The use of cephalosporins for gonorrhea: the impending problem of resistance.
The use of cephalosporins for gonorrhea: the impending problem of resistance.
复制标题
DOI：
10.1517/14656560902731993
复制
发表时间：
2009-03
影响因子：
3.2
通讯作者：
Klausner JD
中科院分区：
文献类型：
--
作者：
Barry PM;Klausner JD
淋病仍然是一个重要的临床和公共卫生问题在世界各地。淋球菌感染历来通过革兰氏染色和培养来诊断，但越来越多地通过核酸检测来诊断，从而消除了抗菌药物敏感性检测的机会。淋球菌感染通常用单剂量治疗，发现治愈>95%的病例。不幸的是，淋球菌已经反复对包括磺胺类、青霉素、四环素和氟喹诺酮类在内的抗菌药物产生耐药性。这使得第三代头孢菌素成为目前推荐作为某些地区淋病一线治疗的唯一一类抗菌药物。然而，对口服第三代头孢菌素的耐药性已经出现并在亚洲、澳大利亚和其他地区蔓延。这种耐药机制似乎与镶嵌青霉素结合蛋白（佩纳）以及先前发现的赋予β-内酰胺类抗生素耐药性的其他染色体突变（ponA、mtrR、penB、pilQ）有关。很少有好的选择存在或正在开发的治疗头孢菌素耐药菌株，因为大多数有多药耐药性。防止耐药菌株的传播将取决于雄心勃勃的抗菌药物管理计划，加强和扩大监测网络，并通过有效的性传播疾病控制和预防。
Gonorrhea remains an important clinical and public health problem throughout the world. Gonococcal infections have historically been diagnosed by Gram stain and culture, but are increasingly diagnosed through nucleic acid tests thereby eliminating the opportunity for antimicrobial susceptibility testing. Gonococcal infections are typically treated with single-dose therapy with an agent found to cure >95% of cases. Unfortunately, the gonococcus has repeatedly developed resistance to antimicrobials including sulfonamides, penicillin, tetracyclines, and fluoroquinolones. This has left third-generation cephalosporins as the lone class of antimicrobials currently recommended as first line therapy for gonorrhea in some regions. However, resistance to oral third-generation cephalosporins has emerged and spread in Asia, Australia and elsewhere. The mechanism of this resistance seems to be associated with a mosaic penicillin binding protein (penA) in addition to other chromosomal mutations previously found to confer resistance to beta-lactam antimicrobials (ponA, mtrR, penB, pilQ). Few good options exist or are in development for treating cephalosporin resistant isolates as most have had multidrug resistance. Preventing the spread of resistant isolates will depend on ambitious antimicrobial management programs, strengthening and expanding surveillance networks, and through effective sexually transmitted disease control and prevention.
登录
查看更多内容
影响因子：
158.5
作者：
BOSLEGO, JW;TRAMONT, EC;STEIN, DC
通讯作者：
STEIN, DC
DOI：
10.1007/s101560170034
发表时间：
2001-03-01
期刊：
Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy
影响因子：
--
作者：
Akasaka, S;Muratani, T;Matsumoto, T
通讯作者：
Matsumoto, T
影响因子：
5.2
作者：
Bala, Manju;Ray, Krishna;Jain, R. K.
通讯作者：
Jain, R. K.
影响因子：
4.9
作者：
Ameyama, S;Onodera, S;Oishi, Y
通讯作者：
Oishi, Y
影响因子：
158.5
作者：
BERG, SW;KILPATRICK, ME;MCCUTCHAN, JA
通讯作者：
MCCUTCHAN, JA