How actively should we screen for chlamydia and gonorrhoea in MSM and other high-ST-prevalence populations as we enter the era of increasingly untreatable infections? A viewpoint.

How actively should we screen for chlamydia and gonorrhoea in MSM and other high-ST-prevalence populations as we enter the era of increasingly untreatable infections? A viewpoint. J Med Microbiol. 2018 Dec 06;: Authors: Kenyon C Abstract A number of national and international organizations are advocating more intensive screening for Chlamydia trachomatis and Neisseria gonorrhoeae in high-prevalence populations as a way to reduce the prevalence of these infections. In this article, we review the available evidence and conclude that there is a paucity of evidence to support this approach. We further hypothesize that increasing screening intensity in high-prevalence populations will result in a considerable risk for the emergence of antimicrobial resistance in Neisseria gonorrhoeae and other pathobionts. PMID: 30520712 [PubMed - as supplied by publisher]
Source: Journal of Medical Microbiology - Category: Microbiology Authors: Tags: J Med Microbiol Source Type: research

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The FDA today approved Fetroja (cefiderocol), an antibacterial drug for treatment of patients with complicated urinary tract infections (cUTI), including kidney infections caused by susceptible Gram-negative microorganisms, who have limited or no alternative treatment options.
Source: FDA Center for Drug Evaluation and Research - What's New - Category: Drugs & Pharmacology Authors: Source Type: news
ConclusionsCarbapenem-based regimen of combination therapy, seems to be an option to treat patients infected withKlebsiella pneumoniae resistant to ceftazidime/avibactam and susceptible to carbapenem, at least when the risk of mortality is low.
Source: Journal of Global Antimicrobial Resistance - Category: Infectious Diseases Source Type: research
Numerous preexposure prophylaxis (PrEP) guidelines recommend three-monthly screening for gonorrhoea and chlamydia. To quantify the risk of antimicrobial resistance this may induce, we conducted a literature review of the incidence of gonorrhoea and chlamydia in PrEP studies that conducted 3-site, 3-monthly screening. We found that screening could result in macrolide consumption rates that exceed those in high macrolide consumption populations where consumption has been strongly associated with macrolide resistance.
Source: AIDS - Category: Infectious Diseases Tags: Research Letter Source Type: research
ConclusionsGepotidacin demonstrated highin vitro activity against gonococcal strains, indicating that gepotidacin could potentially be an effective option for gonorrhoea treatment, particularly in a dual antimicrobial therapy regimen and for patients with resistance or allergy to extended-spectrum cephalosporins. Nevertheless, elucidatingin vitro andin vivo resistance emergence and mechanisms in detail, together with further gonorrhoea clinical studies, ideally also including chlamydia andMycoplasma genitalium are essential.
Source: Journal of Antimicrobial Chemotherapy - Category: Microbiology Source Type: research
Conclusion This large study found an association between having the MeNZB vaccine and a reduced likelihood of being diagnosed with gonorrhoea. But it's difficult to form any firm conclusions because of the nature of the case and control groups. For example, given that both groups were sexually active, we don't know why the majority of people with gonorrhoea didn't also have a chlamydia infection, and how this may have affected the results. It could just be down to pure chance and have nothing to do with the vaccine. So before we celebrate the alleged "cure of gonorrhoea", there are many things to consider: T...
Source: NHS News Feed - Category: Consumer Health News Tags: Medication Source Type: news
Gonorrhoea antimicrobial resistance Fifer et al from Public Health England highlight in a letter in the New England Journal of Medicine1 a multiresistant strain of Neisseria gonorrhoeae (NG) in urethral and pharyngeal samples in a heterosexual man, who failed first-line dual therapy with a single intramuscular dose of ceftriaxone 500 mg and a single oral dose of azithromycin 1 g. The strain was resistant to ceftriaxone, azithromycin, cefixime, cefotaxime, penicillin, tetracycline, and ciprofloxacin, but was susceptible to spectinomycin. The urethral sample tested negative on test of cure but the pharyngeal sample...
Source: Sexually Transmitted Infections - Category: Sexual Medicine Authors: Tags: Clinical round-up Source Type: research
DiscussionThe options for future treatment of gonorrhoea are limited. Results from this randomised trial will demonstrate whether gentamicin is not clinically worse than ceftriaxone for the treatment of gonorrhoea. This will inform clinical practice and policy for the treatment of gonorrhoea when current therapy with cephalosporins is no longer effective, or is contraindicated.Trial registrationInternational Standard Randomised Controlled Trial Number –ISRCTN51783227, Registered on 18 September 2014. Current protocol version 2.0 17 June 2015.
Source: Trials - Category: Research Source Type: clinical trials
We present the updated International Union against Sexually Transmitted Infections (IUSTI) guideline for the management of non-gonococcal urethritis in men. This guideline recommends confirmation of urethritis in symptomatic men before starting treatment. It does not recommend testing asymptomatic men for the presence of urethritis. All men with urethritis should be tested for Chlamydia trachomatis and Neisseria gonorrhoeae and ideally Mycoplasma genitalium using a nucleic acid amplification test (NAAT) as this is highly likely to improve clinical outcomes. If a NAAT is positive for gonorrhoea, a culture should be performe...
Source: International Journal of STD and AIDS - Category: Global & Universal Authors: Tags: Guidelines Source Type: research
WHO issues new guidelines for chlamydia, gonorrhoea and syphilis Related items fromOnMedica Tackling antimicrobial resistance GPs prescribing outdated antibiotics for gonorrhoea Rate of syphilis in London is three times higher than rest of England Doctors told to halve inappropriate antibiotic prescriptions by 2020 Point-of-care diagnostics needed to curb antimicrobial resistance
Source: OnMedica Latest News - Category: UK Health Source Type: news
Clinicians will want to take an early look at this months Clinical Roundup,1 now an established series which is proving popular thanks to its authors Sophie Herbert and Lewis Haddow. This month, we have also rushed into production for our clinical readers a BASHH column,2 which introduces the new position statement on the treatment of co-incident rectal chlamydia and gonorrhoea. With the looming spectre of gonococcal antimicrobial resistance, we are likely to see more rapid changes in guidelines and develop a more proactive approach to stewarding the antibiotics that we still have available. Clinicians might be forgiven fo...
Source: Sexually Transmitted Infections - Category: Sexual Medicine Authors: Tags: Drugs: infectious diseases, HIV/AIDS, Reproductive medicine, Ophthalmology, Adolescent health, Child health, Condoms, HIV / AIDS, Chlamydia, Gonorrhoea, HIV infections, Sex workers, Urethritis, Vulvovaginal disorders Whistlestop tour Source Type: research
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