耐药淋病:2013年至2020年英国国家公共卫生应对。

Rachel Merrick, Michelle Cole, Rachel Pitt, Qudsia Enayat, Zdravko Ivanov, Michaela Day, Suzy Sun, Katy Sinka, Neil Woodford, Hamish Mohammed, Helen Fifer
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引用次数: 4

摘要

淋病奈瑟菌已对用于治疗淋病的所有抗菌素产生耐药性,而且头孢曲松耐药菌株的出现威胁到经验性治疗的最后一线选择。2013年淋病球菌抗微生物药物耐药性监测规划(GRASP)行动计划建议采取措施延缓淋病奈瑟菌抗微生物药物耐药性(AMR)的传播。我们回顾了自那时以来淋球菌抗菌素耐药性的趋势以及实施《行动计划》建议以应对耐药淋病奈瑟菌事件的经验。2013年至2019年期间,英国淋病诊断增加了128%,达到70,922例,是有史以来报告的最大年度数字。在此期间,淋球菌分离株对阿奇霉素的敏感性降低(最低抑制浓度> 0.5 mg/L),从2016年的4.7%上升到2020年的8.7%;这导致2019年英国淋病一线治疗从双重治疗(头孢曲松/阿奇霉素)转变为头孢曲松单药治疗。我们还发现了首次使用双治疗方案(头孢曲松/阿奇霉素)治疗咽淋病的全球失败,随后又发现了另外6株头孢曲松耐药菌株。性健康临床医生和实验室继续与英国卫生安全局(UKHSA)合作,对于及时发现具有头孢曲松耐药性的淋病奈瑟菌菌株并迅速遏制这些菌株在英格兰境内的传播至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Antimicrobial-resistant gonorrhoea: the national public health response, England, 2013 to 2020.

Antimicrobial-resistant gonorrhoea: the national public health response, England, 2013 to 2020.

Antimicrobial-resistant gonorrhoea: the national public health response, England, 2013 to 2020.

Neisseria gonorrhoeae has developed resistance to all antimicrobials used to treat gonorrhoea, and the emergence of ceftriaxone-resistant strains threatens the last-line option for empirical treatment. The 2013 Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) Action Plan recommended measures to delay the spread of antimicrobial resistance (AMR) in N. gonorrhoeae in England. We reviewed trends in gonococcal AMR since then and the experience of implementing the Action Plan's recommendations to respond to incidents of resistant N. gonorrhoeae. Between 2013 and 2019, diagnoses of gonorrhoea in England rose by 128% to 70,922, the largest annual number ever reported. Over this period, N. gonorrhoeae isolates have become less susceptible to azithromycin (minimum inhibitory concentration > 0.5 mg/L), increasing from 4.7% in 2016 to 8.7% in 2020; this led to a change in first-line treatment for gonorrhoea in the United Kingdom (UK) from dual therapy (ceftriaxone/azithromycin) to ceftriaxone monotherapy in 2019. We also detected the first global treatment failure for pharyngeal gonorrhoea with a dual-therapy regimen (ceftriaxone/azithromycin), followed by an additional six ceftriaxone-resistant strains. Continued engagement of sexual health clinicians and laboratories with the UK Health Security Agency (UKHSA) is essential for the timely detection of N. gonorrhoeae strains with ceftriaxone resistance and to rapidly contain transmission of these strains within England.

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