WHO Collaborating Centre for Gonorrhoea and Other STIs, Department of Laboratory Medicine, Microbiology, Örebro University Hospital, SE-701 85 Örebro, Sweden.
Hubert Department of Global Health, Rollins School of Public Health of Emory University and Department of Medicine, Division of Infectious Diseases.
Microbiol Spectr. 2016 Jun;4(3). doi: 10.1128/microbiolspec.EI10-0009-2015.
Neisseria gonorrhoeae is a strictly human pathogen that is typically transmitted by sexual contact. The associated disease gonorrhea has plagued humankind for thousands of years, with a current estimated incidence of 78 million cases per year. Advances in antimicrobial discovery in the 1920s and 1930s leading to the discovery of sulfonamides and penicillin begun the era of effective antimicrobial treatment of gonorrhea. Unfortunately, the gonococcus developed decreased susceptibility or even resistance to these initially employed antibiotics, a trend that continued over subsequent decades with each new antibiotic that was brought into clinical practice. As this pattern of resistance has continued into the 21st century, there is now reason for great concern, especially in an era when few new antibiotics have prospects for use as treatment of gonorrhea. Here, we review the history of gonorrhea treatment regimens and gonococcal resistance to antibiotics, the mechanisms of resistance, resistance monitoring schemes that exist in different international settings, global responses to the challenge of resistance, and prospects for future treatment regimens in the 21st century.
淋病奈瑟菌是一种严格的人类病原体，通常通过性接触传播。相关疾病淋病已经困扰了人类几千年，目前估计每年有 7800 万例。20 世纪 20 年代和 30 年代抗菌药物发现方面的进展导致了磺胺类药物和青霉素的发现，开创了淋病有效抗菌治疗的时代。不幸的是，淋球菌对这些最初使用的抗生素的敏感性降低甚至产生耐药性，这种趋势在随后的几十年中随着每种新抗生素被应用于临床实践而持续存在。随着这种耐药模式持续到 21 世纪，现在有理由感到担忧，特别是在几乎没有新抗生素有望用于治疗淋病的时代。在这里，我们回顾了淋病治疗方案和淋球菌对抗生素的耐药性、耐药机制、不同国际环境中存在的耐药性监测方案、全球对耐药性挑战的应对措施以及 21 世纪未来治疗方案的前景。
