CDC: Cephalosporin-Resistant Gonorrhea Imminent in U.S.
Asia, Europe report treatment failures; cefixime minimum inhibitory concentration up in U.S.
MONDAY, Feb. 18 (HealthDay News) -- Neisseria gonorrhoeae has developed antimicrobial resistance since the 1930s and may be developing resistance to cephalosporins, according to research published in the Feb. 15 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.
Edward W. Hook III., M.D., from the University of Alabama in Birmingham, and colleagues examined antimicrobial resistance of N. gonorrhoeae since the 1930s and have suggested steps that can be taken to delay the emergence of cephalosporin-resistant strains.
According to the report, since before the 1930s, N. gonorrhoeae has become resistant to several antimicrobials, including sulfonamides, penicillin, tetracycline, and fluoroquinolones. Since 2007, the only remaining antimicrobials recommended for the treatment of gonococcal infections are cephalosporins. Beginning in Asia and more recently in Europe there have been reports of unsuccessful treatment of gonorrhea with oral cephalosporins. Based on the Gonococcal Isolate Surveillance System, cephalosporin resistance may be emerging in the United States, with a recent increase in the cefixime minimum inhibitory concentration. Steps to delay the emergence of cephalosporin-resistant strains include use of surveillance data to prioritize populations and areas for enhanced primary prevention, screening, or partner services. Sexually active men who have sex with men and high-risk sexually active women should be screened at least annually and treated appropriately. Sexually active adults should be counseled about ways to reduce transmission.
"Based on past and current data, N. gonorrhoeae will continue to acquire antimicrobial resistance," the authors write. "However, experience and current data suggest that public health actions outlined in this report provide the best chance of averting the unfavorable outcome of multidrug-resistant gonorrhea, greater disease burden, heightened risk for sequelae, and greater health care costs."