospective study was performed of 596 cases of positive cultures for Neisseria gonorrhoeae in modified New York City culture (MNYC) media diagnosed from 1995 to 1999. The sensitivity of the cervical slides in women was 51% while in men who have sex with men (MSM) the sensitivity of urethral and rectal slides were 89% and 54% respectively. The sensitivity of urethral slides in heterosexual men was 84%. Neisseria serovar 1B02 among MSM and serovar 1B31 among women were mostly undiagnosed with microscopy. Serovars 1A05, 1A21, B08 among heterosexual men were exclusively associated with negative microscopy. Microscopy is important in the rapid detection and treatment of gonorrhoea. Infections with certain serovars are less likely to be detected by microscopy; making them more likely to spread within the community. Culture from different ano-genital sites is essential to maximize detection of gonorrhoea in all patients.
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Valejo Coelho, Margarida Moura, Eugénia Matos-Pires, Vasco Serrão, Ana Rodrigues i Cândida Fernandes. "Extragenital Gonorrhoea in Men Who Have Sex with Men: A Retrospective Study in a STI Clinic in Lisbon, Portugal". Acta Médica Portuguesa 31, nr 5 (30.05.2018): 247. http://dx.doi.org/10.20344/amp.10146.
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Introduction: Recent studies worldwide reveal a significant prevalence of extragenital infections by Neisseria gonorrhoeae among men who have sex with men. We aimed to analyse the frequency and characteristics of extragenital gonococcal infections diagnosed in men who have sex with men in a walk-in Sexually Transmitted Infection clinic in Lisbon, Portugal.Material and Methods: We conducted a cross-sectional, retrospective study of the anorectal and/or oropharyngeal Neisseria gonorrhoeae infections in men who have sex with men, diagnosed in our Sexually Transmitted Infection clinic between January 2014 and December 2016.Results: We found extragenital infection in 87 cases of gonorrhoea identified in men who have sex with men in this period, including: 49 cases of anorectal disease, 9 of oropharyngeal disease, 13 cases of infection at both extragenital sites, and 16 of simultaneous extragenital and urogenital gonorrhoea. Patients’ ages ranged from 17 to 64 years (median: 28 years). Forty-seven (54%) of the patients did not present with any extragenital symptoms. Thirty (35%) were human immunodeficiency virus-1-positive.Discussion: Since most extragenital Neisseria gonorrhoeae infections are asymptomatic, they may be missed and go untreated unless actively investigated. Current international guidelines recommend the screening of gonorrhoea at extragenital sites in men who have sex with men because anorectal and oropharyngeal infections constitute a potential disease reservoir, and may facilitate transmission and/or acquisition of human immunodeficiency virus infection.Conclusion: Our results highlight the relevance of testing men who have sex with men for Neisseria gonorrhoeae at extragenital sites, regardless of the existence of local complaints. The implementation of adequate screening programmes in Portugal should be considered. We also reinforce the need to raise awareness in the population regarding the adoption of prophylactic measures against transmission of sexually transmitted infections during anal and/or oral sexual exposure.
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Mossenson, Adam, Kathryn Algie, Melanie Olding, Linda Garton i Carole Reeve. "'Yes wee can' - a nurse-driven asymptomatic screening program for chlamydia and gonorrhoea in a remote emergency department". Sexual Health 9, nr 2 (2012): 194. http://dx.doi.org/10.1071/sh11064.
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Background A nurse-driven, urine-based screening program for Neisseria gonorrhoeae and Chlamyida trachomatis was conducted in a remote emergency department targeting asymptomatic youth. Methods: Individuals who presented to the Emergency Department with non-genitourinary complaints between the ages of 16 and 34 were offered free opportunistic urinary testing for gonorrhoea and chlamydia. Results: In total, 178 eligible patients were offered screening, 65% consented for testing and 14 patients (12%) returned positive results, with 10 diagnoses of chlamydia, 9 of gonorrhoea and 5 with both. Discussion: Emergency departments are an underutilised interface between difficult to reach at risk youth populations and public health services.
