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[PMID]:29458676
[Au] Autor:Gorla MC; Cassiolato AP; Pinhata JMW; de Moraes C; Corso A; Gagetti P; Lemos AP
[Ad] Endereço:1​Bacteriology Department, Adolfo Lutz Institute, Av. Dr. Arnaldo 351, São Paulo, CEP 01246-902, SP, Brazil.
[Ti] Título:Emergence of resistance to ciprofloxacin in Neisseria meningitidis in Brazil.
[So] Source:J Med Microbiol;67(3):286-288, 2018 Mar.
[Is] ISSN:1473-5644
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:To prevent secondary invasive meningococcal disease (IMD) cases and outbreaks, antimicrobial prophylaxis of high-risk contacts is indicated. This study reports two ciprofloxacin-resistant Neisseria meningitidis strains in Brazil. The 3523 N. meningitidis isolates collected throughout Brazil from 2009 to 2016 were evaluated for antimicrobial resistance. Meningococcal isolates showing minimal inhibitory concentrations, MICs≥0.125µg ml to ciprofloxacin, were analysed to determine the presence of mutations in the quinolone resistance-determining regions (QRDRs) of gyrA and parC genes. Two ciprofloxacin-resistant N. meningitidis isolates were found, both presenting a single mutation in the quinolone resistance-determining region of the gyrA gene. These results confirmed that ciprofloxacin is still a first-line drug for chemoprophylaxis. However, we highlight the importance of continued surveillance to monitor the trends of N. meningitidis susceptibility profiles to the antimicrobials recommended for chemoprophylaxis and IMD treatment.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Ciprofloxacino/farmacologia
Farmacorresistência Bacteriana/genética
Infecções Meningocócicas/microbiologia
Neisseria meningitidis/efeitos dos fármacos
Neisseria meningitidis/genética
[Mh] Termos MeSH secundário: Brasil/epidemiologia
DNA Girase/genética
DNA Topoisomerase IV/genética
Fluoroquinolonas/farmacologia
Seres Humanos
Infecções Meningocócicas/epidemiologia
Testes de Sensibilidade Microbiana
Tipagem de Sequências Multilocus
Mutação
Neisseria gonorrhoeae/isolamento & purificação
Quinolonas/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Fluoroquinolones); 0 (Quinolones); 5E8K9I0O4U (Ciprofloxacin); EC 5.99.1.- (DNA Topoisomerase IV); EC 5.99.1.3 (DNA Gyrase)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180221
[St] Status:MEDLINE
[do] DOI:10.1099/jmm.0.000685


  2 / 8736 MEDLINE  
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[PMID]:28460033
[Au] Autor:Ram S; Shaughnessy J; de Oliveira RB; Lewis LA; Gulati S; Rice PA
[Ad] Endereço:Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, MA 01605, USA.
[Ti] Título:Gonococcal lipooligosaccharide sialylation: virulence factor and target for novel immunotherapeutics.
[So] Source:Pathog Dis;75(4), 2017 Jun 01.
[Is] ISSN:2049-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Gonorrhea has become resistant to most conventional antimicrobials used in clinical practice. The global spread of multidrug-resistant isolates of Neisseria gonorrhoeae could lead to an era of untreatable gonorrhea. New therapeutic modalities with novel mechanisms of action that do not lend themselves to the development of resistance are urgently needed. Gonococcal lipooligosaccharide (LOS) sialylation is critical for complement resistance and for establishing infection in humans and experimental mouse models. Here we describe two immunotherapeutic approaches that target LOS sialic acid: (i) a fusion protein that comprises the region in the complement inhibitor factor H (FH) that binds to sialylated gonococci and IgG Fc (FH/Fc fusion protein) and (ii) analogs of sialic acid that are incorporated into LOS but fail to protect the bacterium against killing. Both molecules showed efficacy in the mouse vaginal colonization model of gonorrhea and may represent promising immunotherapeutic approaches to target multidrug-resistant isolates. Disabling key gonococcal virulence mechanisms is an effective therapeutic strategy because the reduction of virulence is likely to be accompanied by a loss of fitness, rapid elimination by host immunity and consequently, decreased transmission.
