World Health Organization Global Gonococcal Antimicrobial Surveillance Program (WHO GASP): review of new data and evidence to inform international collaborative actions and research efforts

被引：170

作者：

Unemo, Magnus ^{[1
]}

Lahra, Monica M. ^{[2
]}

Cole, Michelle ^{[3
]}

Galarza, Patricia ^{[4
]}

Ndowa, Francis ^{[5
]}

Martin, Irene ^{[6
]}

Dillon, Jo-Anne R. ^{[7
]}

Ramon-Pardo, Pilar ^{[8
]}

Bolan, Gail ^{[9
]}

Wi, Teodora ^{[10
]}

机构：

[1] Orebro Univ, Fac Med & Hlth, Dept Lab Med, WHO,Collaborating Ctr Gonorrhoea & Other STIs, SE-70185 Orebro, Sweden

[2] New South Wales Hlth Pathol, WHO, Microbiol, Collaborating Ctr Sexually Transmitted Infect & A, Randwick, NSW, Australia

[3] Publ Hlth England, Natl Infect Serv, London, England

[4] Natl Inst Infect Dis ANLIS Dr Carlos G Malbran, Natl Reference Lab STDs, Buenos Aires, DF, Argentina

[5] Skin & Genitourinary Med Clin, Harare, Zimbabwe

[6] Publ Hlth Agcy Canada, Natl Microbiol Lab, Winnipeg, MB, Canada

[7] Univ Saskatchewan, Saskatoon, SK, Canada

[8] WHO, Communicable Dis & Environm Determinants Hlth Dep, Washington, DC USA

[9] Ctr Dis Control & Prevent, Div STD Prevent, Atlanta, GA USA

[10] WHO, Dept Reprod Hlth & Res, Geneva, Switzerland

来源：

SEXUAL HEALTH | 2019年 / 16卷 / 05期

关键词：

antimicrobial resistance; azithromycin; ceftriaxone; gonorrhoea; Neisseria gonorrhoeae; treatment; RESISTANT NEISSERIA-GONORRHOEAE; DECREASED CEPHALOSPORIN SUSCEPTIBILITY; MULTIDRUG-RESISTANT; GENOMIC EPIDEMIOLOGY; PHARYNGEAL GONORRHEA; QUALITY-ASSURANCE; GENETIC-CHARACTERIZATION; AZITHROMYCIN RESISTANCE; UNTREATABLE GONORRHEA; CEFTRIAXONE TREATMENT;

D O I：

10.1071/SH19023

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a serious public health problem, compromising the management and control of gonorrhoea globally. Resistance in N. gonorrhoeae to ceftriaxone, the last option for firstline empirical monotherapy of gonorrhoea, has been reported from many countries globally, and sporadic failures to cure especially pharyngeal gonorrhoea with ceftriaxone monotherapy and dual antimicrobial therapies (ceftriaxone plus azithromycin or doxycycline) have been confirmed in several countries. In 2018, the first gonococcal isolates with ceftriaxone resistance plus high-level azithromycin resistance were identified in England and Australia. The World Health Organization (WHO) Global Gonococcal Antimicrobial Surveillance Program (GASP) is essential to monitor AMR trends, identify emerging AMR and provide evidence for refinements of treatment guidelines and public health policy globally. Herein we describe the WHO GASP data from 67 countries in 2015-16, confirmed gonorrhoea treatment failures with ceftriaxone with or without azithromycin or doxycycline, and international collaborative actions and research efforts essential for the effective management and control of gonorrhoea. In most countries, resistance to ciprofloxacin is exceedingly high, azithromycin resistance is present and decreased susceptibility or resistance to ceftriaxone has emerged. Enhanced global collaborative actions are crucial for the control of gonorrhoea, including improved prevention, early diagnosis, treatment of index patient and partner (including test-of-cure), improved and expanded AMR surveillance (including surveillance of antimicrobial use and treatment failures), increased knowledge of correct antimicrobial use and the pharmacokinetics and pharmacodynamics of antimicrobials and effective drug regulations and prescription policies (including antimicrobial stewardship). Ultimately, rapid, accurate and affordable point-of-care diagnostic tests (ideally also predicting AMR and/or susceptibility), new therapeutic antimicrobials and, the only sustainable solution, gonococcal vaccine(s) are imperative.

引用

页码：412 / 425

页数：14