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Marangoni, Antonella, Giacomo Marziali, Melissa Salvo, Antonietta D’Antuono, Valeria Gaspari, Claudio Foschi i Maria Carla Re. "Mosaic structure of the penA gene in the oropharynx of men who have sex with men negative for gonorrhoea". International Journal of STD & AIDS 31, nr 3 (30.01.2020): 230–35. http://dx.doi.org/10.1177/0956462419889265.
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The oropharynx represents a crucial site for the emergence of multi-drug resistance in Neisseria gonorrhoeae. The mosaic penA alleles, associated with decreased susceptibility to cephalosporins, have emerged by DNA recombination with partial penA genes, particularly those from commensal pharyngeal Neisseria species. Here, we investigated the prevalence of the mosaic structure of the penA gene in the oropharynx of men who have sex with men testing negative for pharyngeal gonorrhoea. From January 2016 to June 2018, 351 gonorrhoea-negative men who have sex with men attending a sexually transmitted infection clinic in Italy were enrolled. Pharyngeal swabs underwent a real-time polymerase chain reaction (PCR) for the detection of the mosaic penA gene. In case of positivity, PCR products were sequenced and searched against several sequences of Neisseria strains. Overall, 31 patients (8.8%) were found positive for the presence of the mosaic penA gene. The positivity was significantly associated with previous cases of pharyngeal gonorrhoea (relative risk [RR]: 3.56, 95% confidence interval 1.44–8.80) and with recent exposure to beta-lactams (RR: 4.29, 95% confidence interval 2.20–8.38). All penA-positive samples showed a high relatedness (90–99%) with mosaic-positive Neisseria strains. Our data underline that commensal Neisseria species of the oropharynx may be a significant reservoir for genetic material conferring antimicrobial resistance in N. gonorrhoeae.
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Bingham, Amie L., Anne M. Kavanagh, Christopher Kit Fairley, Louise A. Keogh, Rebecca J. Bentley i Jane S. Hocking. "Income inequality and Neisseria gonorrhoeae notifications in females: a country-level analysis". Sexual Health 11, nr 6 (2014): 556. http://dx.doi.org/10.1071/sh13188.
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Background Patterns of population susceptibility to sexually transmissible infections may be influenced by various social determinants of health, however these receive relatively little attention. Income inequality is one such determinant that has been linked to a number of poor health outcomes. The objective of this analysis was to determine whether there is an association between income inequality and Neisseria gonorrhoeae notification rates when measured at the country level. Methods: Gini coefficients, gonorrhoea notification rates among women, per capita gross domestic product and approximate size of female population were obtained for 11 countries of the OECD. Linear regression was used to measure the association between income inequality and gonorrhoea notification rates, using generalised estimation equations (GEE) to control for the non-independence of repeat measures from particular countries. Results: A total of 36 observations from 11 countries were included. Gini coefficients ranged from 0.21 to 0.38 and gonorrhoea notifications from 0.7 to 153 per 100000 females. Significant associations were found between country-level income inequality and gonorrhoea notification rates among women (b = 17.79 (95% CI: 10.64, 24.94, P < 0.01). Conclusions: Significant associations were found, highlighting the importance of acknowledging and accounting for social determinants of sexual health and suggesting that further research in this arena may be fruitful.
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Higgins, Stephen P., Paul E. Klapper, J. Keith Struthers, Andrew S. Bailey, Alison P. Gough, Rita Moore, Gerald Corbitt i Mukti N. Bhattacharyya. "Detection of male genital infection with Chlamydia trachom atis and Neisseria gonorrhoeae using an automated multiplex PCR system (Cobas AmplicorTM)". International Journal of STD & AIDS 9, nr 1 (1.01.1998): 21–24. http://dx.doi.org/10.1258/0956462981920982.
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Summary: We evaluated Cobas AmplicorTM, a highly automated polymerase chain reaction (PCR) system, to test first-void urine (FVU) and urethral swab specimens for Chlamydia trachomatis and Neisseria gonorrhoeae in men attending a sexually transmitted infection (STI) clinic. Results were compared against an inhouse radioimmune dot blot (DB) test for C. trachomatis and selective culture for N. gonorrhoeae . Three hundred and ninety sets of specimens were obtained from 378 consecutive new and returned-new patients. Gonorrhoea prevalence was 9.49%, with no significant difference in sensitivity or specificity between culture and PCR. Chlamydia prevalence was 15.4%, with sensitivities of: DB 55%, PCR of FVU 86.7%, urethral swab PCR 90%. The specificity of PCR on FVU and urethral swabs was 100%. We have shown that Cobas AmplicorTM PCR is highly sensitive and specific in the diagnosis of chlamydia and gonorrhoea in men attending an STI clinic. Further economic and scientific studies are needed to determine the costeffectiveness of this technique for screening in primary care settings.