[Mh] Termos MeSH primário: Gonorreia/prevenção & controle
Lipopolissacarídeos/metabolismo
Neisseria gonorrhoeae/fisiologia
Ácidos Siálicos/metabolismo
Fatores de Virulência/metabolismo
[Mh] Termos MeSH secundário: Animais
Fator H do Complemento/genética
Fator H do Complemento/metabolismo
Modelos Animais de Doenças
Feminino
Fragmentos Fc das Imunoglobulinas/genética
Fragmentos Fc das Imunoglobulinas/metabolismo
Camundongos
Neisseria gonorrhoeae/efeitos dos fármacos
Ligação Proteica
Proteínas Recombinantes de Fusão/metabolismo
Vagina/microbiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Immunoglobulin Fc Fragments); 0 (Lipopolysaccharides); 0 (Recombinant Fusion Proteins); 0 (Sialic Acids); 0 (Virulence Factors); 0 (lipid-linked oligosaccharides); 80295-65-4 (Complement Factor H)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1093/femspd/ftx049


  3 / 8736 MEDLINE  
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[PMID]:29360873
[Au] Autor:Xu SX; Leontyev D; Kaul R; Gray-Owen SD
[Ad] Endereço:Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada.
[Ti] Título:Neisseria gonorrhoeae co-infection exacerbates vaginal HIV shedding without affecting systemic viral loads in human CD34+ engrafted mice.
[So] Source:PLoS One;13(1):e0191672, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:HIV synergy with sexually transmitted co-infections is well-documented in the clinic. Co-infection with Neisseria gonorrhoeae in particular, increases genital HIV shedding and mucosal transmission. However, no animal model of co-infection currently exists to directly explore this relationship or to bridge the gap in understanding between clinical and in vitro studies of this interaction. This study aims to test the feasibility of using a humanized mouse model to overcome this barrier. Combining recent in vivo modelling advancements in both HIV and gonococcal research, we developed a co-infection model by engrafting immunodeficient NSG mice with human CD34+ hematopoietic stem cells to generate humanized mice that permit both systemic HIV infection and genital N. gonorrhoeae infection. Systemic plasma and vaginal lavage titres of HIV were measured in order to assess the impact of gonococcal challenge on viral plasma titres and genital shedding. Engrafted mice showed human CD45+ leukocyte repopulation in blood and mucosal tissues. Systemic HIV challenge resulted in 104-105 copies/mL of viral RNA in blood by week 4 post-infection, as well as vaginal shedding of virus. Subsequent gonococcal challenge resulted in unchanged plasma HIV levels but higher viral shedding in the genital tract, which reflects published clinical observations. Thus, human CD34+ stem cell-transplanted NSG mice represent an experimentally tractable animal model in which to study HIV shedding during gonococcal co-infection, allowing dissection of molecular and immunological interactions between these pathogens, and providing a platform to assess future therapeutics aimed at reducing HIV transmission.
[Mh] Termos MeSH primário: Antígenos CD34/imunologia
Gonorreia/complicações
Infecções por HIV/complicações
HIV/fisiologia
Neisseria gonorrhoeae/isolamento & purificação
Vagina/virologia
Carga Viral
Eliminação de Partículas Virais
[Mh] Termos MeSH secundário: Animais
Feminino
Infecções por HIV/virologia
Seres Humanos
Camundongos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antigens, CD34)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191672


  4 / 8736 MEDLINE  
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[PMID]:29174733
[Au] Autor:Dize L; Silver B; Gaydos C
[Ad] Endereço:International Sexually Transmitted Diseases Research Laboratory, Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, USA. Electronic address: Ladize@gmail.com.
[Ti] Título:Comparison of the Cepheid GeneXpert CT/NG assay to the Hologic Aptima Combo2 assay for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in self-collected rectal swabs.
[So] Source:Diagn Microbiol Infect Dis;90(2):83-84, 2018 Feb.
[Is] ISSN:1879-0070
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Self-collected rectal-swabs were tested for CT and NG on GeneXpert CT/NG as compared to APTIMA Combo2. Of 448 rectal-swabs, 22 were positive for CT; 7 for NG on both assays; two were discordant. Sensitivity and specificity of GeneXpert was 95.5% and 99.7% for chlamydia, respectively; for gonorrhea both were 100%.
