Emerg Infect Dis. 2018 Jul;24(7):1195-1203. doi: 10.3201/eid2407.172104.
Contemporary strategies to curtail the emergence of antimicrobial resistance in Neisseria gonorrhoeae include screening for and treating asymptomatic infections in high-prevalence populations in whom antimicrobial drug-resistant infections have typically emerged. We argue that antimicrobial resistance in these groups is driven by a combination of dense sexual network connectivity and antimicrobial drug exposure (for example, through screen-and-treat strategies for asymptomatic N. gonorrhoeae infection). Sexual network connectivity sustains a high-equilibrium prevalence of N. gonorrhoeae and increases likelihood of reinfection, whereas antimicrobial drug exposure results in selection pressure for reinfecting N. gonorrhoeae strains to acquire antimicrobial resistance genes from commensal pharyngeal or rectal flora. We propose study designs to test this hypothesis.
遏制淋病奈瑟菌出现抗菌药物耐药性的当代策略包括筛查和治疗高流行人群中的无症状感染，因为这些人群中通常会出现抗菌药物耐药性感染。我们认为，这些人群中的抗菌药物耐药性是由密集的性网络连通性和抗菌药物暴露（例如，通过无症状淋病奈瑟菌感染的筛查和治疗策略）共同驱动的。性网络连通性维持了淋病奈瑟菌的高均衡流行率，并增加了再次感染的可能性，而抗菌药物暴露则导致再次感染的淋病奈瑟菌菌株通过从咽或直肠共生菌群中获得抗菌药物耐药基因而产生选择压力。我们提出了研究设计来检验这一假设。
