耐药淋球菌的备选治疗方案

doi:10.35541/cjd.20210828

Abstract

Abstract: 【Abstract】 At present, ceftriaxone remains the primary first-line agent for the treatment of gonorrhea. With widespread resistance of Neisseria gonorrhoeae to multiple antibiotics, it is urgent to seek effective alternative treatments to slow down the process of gonococcal antibiotic resistance. This review summarizes potentially effective anti-gonococcal agents in terms of combination therapy, recycling of old antibiotics and development of new drugs.

Key words: Gonorrhea, Neisseria gonorrhoeae, Antibiotic resistant, bacterial, Alternative treatments, Treatment strategy

Zhang Jin, Chen Shaochun, Yin Yueping. Promising treatment options for antibiotic-resistant Neisseria gonorrhoeae[J]. Chinese Journal of Dermatology, 2024, 57(3): 272-275.doi:10.35541/cjd.20210828

References ［31］

［1］	Rowley J, Vander Hoorn S, Korenromp E, et al. Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016［J］. Bull World Health Organ, 2019,97（8）:548⁃562P. doi: 10.2471/BLT.18.228486.
［2］	疾病预防控制局. 2019年全国法定传染病疫情概况［EB/OL］.（2021⁃03⁃12）［2021⁃11⁃10］.http://www.nhc.gov.cn/jkj/s3578/202103/f1a448b7df7d4760976fea6d55834966.shtml.
［3］	Unemo M, Shafer WM. Antimicrobial resistance in Neisseria gonorrhoeae in the 21st century: past, evolution, and future［J］. Clin Microbiol Rev, 2014,27（3）:587⁃613. doi: 10.1128/CMR. 00010⁃14.
［4］	Chen SC, Yuan LF, Zhu XY, et al. Sustained transmission of the ceftriaxone⁃resistant Neisseria gonorrhoeae FC428 clone in China［J］. J Antimicrob Chemother, 2020,75（9）:2499⁃2502. doi: 10.1093/jac/dkaa196.
［5］	Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021［J］. MMWR Recomm Rep, 2021,70（4）:1⁃187. doi: 10.15585/mmwr.rr7004a1.
［6］	Kenyon C, Laumen J, Van Dijck C, et al. Gonorrhoea treatment combined with population⁃level general cephalosporin and quinolone consumption may select for Neisseria gonorrhoeae antimicrobial resistance at the levels of NG⁃MAST genogroup: an ecological study in Europe［J］. J Glob Antimicrob Resist, 2020,23:377⁃384. doi: 10.1016/j.jgar.2020.10.022.
［7］	Kirkcaldy RD, Weinstock HS, Moore PC, et al. The efficacy and safety of gentamicin plus azithromycin and gemifloxacin plus azithromycin as treatment of uncomplicated gonorrhea［J］. Clin Infect Dis, 2014,59（8）:1083⁃1091. doi: 10.1093/cid/ciu521.
［8］	Hamasuna R, Ohnishi M, Matsumoto M, et al. In vitro activity of sitafloxacin and additional newer generation fluoroquinolones against ciprofloxacin⁃resistant Neisseria gonorrhoeae isolates［J］. Microb Drug Resist, 2018,24（1）:30⁃34. doi: 10.1089/mdr.2017. 0054.
［9］	Soge OO, Salipante SJ, No D, et al. In vitro activity of delafloxacin against clinical Neisseria gonorrhoeae isolates and selection of gonococcal delafloxacin resistance［J］. Antimicrob Agents Chemother, 2016,60（5）:3106⁃3111. doi: 10.1128/AAC. 02798⁃15.