[Mh] Termos MeSH primário: Infecções por Chlamydia/diagnóstico
Chlamydia trachomatis/genética
Gonorreia/diagnóstico
Tipagem Molecular/métodos
Neisseria gonorrhoeae/genética
Técnicas de Amplificação de Ácido Nucleico/métodos
[Mh] Termos MeSH secundário: Infecções por Chlamydia/microbiologia
Feminino
Gonorreia/microbiologia
Seres Humanos
Masculino
Reto/microbiologia
Sensibilidade e Especificidade
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


  5 / 8736 MEDLINE  
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[PMID]:28745556
[Au] Autor:Berntsen S; Karlsen APH; Pedersen ML; Mulvad G
[Ad] Endereço:a Queen Ingrid Health Care Center , Nuuk , Greenland.
[Ti] Título:Gonorrhoea in Greenland, incidence and previous preventive measures: a review to improve future strategies.
[So] Source:Int J Circumpolar Health;76(1):1350092, 2017.
[Is] ISSN:2242-3982
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Gonorrhoea continues to be a significant health challenge in Greenland. The aim of this study was to describe the development of gonorrhoea in Greenland through time including incidence rates and previous measures taken to address the challenge. A systematic literature search in PubMed, Embase and The Cochrane Library was conducted. Furthermore, local archives were searched in the Health Clinic in Nuuk for relevant literature. From the 1940s the incidence of gonorrhoea increased steadily with a steep incline around 1970, possibly as a consequence of changes in living conditions and urbanisation. Significant declines in the incidence were seen the late 1970s and again in the late 1980s, most likely in the wake of an outbreak of ulcus molle/chancroid in the 1970s and as a result of focused education in venereology for Greenlandic nurses in the late 1980s combined with the stop-AIDS campaign. Since the early 1990s the incidence of gonorrhoea in Greenland has not risen to previously high levels. However, the incidence remains high and with a gradually increasing trend. Prevention intervention strategies such as peer-to-peer sexual education, storytelling and involvement of parent/guardian in sexual education of the youth could be appropriate approaches to improve sexual health in Greenland.
[Mh] Termos MeSH primário: Serviços de Saúde Comunitária/organização & administração
Gonorreia/epidemiologia
Gonorreia/prevenção & controle
Prevenção Primária/organização & administração
Comportamento Sexual/estatística & dados numéricos
[Mh] Termos MeSH secundário: Busca de Comunicante
Feminino
Gonorreia/diagnóstico
Groenlândia
Seres Humanos
Masculino
Neisseria gonorrhoeae/isolamento & purificação
Prevalência
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1080/22423982.2017.1350092


  6 / 8736 MEDLINE  
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[PMID]:28747205
[Au] Autor:Fingerhuth SM; Low N; Bonhoeffer S; Althaus CL
[Ad] Endereço:Institute of Integrative Biology, ETH Zurich, Zurich, 8092, Switzerland. stephanie.fingerhuth@env.ethz.ch.
[Ti] Título:Detection of antibiotic resistance is essential for gonorrhoea point-of-care testing: a mathematical modelling study.
[So] Source:BMC Med;15(1):142, 2017 07 26.