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Radovanovic, Marina, Dusan Kekic, Milos Jovicevic, Jovana Kabic, Ina Gajic, Natasa Opavski i Lazar Ranin. "Current Susceptibility Surveillance and Distribution of Antimicrobial Resistance in N. gonorrheae within WHO Regions". Pathogens 11, nr 11 (25.10.2022): 1230. http://dx.doi.org/10.3390/pathogens11111230.
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Neisseria gonorrhoeae (N. gonorrhoeae) is the etiological agent of the second most common sexually transmitted disease in the world, gonorrhoea. Currently recommended and last available first-line therapy is extended-spectrum cephalosporins most often combined with azitromycin. However, misuse of antibiotics and the abilities of N. gonorrhoeae to acquire new genetic and plasmid-borne resistance determinants has gradually led to the situation where this bacterium has become resistant to all major classes of antibiotics. Together with a generally slow update of treatment guidelines globally, as well as with the high capacity of gonococci to develop and retain AMR, this may lead to the global worsening of gonococcal AMR. Since effective vaccines are unavailable, the management of gonorrhoea relies mostly on prevention and accurate diagnosis, together with antimicrobial treatment. The study overviews the latest results of mostly WHO-initiated studies, primarily focusing on the data regarding the molecular basis of the resistance to the current and novel most promising antibacterial agents, which could serve to establish or reinforce the continual, quality-assured and comparable AMR surveillance, including systematic monitoring and treatment with the use of molecular AMR prediction methods.
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Heijne, Janneke C. M., Ingrid V. F. van den Broek, Sylvia M. Bruisten, Jan E. A. van Bergen, Hanneke de Graaf i Birgit H. B. van Benthem. "National prevalence estimates of chlamydia and gonorrhoea in the Netherlands". Sexually Transmitted Infections 95, nr 1 (20.06.2018): 53–59. http://dx.doi.org/10.1136/sextrans-2017-053478.
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ObjectivesNational prevalence estimates of Chlamydia trachomatis (chlamydia) and Neisseria gonorrhoeae (gonorrhoea) are important for providing insights in the occurrence and control of these STIs. The aim was to obtain national prevalence estimates for chlamydia and gonorrhoea and to investigate risk factors associated with infection.MethodsBetween November 2016 and January 2017, we performed a national population-based cross-sectional probability sample survey among men and women aged 18–34 years in the Netherlands. Individuals were invited to complete a questionnaire about sexual health. At the end of the questionnaire, sexually active individuals could request a home-based sampling kit. Samples were tested for chlamydia and gonorrhoea using nucleic acid amplification test (NAAT). Logistic regression analyses were performed for predictors of participation and chlamydia infection.ResultsOf the 17 222 invited individuals, 4447 (26%) participated. Of these, 3255 were eligible for prevalence survey participation and 550 (17%) returned a sample. Participation in the prevalence survey was associated with age (20+) and risk factors for STI. We did not detect any gonorrhoea. The overall weighted prevalence of chlamydia was 2.8% (95% CI 1.5% to 5.2%); 1.1% (0.1% to 7.2%) in men and 5.6% (3.3% to 9.5%) in women. Risk factors for chlamydia infections in women aged 18–24 years were low/medium education level, not having a relationship with the person you had most recent sex with and age at first sex older than 16.ConclusionsChlamydia and gonorrhoea prevalence were low in the general Dutch population, as was the participation rate. Repeated prevalence surveys are needed to analyse trends in STI prevalences and to evaluate control policies.
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Nadeak, Kristina. "Diagnostic test of urine sample, vaginal smear and combination of urine with vaginal smear to identify Neisseria gonorrhoeae with polymerase chain reaction method". International Journal of Research in Medical Sciences 7, nr 7 (28.06.2019): 2547. http://dx.doi.org/10.18203/2320-6012.ijrms20192625.