［10］	Hook EW 3rd, Golden MR, Taylor SN, et al. Efficacy and safety of single⁃dose oral delafloxacin compared with intramuscular ceftriaxone for uncomplicated gonorrhea treatment: an open⁃label, noninferiority, phase 3, multicenter, randomized study［J］. Sex Transm Dis, 2019,46（5）:279⁃286. doi: 10.1097/OLQ. 0000000000000971.
［11］	Barbee LA, Golden MR. Aztreonam for Neisseria gonorrhoeae: a systematic review and meta⁃analysis［J］. J Antimicrob Chemother, 2020,75（7）:1685⁃1688. doi: 10.1093/jac/dkaa108.
［12］	Barbee LA, Soge OO, Ocbamichael N, et al. Single⁃arm open⁃label clinical trial of two grams of aztreonam for the treatment of Neisseria gonorrhoeae［J］. Antimicrob Agents Chemother, 2020,65（1）. doi: 10.1128/AAC.01739⁃20.
［13］	Unemo M, Golparian D, Limnios A, et al. In vitro activity of ertapenem versus ceftriaxone against Neisseria gonorrhoeae isolates with highly diverse ceftriaxone MIC values and effects of ceftriaxone resistance determinants: ertapenem for treatment of gonorrhea?［J］. Antimicrob Agents Chemother, 2012,56（7）:3603⁃3609. doi: 10.1128/AAC.00326⁃12.
［14］	Eyre DW, Town K, Street T, et al. Detection in the United Kingdom of the Neisseria gonorrhoeae FC428 clone, with ceftriaxone resistance and intermediate resistance to azithromycin, October to December 2018［J］. Euro Surveill, 2019,24（10）. doi: 10.2807/1560⁃7917.ES.2019.24.10.1900147.
［15］	Lagacé⁃Wiens P, Adam HJ, Laing NM, et al. Antimicrobial susceptibility of clinical isolates of Neisseria gonorrhoeae to alternative antimicrobials with therapeutic potential［J］. J Antimicrob Chemother, 2017,72（8）:2273⁃2277. doi: 10.1093/jac/dkx147.
［16］	Quaye N, Cole MJ, Ison CA. Evaluation of the activity of ertapenem against gonococcal isolates exhibiting a range of susceptibilities to cefixime［J］. J Antimicrob Chemother, 2014,69（6）:1568⁃1571. doi: 10.1093/jac/dkt537.
［17］	Yang F, Yan J, Zhang J, et al. Evaluation of alternative antibiotics for susceptibility of gonococcal isolates from China［J］. Int J Antimicrob Agents, 2020,55（2）:105846. doi: 10.1016/j.ijantimicag.2019.11.003.
［18］	Hauser C, Hirzberger L, Unemo M, et al. In vitro activity of fosfomycin alone and in combination with ceftriaxone or azithromycin against clinical Neisseria gonorrhoeae isolates［J］. Antimicrob Agents Chemother, 2015,59（3）:1605⁃1611. doi: 10. 1128/AAC.04536⁃14.
［19］	Tesh LD, Shaeer KM, Cho JC, et al. Neisseria gonorrhoeae and fosfomycin: Past, present and future. Int J Antimicrob Agents 2015,46（3）:290⁃296. doi: 10.1016/j.ijantimicag.2015.05.007.
［20］	Bala M, Singh V, Philipova I, et al. Gentamicin in vitro activity and tentative gentamicin interpretation criteria for the CLSI and calibrated dichotomous sensitivity disc diffusion methods for Neisseria gonorrhoeae［J］. J Antimicrob Chemother, 2016,71（7）:1856⁃1859. doi: 10.1093/jac/dkw102.