[Is] ISSN:1741-7015
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Antibiotic resistance is threatening to make gonorrhoea untreatable. Point-of-care (POC) tests that detect resistance promise individually tailored treatment, but might lead to more treatment and higher levels of resistance. We investigate the impact of POC tests on antibiotic-resistant gonorrhoea. METHODS: We used data about the prevalence and incidence of gonorrhoea in men who have sex with men (MSM) and heterosexual men and women (HMW) to calibrate a mathematical gonorrhoea transmission model. With this model, we simulated four clinical pathways for the diagnosis and treatment of gonorrhoea: POC test with (POC+R) and without (POC-R) resistance detection, culture and nucleic acid amplification tests (NAATs). We calculated the proportion of resistant infections and cases averted after 5 years, and compared how fast resistant infections spread in the populations. RESULTS: The proportion of resistant infections after 30 years is lowest for POC+R (median MSM: 0.18%, HMW: 0.12%), and increases for culture (MSM: 1.19%, HMW: 0.13%), NAAT (MSM: 100%, HMW: 99.27%), and POC-R (MSM: 100%, HMW: 99.73%). Per 100 000 persons, NAAT leads to 36 366 (median MSM) and 1228 (median HMW) observed cases after 5 years. Compared with NAAT, POC+R averts more cases after 5 years (median MSM: 3353, HMW: 118). POC tests that detect resistance with intermediate sensitivity slow down resistance spread more than NAAT. POC tests with very high sensitivity for the detection of resistance are needed to slow down resistance spread more than by using culture. CONCLUSIONS: POC with high sensitivity to detect antibiotic resistance can keep gonorrhoea treatable longer than culture or NAAT. POC tests without reliable resistance detection should not be introduced because they can accelerate the spread of antibiotic-resistant gonorrhoea.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Resistência Microbiana a Medicamentos
Gonorreia/tratamento farmacológico
Gonorreia/transmissão
Modelos Teóricos
Neisseria gonorrhoeae/efeitos dos fármacos
Testes Imediatos
[Mh] Termos MeSH secundário: Adulto
Feminino
Gonorreia/microbiologia
Seres Humanos
Incidência
Masculino
Testes de Sensibilidade Microbiana/métodos
Testes de Sensibilidade Microbiana/estatística & dados numéricos
Técnicas de Amplificação de Ácido Nucleico/métodos
Técnicas de Amplificação de Ácido Nucleico/estatística & dados numéricos
Sistemas Automatizados de Assistência Junto ao Leito/normas
Sistemas Automatizados de Assistência Junto ao Leito/estatística & dados numéricos
Testes Imediatos/normas
Testes Imediatos/estatística & dados numéricos
Prevalência
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180127
[Lr] Data última revisão:
180127
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1186/s12916-017-0881-x


  7 / 8736 MEDLINE  
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[PMID]:29240786
[Au] Autor:Stefanelli P; Vescio MF; Landini MP; Dal Conte I; Matteelli A; Cristaudo A; Gaino M; Cusini M; Barbui AM; Mencacci A; De Nittis R; Ghisetti V; Stroppiana E; Carannante A; Neisseria gonorrhoeae antimicrobials resistant Study Group
[Ad] Endereço:Department Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.
[Ti] Título:Time trend analysis (2009-2016) of antimicrobial susceptibility in Neisseria gonorrhoeae isolated in Italy following the introduction of the combined antimicrobial therapy.
[So] Source:PLoS One;12(12):e0189484, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Neisseria gonorrhoeae (NG) antimicrobial susceptibility trends to azithromycin, cefixime and ceftriaxone were analyzed, from 2009 to 2016, to monitor changing antimicrobial susceptibility concomitant with the change in prescribing practice in 2012 from cefixime, or ceftriaxone, to ceftriaxone plus azithromycin. Patient characteristics predictive to be infected by antibiotic resistant N. gonorrhoeae were estimated. Finally, the protocol for the treatment of gonorrhoea, in comparison with the international guidelines, was also evaluated. MATERIALS AND METHODS: Data on NG antimicrobial resistance were obtained from a network of sexually transmitted diseases clinics and other laboratories in 12 cities in Italy. We tested the 1,433 gonococci for antimicrobial susceptibility to azithromycin, cefixime and ceftriaxone using a gradient diffusion method. Logistic-regression methods with cluster robust standard errors were used to investigate the association of resistance categories with demographic and clinical patient characteristics and to assess changes in prescribing practices. To minimize bias due to missing data, all statistical models were fitted to data with forty rounds of multiple imputation, using chained equations. RESULTS: The percentage of isolates resistant to cefixime was 17.10% in 2009 and declined up to 1.39% in 2016; at the same