First four failures of cefathiamidine to treat urogenital gonorrhoea in Guangzhou, China, 2014–15

Sexual Health ◽  
2017 ◽  
Vol 14 (3) ◽  
pp. 289
Author(s):  
Jingyao Liang ◽  
Ridong Yang ◽  
Xiaodong Li ◽  
Chao Bi ◽  
Xingdong Ye ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Treatment Guidelines ◽  
Clinical Treatment ◽  
Drug Resistant ◽  
Effective Treatments

Neisseria gonorrhoeae has a remarkable ability to develop resistance to all available therapeutic antimicrobials. This report describes the first four cases of verified failure to treat gonorrhoea using 1000 mg cefathiamidine intramuscularly in Guangzhou, China; for each case, the patient was clinically cured after treatment with 500 mg ceftriaxone intramuscularly. Enhanced monitoring of clinical treatment failures, finding new effective treatments and updating treatment guidelines are all of utmost importance to curb the spread of drug-resistant gonorrhoea.

scholarly journals trans-Translation inhibitors bind to a novel site on the ribosome and clear Neisseria gonorrhoeae in vivo

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Zachary D. Aron ◽  
Atousa Mehrani ◽  
Eric D. Hoffer ◽  
Kristie L. Connolly ◽  
Pooja Srinivas ◽  
...  
Keyword(s):  
Oral Dose ◽  
Neisseria Gonorrhoeae ◽  
Multiple Drug ◽  
Specific Inhibition ◽  
Drug Resistant ◽  
Peptidyl Transfer ◽  
Bacterial Ribosome ◽  
Multiple Drug Resistant ◽  
Unique Site

AbstractBacterial ribosome rescue pathways that remove ribosomes stalled on mRNAs during translation have been proposed as novel antibiotic targets because they are essential in bacteria and are not conserved in humans. We previously reported the discovery of a family of acylaminooxadiazoles that selectively inhibit trans-translation, the main ribosome rescue pathway in bacteria. Here, we report optimization of the pharmacokinetic and antibiotic properties of the acylaminooxadiazoles, producing MBX-4132, which clears multiple-drug resistant Neisseria gonorrhoeae infection in mice after a single oral dose. Single particle cryogenic-EM studies of non-stop ribosomes show that acylaminooxadiazoles bind to a unique site near the peptidyl-transfer center and significantly alter the conformation of ribosomal protein bL27, suggesting a novel mechanism for specific inhibition of trans-translation by these molecules. These results show that trans-translation is a viable therapeutic target and reveal a new conformation within the bacterial ribosome that may be critical for ribosome rescue pathways.

scholarly journals Antimicrobial resistance in Neisseria gonorrhoeae isolates and gonorrhoea treatment in the Republic of Belarus, Eastern Europe, 2009–2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aliaksandra Aniskevich ◽  
Iryna Shimanskaya ◽  
Iryna Boiko ◽  
Tatyana Golubovskaya ◽  
Daniel Golparian ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Eastern Europe ◽  
Treatment Guidelines ◽  
Statistical Significance ◽  
Antimicrobial Treatment ◽  
National Guidelines ◽  
First Line ◽  
Exact Test ◽  
The Republic