［21］	Ross J, Brittain C, Cole M, et al. Gentamicin compared with ceftriaxone for the treatment of gonorrhoea（G⁃ToG）: a randomised non⁃inferiority trial［J］. Lancet, 2019,393（10190）:2511⁃2520. doi: 10.1016/S0140⁃6736（18）32817⁃4.
［22］	Sood S, Agarwal SK, Singh R, et al. In vitro assessment of gentamicin and azithromycin⁃based combination therapy against Neisseria gonorrhoeae isolates in India［J］. J Med Microbiol, 2019,68（4）:555⁃559. doi: 10.1099/jmm.0.000953.
［23］	Livermore DM, Tulkens PM. Temocillin revived［J］. J Antimicrob Chemother, 2009,63（2）:243⁃245. doi: 10.1093/jac/dkn511.
［24］	Ghathian K, Calum H, Gyssens IC, et al. Temocillin in vitro activity against recent clinical isolates of Neisseria gonorrhoeae compared with penicillin, ceftriaxone and ciprofloxacin. J Antimicrob Chemother, 2016,71（4）:1122⁃1123. doi: 10.1093/jac/dkv434.
［25］	Chen MY, McNulty A, Avery A, et al. Solithromycin versus ceftriaxone plus azithromycin for the treatment of uncomplicated genital gonorrhoea（SOLITAIRE⁃U）: a randomised phase 3 non⁃inferiority trial［J］. Lancet Infect Dis, 2019,19（8）:833⁃842. doi: 10.1016/S1473⁃3099（19）30116⁃1.
［26］	Taylor SN, Marrazzo J, Batteiger BE, et al. Single⁃dose zoliflodacin（ETX0914） for treatment of urogenital gonorrhea［J］. N Engl J Med, 2018,379（19）:1835⁃1845. doi: 10.1056/NEJMoa1706988.
［27］	Theuretzbacher U, Barbee L, Connolly K, et al. Pharmacokinetic/pharmacodynamic considerations for new and current therapeutic drugs for uncomplicated gonorrhoea⁃challenges and opportunities［J］. Clin Microbiol Infect, 2020,26（12）:1630⁃1635. doi: 10.1016/j.cmi.2020.08.006.
［28］	Biedenbach DJ, Bouchillon SK, Hackel M, et al. In vitro activity of gepotidacin, a novel triazaacenaphthylene bacterial topoisomerase inhibitor, against a broad spectrum of bacterial pathogens［J］. Antimicrob Agents Chemother, 2016,60（3）:1918⁃1923. doi: 10.1128/AAC.02820⁃15.
［29］	Scangarella⁃Oman NE, Hossain M, Dixon PB, et al. Microbiological analysis from a phase 2 randomized study in adults evaluating single oral doses of gepotidacin in the treatment of uncomplicated urogenital gonorrhea caused by Neisseria gonorrhoeae［J］. Antimicrob Agents Chemother, 2018,62（12）. doi: 10.1128/AAC.01221⁃18.
［30］	Jacobsson S, Golparian D, Scangarella⁃Oman N, et al. In vitro activity of the novel triazaacenaphthylene gepotidacin（GSK2140944） against MDR Neisseria gonorrhoeae［J］. J Antimicrob Chemother, 2018,73（8）:2072⁃2077. doi: 10.1093/jac/dky162.
［31］	Taylor SN, Morris DH, Avery AK, et al. Gepotidacin for the treatment of uncomplicated urogenital gonorrhea: a phase 2, randomized, dose⁃ranging, single⁃oral dose evaluation［J］. Clin Infect Dis, 2018,67（4）:504⁃512. doi: 10.1093/cid/ciy145.