time, those resistant to azithromycin was 23.68% in 2009 and 3.00% in 2012. Starting from 2013, azithromycin resistant gonococci tended to increase up to 7.44% in 2016. No ceftriaxone resistant isolates were observed. By multivariate analysis, the men who have sex with women (MSW) and women had a proportional adjusted OR of resistance of 1.25 (95%CI: 0.90; 1.73) and 1.67 (95%CI: 1.16; 2.40), respectively, in comparison with men who have sex with men (MSM). An aOR of resistance of 0.48 (95%CI: 0.21; 1.12) among NG isolated in the pharynx, compared with those isolated in genital sites, was calculated. The proportional aOR of resistance was 0.58 (95%CI: 0.38; 0.89) for presence vs absence of co-infection and 2.00 (95%CI: 1.36; 2.96) for past history vs no history of gonorrhoea.Finally, at least for the period 2013-2016, the older, subjects with anorectal or pharyngeal gonorrhoea infection, subjects with a co-infection, subjects with a previous gonorrhoea infection were not always correctly treated. CONCLUSIONS: Overall, our findings suggest the shifts in N. gonorrhoeae susceptibility to cefixime and azithromycin in the time frame period. First of all, the increasing rate of azithromycin resistance in 2015-2016 in NG isolated in the country need to be monitor in the future. Finally, extensive information on treatment regimens may be useful to asses treatment adherence particularly for the older subjects, subjects with an anorectal or pharyngeal infection, subjects with a co-infection and subjects with a previous history of gonorrhoea. Gonorrhoea treatment strategy should be based on the evidence obtained by the local antimicrobial surveillance system and data about treatment failures.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Neisseria gonorrhoeae/efeitos dos fármacos
[Mh] Termos MeSH secundário: Adulto
Antibacterianos/administração & dosagem
Quimioterapia Combinada
Feminino
Seres Humanos
Itália
Masculino
Testes de Sensibilidade Microbiana
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189484


  8 / 8736 MEDLINE  
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[PMID]:29240781
[Au] Autor:Salow KR; Cohen AC; Bristow CC; McGrath MR; Klausner JD
[Ad] Endereço:Public Health Division, AIDS Healthcare Foundation, Los Angeles, California, United States of America.
[Ti] Título:Comparing mail-in self-collected specimens sent via United States Postal Service versus clinic-collected specimens for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in extra-genital sites.
[So] Source:PLoS One;12(12):e0189515, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To evaluate the concordance between clinic-collected extra-genital specimens and self-collected mailed-in extra-genital specimens among participants seeking sexually transmitted infection testing at a free clinic in Hollywood, CA. METHODS: A convenience sample of 210 men who have sex with men were enrolled between February 29, 2016 and December 21, 2016 and received mail-in testing kits for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). All testing was performed using the GeneXpert® CT/NG (Cepheid, Sunnyvale, CA). RESULTS: From the 210 mail-in kits distributed, 149 mail-in kits (71.0%) were returned to the laboratory, resulting in 145 pairs (clinic-collected and mail-in) of rectal test results and 148 pairs of pharyngeal test results for both CT and NG detection. The concordance was 95.0% for all CT rectal tests, 99.3% for all CT pharyngeal tests, 95.7% for all NG rectal tests, and 97.2% for all NG pharyngeal tests. CONCLUSION: Roughly two-thirds of mail-in test kits were returned and concordance was generally high, however more than one-third of positive results were missed in mail-in samples. The prevalence of potential false-negative results among mail-in samples warrants caution when implementing mail-in STI testing strategies.
[Mh] Termos MeSH primário: Chlamydia trachomatis/isolamento & purificação
Homossexualidade Masculina
Neisseria gonorrhoeae/isolamento & purificação
Faringe/microbiologia
Serviços Postais
Reto/microbiologia
Doenças Sexualmente Transmissíveis/diagnóstico
Manejo de Espécimes
[Mh] Termos MeSH secundário: Seres Humanos
Masculino
Doenças Sexualmente Transmissíveis/microbiologia
Estados Unidos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171229
[Lr] Data última revisão:
171229
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189515


  9 / 8736 MEDLINE  
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[PMID]:29231153
[Au] Autor:Kulkarni SV; Bala M; Muqeeth SA; Sasikala G; Nirmalkar AP; Thorat R; Kambli H; Sawant J; Risbud A; Gangakhedkar RR; Godbole SV
[Ad] Endereço:1​ICMR-National AIDS Research Institute, Pune, Maharashtra, India.
[Ti] Título:Antibiotic susceptibility pattern of Neisseria gonorrhoeae strains isolated from five cities in India during 2013-2016.
[So] Source:J Med Microbiol;67(1):22-28, 2018 Jan.