Abstract Background Limited antimicrobial resistance (AMR) data for Neisseria gonorrhoeae are available in Eastern Europe. We investigated AMR in N. gonorrhoeae isolates in the Republic of Belarus from 2009 to 2019, antimicrobial treatment recommended nationally, and treatment given to patients with gonorrhoea. Methods N. gonorrhoeae isolates (n = 522) cultured in three regions of Belarus in 2009–2019 were examined. Determination of minimum inhibitory concentrations (MICs) of eight antimicrobials was performed using Etest. Resistance breakpoints from the European Committee on Antimicrobial Susceptibility Testing were applied where available. A Nitrocefin test identified β-lactamase production. Gonorrhoea treatment for 1652 patients was also analysed. Statistical significance was determined by the Z-test, Fisher’s exact test, or Mann-Whitney U test with p-values of < 0.05 indicating significance. Results In total, 27.8% of the N. gonorrhoeae isolates were resistant to tetracycline, 24.7% to ciprofloxacin, 7.0% to benzylpenicillin, 2.7% to cefixime, and 0.8% to azithromycin. No isolates were resistant to ceftriaxone, spectinomycin, or gentamicin. However, 14 (2.7%) isolates had a ceftriaxone MIC of 0.125 mg/L, exactly at the resistance breakpoint (MIC > 0.125 mg/L). Only one (0.2%) isolate, from 2013, produced β-lactamase. From 2009 to 2019, the levels of resistance to ciprofloxacin and tetracycline were relatively high and stable. Resistance to cefixime was not identified before 2013 but peaked at 22.2% in 2017. Only sporadic isolates with resistance to azithromycin were found in 2009 (n = 1), 2012 (n = 1), and 2018–2019 (n = 2). Overall, 862 (52.2%) patients received first-line treatment according to national guidelines (ceftriaxone 1 g). However, 154 (9.3%) patients received a nationally recommended alternative treatment (cefixime 400 mg or ofloxacin 400 mg), and 636 (38.5%) were given non-recommended treatment. Conclusions The gonococcal resistance to ciprofloxacin and tetracycline was high, however, the resistance to azithromycin was low and no resistance to ceftriaxone was identified. Ceftriaxone 1 g can continuously be recommended as empiric first-line gonorrhoea therapy in Belarus. Fluoroquinolones should not be prescribed for treatment if susceptibility has not been confirmed by testing. Timely updating and high compliance with national evidence-based gonorrhoea treatment guidelines based on quality-assured AMR data are imperative. The need for continued, improved and enhanced surveillance of gonococcal AMR in Belarus is evident.

scholarly journals Efficacy of transdermal rotigotine in chronic cluster headache: A case series

2018 ◽  
Vol 1 ◽  
pp. 251581631880969
Author(s):  
Cherubino Di Lorenzo ◽  
Lanfranco Pellesi ◽  
Gianluca Coppola ◽  
Vincenzo Parisi ◽  
Maurizio Evangelista ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Case Series ◽  
Chronic Cluster Headache ◽  
Drug Resistant ◽  
Transdermal Patch ◽  
Full Resolution ◽  
Episodic Cluster Headache ◽  
Monoaminergic System ◽  
Rotigotine Transdermal Patch ◽  
Effective Treatments

Cluster headache (CH) is one of the most severe forms of headache, but the number of effective treatments is still limited. Recently, we reported the case of a drug-resistant CH patient responsive to the rotigotine transdermal patch, which is used in the treatment of Parkinson’s disease. This report formed the basis for a case series where other drug-resistant CH patients were treated with rotigotine. Here are the results of this study. Twenty-two CH patients underwent the treatment. Eight were episodic cluster headache (ECH) patients and 14 were chronic cluster headache (CCH) patients. Of the eight ECH patients, four reported that their CH had been stopped by the treatment. Of the 14 CCH patients, 11 were considered responders to the treatment (5 experienced a full resolution of headache, and 6 had a headache reduction of at least 50% in terms of mean monthly number of attacks). Our case series confirms the previous observation that rotigotine could be helpful in the treatment of CH. It may even influence the monoaminergic system that has a key role in the pathogenesis of CH.

scholarly journals Disseminated Gonococcal Infections in Patients Receiving Eculizumab: A Case Series

2018 ◽  
Vol 69 (4) ◽  
pp. 596-600 ◽  
Author(s):  
Page E Crew ◽  
Winston E Abara ◽  
Lynda McCulley ◽  
Peter E Waldron ◽  
Robert D Kirkcaldy ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Medical Literature ◽  
Treatment Guidelines ◽  
Antimicrobial Prophylaxis ◽  
Case Series ◽  
The United States ◽  
Underlying Disease ◽  
Sexually Transmitted ◽  
Control And Prevention ◽  
Terminal Complement

