Neisseria gonorrhoeae antimicrobial resistance among men who have sex with men and men who have sex exclusively with women: the Gonococcal Isolate Surveillance Project, 2005-2010.
Neisseria gonorrhoeae antimicrobial resistance among men who have sex with men and men who have sex exclusively with women: the Gonococcal Isolate Surveillance Project, 2005-2010.
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DOI：
10.7326/0003-4819-158-5-201303050-00004
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发表时间：
2013-03-05
影响因子：
39.2
通讯作者：
Weinstock HS
中科院分区：
文献类型：
--
作者：
Kirkcaldy RD;Zaidi A;Hook EW 3rd;Holmes KK;Soge O;del Rio C;Hall G;Papp J;Bolan G;Weinstock HS
淋病治疗因淋病奈瑟菌的耐药性而变得复杂。淋球菌氟喹诺酮耐药性在男男性行为者（MSM）中比在只与女性发生性关系的男性（MSW）中出现得更快。判断N.与来自MSW的淋病尿道分离株相比，来自MSM的淋病尿道分离株更可能对用于治疗淋病的抗菌剂表现出耐药性或最低抑菌浓度（MIC）升高。来自淋球菌分离株监测项目（GISP）的6年监测数据美国30个城市公共资助的性传播疾病诊所的男性，共有34，600例症状性尿道淋病发作。主要结局包括表现出耐药性或MIC升高的分离株百分比，以及MSM分离株与MSW分离株之间耐药性或MIC升高的校正比值比。GISP由美国卫生与公众服务部下属的CDC资助。MSM分离株的头孢菌素MIC显著高于MSW分离株（P <=0.028）。MSM分离株对环丙沙星、青霉素和四环素的耐药率较高，且较城市生活垃圾分离株耐药率高（P <0.001）。哨点监测可能不能代表所有淋病患者。一些患者的HIV状态、旅行史和抗菌药物使用数据缺失。男男性接触者容易受到新出现的多重耐药N。淋病由于抗菌药物敏感性测试在临床实践中没有常规进行，临床医生应监测诊断为淋病的MSM治疗失败。需要加强对男男性接触者的预防战略和新的抗菌治疗选择。
Gonorrhea treatment has been complicated by antimicrobial resistance in Neisseria gonorrhoeae. Gonococcal fluoroquinolone resistance emerged more rapidly among men who have sex with men (MSM) than among men who have sex exclusively with women (MSW). To determine whether N. gonorrhoeae urethral isolates from MSM were more likely than isolates from MSW to exhibit resistance to or elevated minimum inhibitory concentrations (MICs) of antimicrobials used to treat gonorrhea. Six years of surveillance data from the Gonococcal Isolate Surveillance Project (GISP) Publicly-funded sexually transmitted disease clinics in 30 United States cities Men with a total of 34,600 episodes of symptomatic urethral gonorrhea Primary outcomes included percentage of isolates exhibiting resistance or elevated MICs, and adjusted odds ratios for resistance or elevated MICs among isolates from MSM compared to isolates from MSW. GISP is funded by the CDC, an agency of the US Department of Health and Human Services. Isolates from MSM were significantly more likely than isolates from MSW to exhibit elevated cephalosporin MICs (P <=0.028). Isolates from MSM had a high prevalence of resistance to ciprofloxacin, penicillin, and tetracycline and were significantly more likely to exhibit antimicrobial resistance than isolates from MSW (P <0.001). Sentinel surveillance might not be representative of all patients with gonorrhea. HIV status, travel history, and antimicrobial use data were missing for some patients. MSM are vulnerable to the emerging threat of multidrug-resistant N. gonorrhoeae. Because antimicrobial susceptibility testing is not routinely performed in clinical practice, clinicians should monitor for treatment failures among MSM diagnosed with gonorrhea. Strengthened prevention strategies for MSM and new antimicrobial treatment options are needed.
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影响因子：
3.1
作者：
HANDSFIELD, HH;KNAPP, JS;HOLMES, KK
通讯作者：
HOLMES, KK
影响因子：
4.9
作者：
MORSE, SA;JOHNSON, SR;ROBERTS, MC
通讯作者：
ROBERTS, MC
影响因子：
12.7
作者：
Dowell, Deborah;Tian, Lin H.;Newman, Lori M.
通讯作者：
Newman, Lori M.
影响因子：
3.1
作者：
MORSE, SA;LYSKO, PG;HOLMES, KK
通讯作者：
HOLMES, KK
影响因子：
39.2
作者：
Diep, Binh An;Chambers, Henry F.;Perdreau-Remington, Francoise
通讯作者：
Perdreau-Remington, Francoise