[1]	Li Xiaodie, Zhu Lin, Hong Yiyong, Huang Ying, Lai Wei, Gong Zijian. Effect of different experimental conditions on the in vitro transformation efficiency for Neisseria gonorrhoeae [J]. Chinese Journal of Dermatology, 2024, 57(3): 240-245.
[2]	Lu Qin, Huang Meirong, Yang Hui, Zhang Ningqing, Min Xun, Huang Jian, . Preliminary evaluation of the immunoprotective effect of MetQ, a Neisseria gonorrhoeae vaccine candidate protein for intranasal immunization [J]. Chinese Journal of Dermatology, 2024, 57(3): 233-239.
[3]	Zhu Bangyong, Zhou Qian, Wei Jiangping, Gan Quan, Huang Yinjie, Yin Yueping, Xu Wenqi. Susceptibility of gonococcal clinical isolates to gentamicin in Guangxi region [J]. Chinese Journal of Dermatology, 2023, 56(8): 737-741.
[4]	Xia Lingyin, Lu Qin, Wang Xiaosu, Huang Meirong, Min Xun, Huang Jian. Expression and purification of a peptide fragment of 660 - 1468 amino acids in Neisseria gonorrhoeae NGO2105 protein as well as preparation and identification of its polyclonal antibody [J]. Chinese Journal of Dermatology, 2023, 56(3): 216-221.
[5]	Fan Wenge, Zhang Qingsong, Ye Xun, Wei Mei, Fan Zhijiang, Zhang Jing, Wang Ling, Xue Qiao, Tao Xiaoyu, Ding Hao, Zhao Jun. Gonococcal infections of the penile skin and accessory glands in men: high?frequency ultrasound features and their clinical significance [J]. Chinese Journal of Dermatology, 2022, 55(6): 528-531.
[6]	Chen Shaochun, Liu Jingwei, Zhou Ke, Yin Yueping. Ceftriaxone-resistant Neisseria gonorrhoeae strain FC428: prevalence, resistance mechanisms and control strategies [J]. Chinese Journal of Dermatology, 2022, 55(12): 1122-1126.
[7]	National Center for STD Control, Chinese Center for Disease Control and Prevention, Venereology Group, Chinese Society of Dermatology, Subcommittee on Venereology, China Dermatologist Association. Guidelines for diagnosis and treatment of syphilis, gonorrhea and genital Chlamydia trachomatis infection （2020） [J]. Chinese Journal of Dermatology, 2020, 53(3): 168-179.
[8]	Wang Huirong, Lu Xiaoli, Zhang Chunyang, Ke Lizhen. Spatial-temporal distribution characteristics of gonorrhea in Fujian province from 2010 to 2019 [J]. Chinese Journal of Dermatology, 2020, 53(11): 891-894.
[9]	Yue Xiaoli, Gong Xiangdong, Li Jing, Zhang Jiahui. Epidemiological trends and features of gonorrhea in China, 2015—2019 [J]. Chinese Journal of Dermatology, 2020, 53(10): 769-773.
[10]	chuan Xiaohong Su. Resistance of Neisseria gonorrhoeae to azithromycin: an update [J]. Chinese Journal of Dermatology, 2018, 51(5): 394-396.
[11]	. Roles of penA and mtrR gene mutations in in vitro?induced resistance of Neisseria gonorrhoeae to ceftriaxone [J]. Chinese Journal of Dermatology, 2018, 51(5): 369-372.
[12]	. Penicillinase-producing Neisseria gonorrhoeae and its blaTEM-135 gene variants at several gonococcal antimicrobial surveillance sites in China: an epidemiological study [J]. Chinese Journal of Dermatology, 2015, 48(5): 312-316.
[13]	. Opa-typing of Neisseria gonorrhoeae: establishment and evaluation of a new method [J]. Chinese Journal of Dermatology, 2011, 44(5): 314-317.
[14]	. Amino acid substitution or insertion patterns in penicillin-binding protein 2 in Neisseria gonorrhoeae isolates with reduced susceptibility to ceftriaxone [J]. Chinese Journal of Dermatology, 2008, 41(7): 451-454.
[15]	CHEN Hong-Xiang Yan Xiaofeng . Comparison of Typing of the opa Gene and NG-MAST for Discrimination of Neisseria gonorrhoeae Strains from 12 Sexual Partnerships [J]. Chinese Journal of Dermatology, 2008, 41(5): 307-310.

Promising treatment options for antibiotic-resistant Neisseria gonorrhoeae

PDF

PDF (Mobile)

Knowledge

Abstract

Cite this article

share this article

References ［31］

Related Articles 15

Metrics

Comments

Recommended 10