The Impact of Rapid Drug Susceptibility Tests on Gonorrhea Burden and the Life Span of Antibiotic Treatments: A Modeling Study Among Men Who Have Sex With Men in the United States.
The Impact of Rapid Drug Susceptibility Tests on Gonorrhea Burden and the Life Span of Antibiotic Treatments: A Modeling Study Among Men Who Have Sex With Men in the United States.
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DOI：
10.1093/aje/kwad175
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发表时间：
2024-01-08
影响因子：
5
通讯作者：
中科院分区：
文献类型：
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诊断淋球菌感染并确定对抗生素敏感性的快速护理点测试可以实现个性化治疗。这可以改善患者的预后，减缓抗生素耐药性的出现和传播。然而，人们对这种诊断对淋病负担和抗生素有效寿命的长期影响知之甚少。我们使用了一个美国男男性行为者淋病传播的数学模型，来预测淋病病例的年报告率和头孢曲松（推荐用于淋病一线治疗的抗生素）的有效寿命，以及2种以前推荐的抗生素，环丙沙星和四环素，当一个快速的药物敏感性测试，估计敏感性环丙沙星和四环素是可用的。使用灵敏度≥50%且特异性≥95%的快速药敏试验（根据正确确定药物敏感性和非敏感性状态定义），可使环丙沙星、四环素和头孢曲松的联合有效寿命比25年模拟至少延长2年。然而，如果检测特异性不完善，即使在完全敏感的情况下，抗生素有效寿命的延长也伴随着淋病病例报告率的增加。
Rapid point-of-care tests that diagnose gonococcal infections and identify susceptibility to antibiotics enable individualized treatment. This could improve patient outcomes and slow the emergence and spread of antibiotic resistance. However, little is known about the long-term impact of such diagnostics on the burden of gonorrhea and the effective life span of antibiotics. We used a mathematical model of gonorrhea transmission among men who have sex with men in the United States to project the annual rate of reported gonorrhea cases and the effective life span of ceftriaxone, the recommended antibiotic for first-line treatment of gonorrhea, as well as 2 previously recommended antibiotics, ciprofloxacin and tetracycline, when a rapid drug susceptibility test that estimates susceptibility to ciprofloxacin and tetracycline is available. The use of a rapid drug susceptibility test with ≥50% sensitivity and ≥95% specificity, defined in terms of correct ascertainment of drug susceptibility and nonsusceptibility status, could increase the combined effective life span of ciprofloxacin, tetracycline, and ceftriaxone by at least 2 years over 25 years of simulation. If test specificity is imperfect, however, the increase in the effective life span of antibiotics is accompanied by an increase in the rate of reported gonorrhea cases even under perfect sensitivity.
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影响因子：
56.3
作者：
Grad, Yonatan H.;Kirkcaldy, Robert D.;Trees, David;Dordel, Janina;Harris, Simon R.;Goldstein, Edward;Weinstock, Hillard;Parkhill, Julian;Hanage, William P.;Bentley, Stephen;Lipsitch, Marc
通讯作者：
Lipsitch, Marc
2020年CDC治疗指南的更新。
DOI：
10.15585/mmwr.mm6950a6
发表时间：
2020-12-18
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
St Cyr S;Barbee L;Workowski KA;Bachmann LH;Pham C;Schlanger K;Torrone E;Weinstock H;Kersh EN;Thorpe P
通讯作者：
Thorpe P
影响因子：
33.9
作者：
Jones, Michelle L. Johnson;Chapin-Bardales, Johanna;Kuo, Irene
通讯作者：
Kuo, Irene
影响因子：
38.2
作者：
Mortimer, Tatum D.;Zhang, Jessica J.;Ma, Kevin C.;Grad, Yonatan H.
通讯作者：
Grad, Yonatan H.
影响因子：
4.4
作者：
Menzies NA;Soeteman DI;Pandya A;Kim JJ
通讯作者：
Kim JJ