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Background: Gonorrhoea is a disease caused by Neisseria gonorrhoeae that is transmitted through sexual contact. There are several examinations performed on gonorrhoea infection, one of them is Polymerase Chain Reaction (PCR). The objective is to determine the diagnostic test of urine samples, vaginal smear and combination of urine and vaginal smear in identifying Neisseria gonorrhoeae using the PCR method.Methods: This study is a diagnostic test with a cross-sectional design involving 58 female sex workers (FSW). All FSWs are carried out of history and physical examination. Urine sampling, vaginal smear, combination of urine and vaginal smear, and endocervical smear were obtained for identifying Neisseria gonorrhoeae using PCR method, then a diagnostic test analysis of each sample was performed.Results: The diagnostic test of PCR for Neisseria gonorrhoeae from urine samples was found sensitivity 44.4%, specificity 20.0%, positive predictive value (PPV) 83.3%, negative predictive value (NPV) 3.8% and accuracy 42.0%. From vaginal smear, we obtained sensitivity 34.0%, specificity 66.7%, PPV 88.2%, NPV 12.1% and accuracy 38.0%. And from combination of urine and vaginal smear, we obtained sensitivity 51.1%, specificity 20.0%, PPV 85.2%, NPV 4.3% and accuracy 48.0%.Conclusions: From these results the researchers suggested that urine, vaginal and combination of urine and vaginal smear could not be used as an alternative to examine the sensitivity and specificity of Neisseria gonorrhoeae, so the endocervical sample remained the reference sample for examination of nucleic acid amplification tests for Neisseria gonorrhoeae.
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Jain, Anu, Michelle J. Cole, Tim Planche i Catherine A. Ison. "An evaluation of Neisseria gonorrhoeae antimicrobial susceptibility testing in the UK". Journal of Clinical Pathology 67, nr 11 (30.07.2014): 1013–16. http://dx.doi.org/10.1136/jclinpath-2014-202392.
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The only method currently available to perform Neisseria gonorrhoeae antimicrobial susceptibility testing (Ng-AST) requires a viable organism obtained by culture. Reports of in vitro resistance to extended-spectrum cephalosporins, the treatment of choice for gonorrhoea, coupled with increasing gonorrhoea diagnoses is worrying. The aim of this study was to identify various methodologies employed by the UK microbiology laboratories to perform Ng-AST. Of the 118 laboratories that responded, 114 offered Ng-AST; the majority (82.5%, 94/114) of the laboratories used British Society for Antimicrobial Chemotherapy methodology for Ng-AST. The other main findings were infrequent use of quality control procedures and inconsistent susceptibility testing of the antibiotics used routinely for treatment.
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Bromhead, Collette, i Heather Hendrickson. "Untreatable gonorrhoea, are we there yet?" Biochemist 39, nr 3 (1.06.2017): 30–34. http://dx.doi.org/10.1042/bio03903030.
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Gonorrhoea is a relatively common and easily spread bacterial sexually transmitted disease that can cause a wide spectrum of symptoms from none to severe outcomes. Through its penchant for modifying its own genetics, Neisseria gonorrhoeae has gradually evolved to become one of modern medicine's greatest adversaries. In most countries we have only one antibiotic left to treat it with, and even that option is rapidly running out. So how do we stop this train wreck? What do we do when the treatments run out altogether?
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Yiğit, Gülşah. "Neisseria gonorrhoea: Gonorrhoea and antibiotic resistance". Journal of Turkish Family Physician 7, nr 1 (20.03.2016): 7–15. http://dx.doi.org/10.15511/tjtfp.16.01606.
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Raveendran, Geetha, Ramani BaiJoseph Theodore i Ragi RajeevGeetha Kumari. "Gonorrhoea". Journal of The Academy of Clinical Microbiologists 15, nr 1 (2013): 28. http://dx.doi.org/10.4103/0972-1282.116098.
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Sherrard, Jackie. "Gonorrhoea". Medicine 33, nr 10 (październik 2005): 37–39. http://dx.doi.org/10.1383/medc.2005.33.10.37.
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Sherrard, Jackie. "Gonorrhoea". Medicine 29, nr 8 (sierpień 2001): 39–43. http://dx.doi.org/10.1383/medc.29.8.39.28403.
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