Exceedingly high levels of tetracycline resistance in Neisseria gonorrhoeae in eight WHO Enhanced Gonococcal Antimicrobial Surveillance Programme countries in three WHO regions, 2021-2024-doxycycline post-exposure prophylaxis will unlikely impact gonorrhoea burdens

被引：0

作者：

Schroder, Daniel ^{[1
]}

Cherdtrakulkiat, Thitima ^{[2
]}

Doanh, Le Huu ^{[3
]}

Golparian, Daniel ^{[1
]}

Heng, Lon Say ^{[4
]}

Hoffman, Irving ^{[5
]}

Jacobsson, Susanne ^{[1
]}

Jamoralin Jr, Manuel C. ^{[6
]}

Kakooza, Francis ^{[7
]}

Kittiyaowamarn, Rossaphorn ^{[2
]}

Kyambadde, Peter ^{[8
]}

Maseko, Venessa ^{[9
]}

Matoga, Mitch ^{[5
]}

Muller, Etienne ^{[9
]}

Nguyen, Thuy Thi Phan ^{[10
]}

Ouk, Vichea ^{[11
]}

Setiawaty, Vivi ^{[12
]}

Sia, Sonia B. ^{[6
]}

Sulaiman, Verawati ^{[12
]}

Virak, Mot ^{[4
]}

Van, Nguyen Thi Thuy ^{[13
]}

Wi, Teodora ^{[13
]}

Maatouk, Ismael ^{[14
]}

Unemo, Magnus ^{[1
,15
,16
]}

WHO EGASP Tetracycline Study Grp, Lon Say

机构：

[1] Orebro Univ, WHO Collaborating Ctr Gonorrhoea & Other Sexually, Natl Reference Lab Sexually Transmitted Infect, Dept Lab Med,Fac Med & Hlth, Orebro, Sweden

[2] Thailand Minist Publ Hlth, Bangrak STIs Ctr, Dept Dis Control & Prevent, Div AIDS & STIs, Bangkok, Thailand

[3] Natl Hosp Dermatol & Venereol, Hanoi, Vietnam

[4] Natl Ctr HIV AIDS, Dermatol & Sexually Transmitted Dis, Phnom Penh, Cambodia

[5] UNC Project Malawi, Lilongwe, Malawi

[6] Res Inst Trop Med, Dept Hlth, Manila, Philippines

[7] Makerere Univ, Coll Hlth Sci, Infect Dis Inst, Kampala, Uganda

[8] Minist Hlth, Sexually Transmitted Infect Program, Kampala, Uganda

[9] Natl Inst Communicable Dis, Ctr HIV & STIs, Natl Hlth Lab Serv, Johannesburg, South Africa

[10] Ho Chi Minh City Hosp Dermatol & Venereol, Ho Chi Minh City, Vietnam

[11] Lab Natl Inst Publ Hlth, Phnom Penh, Cambodia

[12] Sulianti Saroso Infect Dis Hosp, Jakarta, Indonesia

[13] WHO Country Off, Hanoi, Vietnam

[14] WHO, Hepatitis & STI Programmes, Global HIV, Geneva, Switzerland

[15] Univ Coll London UCL, Inst Global Hlth, London, England

[16] Orebro Univ Hosp, WHO Collaborating Ctr Gonorrhoea & Other Sexually, Dept Lab Med, SE-70185 Orebro, Sweden

来源：

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY | 2025年

关键词：

DOXYCYCLINE;

D O I：

10.1093/jac/dkaf066

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objectives Doxycycline post-exposure prophylaxis (doxycycline-PEP) can reduce incident cases of syphilis, chlamydia and possibly gonorrhoea especially among men who have sex with men with recent bacterial sexually transmitted infections (STIs). Owing to potential implementation of doxycycline-PEP internationally, global tetracycline/doxycycline resistance data for contemporary Neisseria gonorrhoeae isolates has become imperative. We report tetracycline resistance data for gonococcal isolates (n = 2993) from eight WHO Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) countries in three WHO regions in 2021-2024, i.e. to estimate potential impact of doxycycline-PEP on the incident gonorrhoea cases in these WHO EGASP countries. Methods WHO EGASP isolates cultured from men with urethral discharge in Cambodia (n = 482), Indonesia (n = 101), Malawi (n = 121), The Philippines (n = 843), South Africa (n = 597), Thailand (n = 250), Uganda (n = 350) and Vietnam (n = 249) in 2021-2024 were examined. MICs (mg/L) of tetracycline were determined using Etest. Results The tetracycline resistance (range) using the current EUCAST (MIC > 0.5 mg/L) and CLSI (MIC > 1 mg/L) clinical resistance breakpoints in the eight WHO EGASP countries was 92.2% (83.5%-99.6%) and 80.6% (66.3%-98.6%), respectively. Using a previous minocycline-PEP resistance breakpoint (MIC > 2 mg/L) and breakpoint for high-level plasmid (tetM)-mediated tetracycline resistance (MIC > 8 mg/L), the tetracycline resistance (range) was 77.3% (47.4%-98.6%) and 74.3% (31.3%-98.6%), respectively. Conclusions The exceedingly high levels of gonococcal tetracycline resistance (independent of resistance breakpoint used) in the eight WHO EGASP countries elucidate that doxycycline-PEP will unlikely significantly reduce the gonorrhoea cases in these countries. Furthermore, doxycycline-PEP might rapidly select for additional gonococcal strains with tetracycline resistance (low- and high-level) and MDR/XDR strains, i.e. because these strains are mostly resistant to tetracycline.

引用

页数：5

共 1 条

[1] High tetracycline resistance percentages in Neisseria gonorrhoeae in Europe: is doxycycline post-exposure prophylaxis unlikely to reduce the incident gonorrhoea cases?
Unemo, Magnus
Cole, Michelle J.
Kodmon, Csaba
Day, Michaela
Jacobsson, Susanne
LANCET REGIONAL HEALTH-EUROPE, 2024, 38

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