{"id":2442,"date":"2018-10-15T16:22:27","date_gmt":"2018-10-15T16:22:27","guid":{"rendered":"https:\/\/www.mybiosource.com\/learn\/?p=2442"},"modified":"2023-03-14T09:50:12","modified_gmt":"2023-03-14T09:50:12","slug":"std-series-a-look-at-drug-resistant-gonorrhoea","status":"publish","type":"post","link":"https:\/\/www.mybiosource.com\/learn\/std-series-a-look-at-drug-resistant-gonorrhoea\/","title":{"rendered":"STD Series: A look at Drug Resistant Gonorrhoea"},"content":{"rendered":"\n\n\n
\n

Table of Contents<\/u><\/strong><\/h3>\n

1. Introduction<\/strong><\/a>
\n2. Neisseria Gonorrhoea and its severe complications<\/strong><\/a>
\n3. History of Antimicrobial agents for Gonorrhoea treatment<\/strong><\/a>
\n4. Monitoring drug-resistant strains of Neisseria Gonorrhoea<\/strong><\/a>
\n5. WHO’s initiative for the development of new antibiotics for Gonorrhoea treatment<\/strong><\/a>
\n6. Methods to detect the presence of Gonorrhoea <\/strong><\/a>
\n\u2022 NAA or nucleic acid amplification
\n\u2022 Urine sample
\n\u2022 Swab culture
\n\u2022 Blood identification
\n7. Prevention of Gonorrhoea <\/strong><\/a>
\n8. Challenges in detecting and treating Gonorrhoea <\/strong><\/a>
\n\u2022 Lack of symptoms and diagnostic options
\n\u2022 Misdiagnosis and other STDs
\n\u2022 Focus areas for preventing further spread
\n\u2022 Use of antibiotics
\n\u2022 Antibiotic resistance<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Neisseria gonorrhoea<\/span> is considered to be one of the superbugs which seem to become resistant to almost all available microbial<\/span> agent currently in use.<\/p>\n

When left untreated Neisseria<\/span> gonorrhoea<\/span> infection leads to severe complications such as PID or pelvic inflammatory disease<\/span>, ectopic pregnancy, infertility and also raises the risk of abortion within the first trimester, eye infection in newborns.<\/p>\n

 <\/p>\n

Penicillin G was the first antimicrobial<\/span> agent which successfully used for Gonoccocal infection in 1943 and followed for more than 40years until the emergence of resistant species. However, for last 70-80 years, treatment of Neisseria<\/span> gonorrhoea<\/span> becomes complicated as the antimicrobial<\/span> strain of Neisseria<\/span> gonorrhoea<\/span> become highly prevalent showing resistance to almost all antimicrobial<\/span> available such as tetracyclines<\/span>, or fluoroquinolones. According to the first report of Center of Disease Control and Prevention or CDC, published in the year 2013, drug-resistant Neisseria<\/span> gonorrhoea<\/span> was reported as one of three main threats to the USA. Especially for the last 2 years, the existence of resistance strain against ceftriaxone, the last available effective antimicrobial<\/span> agent has been reported from Japan. To deal with the situation, the World Health Organization<\/span> or WHO has implemented \u2018Global Action Plan to Control the Spread and Impact of Antimicrobial<\/span> Resistance in Neisseria<\/span> gonorrhoea<\/span>\u2019. Accordingly, CDC, US and CDC, Europe also published specific plans for accordingly regional distribution. Although<\/p>\n

How\u00a0<\/span>Gonorrhoea becomes drug resistant?<\/strong><\/p>\n

Chromosomal mutation or addition of resistance circular DNA is known as the plasmid is the main reason behind the generation of antimicrobial<\/span> resistant strains. Once the strain is produced, the resistance nature further can be passed to other gonococci bacteria by a method which is known as bacterial transformation. As the antimicrobials used for other diseases are also useful for Gonorrhoea<\/span> and Gonococci bacteria can easily get the resistance gene from other bacteria, gonorrhoea<\/span> becomes resistance relatively quickly. Even, if an antimicrobial<\/span> agent is not used or withdrawal happened during the treatment procedure, Gonorrhoea<\/span> can still be able to carry the resistance gene for the long time span.<\/p>\n

\u00a0How to monitor the drug-resistant strain? <\/em><\/strong><\/p>\n

To look for the global changes in the drug-resistant behaviour of Neisseria<\/span> gonorrhoea<\/span>, WHO has initiated a program which is known as GASP or Global Gonococcal<\/span> Antimicrobial<\/span> Surveillance Programme? Under this program, according to GASP data it has been found that within the time frame of 5 years (2009-2014), in 97 countries drug-resistant strains generated against the drug ciprofloxacin, a widely used medication as well as against drug azithromycin<\/span>. As a last resource, antibiotic cefixime is being used for the pathogenic infection treatment. But resistance against this particular drug also gets recorded for nearly 50 countries. In this situation WHO has recommended the use of antibiotics cephalosporins<\/span> like ceftriaxone and azithromycin<\/span> in Gonorrhoea<\/span> infection since 2016.<\/p>\n

Is there any new drug available?<\/strong><\/p>\n

The development of new medication for Gonorrhoea<\/span> is relatively absent. Until now, only 3 new drugs have been developed and have reached different stages of clinical trials<\/span>. Among these 3 drugs, solithromycin and gepotidacin have approached only until stage II trial. These low numbers if new drugs result from the fact that companies producing antibiotics commercially are not interested in generates medicine for Gonorrhoea<\/span> infection.\u00a0 Secondly, the new microbial<\/span> agents will only work for the low amount of time and eventually, resistance will develop making the new drug non-applicable. To address this issue, WHO also launched an initiative altogether with The Drugs for Neglected Diseases initiative, which is known as GARDP or Global Antibiotic Research and Development Partnership.\u00a0 Under the initiative of GARDP, new antibiotics will be developed for the treatment of Gonococcal<\/span> disease.<\/p>\n

Surveillance for Gonorrhoea<\/span><\/em><\/strong><\/p>\n

Mostly in the USA, resistant strain surveillance is performed through many programs like GISP or Gonococcal<\/span> Isolate Surveillance Project, eGISP or the enhanced Gonococcal<\/span> Isolate Surveillance Project.\u00a0 WHO launches a GASP program through which a worldwide laboratory network is maintained for Gonorrhoea<\/span> infection? WHO GASP program performed several functions like-<\/p>\n