[Is] ISSN:1473-5644
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Emergence of multidrug resistance in Neisseria gonorrhoeae, an STI of public health significance is the biggest challenge to gonorrhoea control. Monitoring for antimicrobial resistance is essential for the early detection of emergent drug resistance patterns. METHODOLOGY: One hundred and twenty four N. gonorrhoeae strains were isolated between September 2013-August 2016 [82-New Delhi, 3-Pune, 3-Mumbai, 20-Secunderabad and 16-Hyderabad] to determine antimicrobial susceptibility and to compare the CLSI disc diffusion method with Etest for these strains. The results of the two methods were compared by using kappa statistics. RESULTS: Ninety eight percent [CI: 96.2-100] of isolates were resistant to ciprofloxacin, 52 % [CI: 43.2-60.8] to penicillin, 56 % [CI: 47.2-64.7] to tetracycline and 5 % [CI: 1.2-8.8] to azithromycin. All the strains were susceptible to spectinomycin, ceftriaxone and cefixime except for two strains which showed decreased susceptibility to ceftriaxone and cefixime. Kappa scores for penicillin, azithromycin, ciprofloxacin, ceftriaxone and cefixime showed that the CLSI method had high agreement with Etest while tetracycline had substantial agreement. CONCLUSION: Our data suggest that the disc diffusion method which is both cost effective and more feasible, can effectively be used routinely for monitoring antibiotic susceptibility in N. gonorrhoeae, in limited resource countries like India. We demonstrate the emergence of decreased susceptibility to ceftriaxone and cefixime and threshold levels of resistance to azithromycin in India. This underscores the importance of maintaining continued surveillance for antibiotic resistance in N. gonorrhoeae and a potential requirement for strategic change in guidelines in the not so distant future.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos
Gonorreia/tratamento farmacológico
Gonorreia/microbiologia
Neisseria gonorrhoeae/efeitos dos fármacos
Neisseria gonorrhoeae/isolamento & purificação
[Mh] Termos MeSH secundário: Adulto
Cidades
Feminino
Seres Humanos
Índia
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171227
[Lr] Data última revisão:
171227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE
[do] DOI:10.1099/jmm.0.000662


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[PMID]:29219803
[Au] Autor:Papp JR; Rowlinson MC; O'Connor NP; Wholehan J; Razeq JH; Glennen A; Ware D; Iwen PC; Lee LV; Hagan C
[Ad] Endereço:1​Centers for Disease Control and Prevention, Atlanta, GA, USA.
[Ti] Título:Accuracy and reproducibility of the Etest to detect drug-resistant Neisseria gonorrhoeae to contemporary treatment.
[So] Source:J Med Microbiol;67(1):68-73, 2018 Jan.
[Is] ISSN:1473-5644
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Neisseria gonorrhoeae is a sexually transmitted bacterial pathogen that continues to evolve to become resistant to known antibiotics. In preparing for potential emergence, the Centers for Disease Control and Prevention recommends that clinical laboratories maintain or develop protocols to assess antibiotic susceptibly for this organism. This study examines the intra-laboratory variability of using the Etest method to provide consistent MIC values for N. gonorrhoeae and also compared the results of the Etest to known agar dilution MIC values. METHODOLOGY: Clinical N. gonorrhoeae isolates, 100 paired duplicates, were tested by eight laboratories for antibiotic susceptibility to ceftriaxone, cefixime and azithromycin using Etest strips.Results/Key findings. Overall, >80 % of the paired Etest MIC values were within one log2 dilution of the replicate. When compared to the agar dilution reference method, the cefixime Etest MIC values were consistently underreported by one dilution (seven laboratories) or two dilutions (one laboratory). The azithromycin Etest MIC values agreed 90.7 % with the agar dilution MIC values while the agreement with ceftriaxone was 90.9 %. CONCLUSION: Overall, the Etest method yielded reproducible MIC values within each laboratory with the azithromycin and ceftriaxone MIC results consistent to the reference agar dilution method while the cefixime result tended to provide a lower MIC value.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Farmacorresistência Bacteriana/efeitos dos fármacos
Neisseria gonorrhoeae/efeitos dos fármacos
Neisseria gonorrhoeae/isolamento & purificação
[Mh] Termos MeSH secundário: Azitromicina/farmacologia
Cefixima/farmacologia
Ceftriaxona/farmacologia
Gonorreia/microbiologia
Seres Humanos
Testes de Sensibilidade Microbiana/métodos
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 75J73V1629 (Ceftriaxone); 83905-01-5 (Azithromycin); 97I1C92E55 (Cefixime)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171227
[Lr] Data última revisão:
171227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE
[do] DOI:10.1099/jmm.0.000651



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