Abstract Background Gonorrhea is the second most commonly reported notifiable condition in the United States. Infrequently, Neisseria gonorrhoeae can cause disseminated gonococcal infection (DGI). Eculizumab, a monoclonal antibody, inhibits terminal complement activation, which impairs the ability of the immune system to respond effectively to Neisseria infections. This series describes cases of N. gonorrhoeae infection among patients receiving eculizumab. Methods Pre- and postmarketing safety reports of N. gonorrhoeae infection in patients receiving eculizumab worldwide were obtained from US Food and Drug Administration safety databases and the medical literature, including reports from the start of pivotal clinical trials in 2004 through 31 December 2017. Included patients had at least 1 eculizumab dose within the 3 months prior to N. gonorrhoeae infection. Results Nine cases of N. gonorrhoeae infection were identified; 8 were classified as disseminated (89%). Of the disseminated cases, 8 patients required hospitalization, 7 had positive blood cultures, and 2 required vasopressor support. One patient required mechanical ventilation. Neisseria gonorrhoeae may have contributed to complications prior to death in 1 patient; however, the fatality was attributed to underlying disease per the reporter. Conclusions Patients receiving eculizumab may be at higher risk for DGI than the general population. Prescribers are encouraged to educate patients receiving eculizumab on their risk for serious gonococcal infections and perform screening for sexually transmitted diseases (STDs) per the Centers for Disease Control and Prevention STD treatment guidelines or in suspected cases. If antimicrobial prophylaxis is used during eculizumab therapy, prescribers should consider trends in gonococcal antimicrobial susceptibility due to emerging resistance concerns.

Variation in Adherence to the Treatment Guidelines for Neisseria gonorrhoeae by Clinical Practice Setting, California, 2009 to 2011

2014 ◽  
Vol 41 (5) ◽  
pp. 338-344 ◽  
Author(s):  
Richard J. Lechtenberg ◽  
Michael C. Samuel ◽  
Kyle T. Bernstein ◽  
Maureen Lahiff ◽  
Nicole Olson ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Neisseria Gonorrhoeae ◽  
Treatment Guidelines ◽  
Practice Setting ◽  
Clinical Practice Setting

scholarly journals Emergence of Extensively Drug-Resistant Proteus mirabilis Harboring a Conjugative NDM-1 Plasmid and a Novel Salmonella Genomic Island 1 Variant, SGI1-Z

2015 ◽  
Vol 59 (10) ◽  
pp. 6601-6604 ◽  
Author(s):  
Shangshang Qin ◽  
Hui Qi ◽  
Qijing Zhang ◽  
Di Zhao ◽  
Zhen-Zhen Liu ◽  
...  
Keyword(s):  
Clinical Isolate ◽  
Molecular Analysis ◽  
Proteus Mirabilis ◽  
Genomic Island ◽  
Bacterial Species ◽  
Clinical Treatment ◽  
Drug Resistant ◽  
Content Type ◽  
Extensively Drug Resistant

ABSTRACTAcquisition ofblaNDM-1in bacterial species, such asProteus mirabilisthat is intrinsically resistant to tetracycline, tigecycline and colistin, will make clinical treatment extremely difficult. Here, we characterized an NDM-1-producing clinical isolate ofP. mirabilis(PM58) that displayed an extensively drug-resistant (XDR) phenotype, susceptible only to aztreonam. Molecular analysis revealed that PM58 harbored both a conjugative NDM-1 plasmid and a novelSalmonellagenomic island 1 variant on chromosome.

scholarly journals Stemming the tide of drug-resistant Neisseria gonorrhoeae: the need for an individualized approach to treatment

2014 ◽  
Vol 70 (2) ◽  
pp. 374-381 ◽  
Author(s):  
S. A. Buono ◽  
T. D. Watson ◽  
L. A. Borenstein ◽  
J. D. Klausner ◽  
M. W. Pandori ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Drug Resistant ◽  
Individualized Approach
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