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Public health measures to control the spread of antimicrobial resistance in Neisseria gonorrhoeae in men who have sex with men

  • M. XIRIDOU (a1), L. C. SOETENS (a1), F. D. H. KOEDIJK (a1) (a2), M. A. B. VAN DER SANDE (a1) (a3) and J. WALLINGA (a1)...

Summary

Gonorrhoea is one of the most common sexually transmitted infections. The control of gonorrhoea is extremely challenging because of the repeated development of resistance to the antibiotics used for its treatment. We explored different strategies to control the spread of antimicrobial resistance and prevent increases in gonorrhoea prevalence. We used a mathematical model that describes gonorrhoea transmission among men who have sex with men and distinguishes gonorrhoea strains sensitive or resistant to three antibiotics. We investigated the impact of combination therapy, switching first-line antibiotics according to resistance thresholds, and other control efforts (reduced sexual risk behaviour, increased treatment rate). Combination therapy can delay the spread of resistance better than using the 5% resistance threshold. Increased treatment rates, expected to enhance gonorrhoea control, may reduce gonorrhoea prevalence only in the short term, but could lead to more resistance and higher prevalence in the long term. Re-treatment of resistant cases with alternative antibiotics can substantially delay the spread of resistance. In conclusion, combination therapy and re-treatment of resistant cases with alternative antibiotics could be the most effective strategies to prevent increases in gonorrhoea prevalence due to antimicrobial resistance.

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Copyright

Corresponding author

* Author for correspondence: Dr M. Xiridou, National Institute of Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands. (Email: maria.xiridou@rivm.nl)

References

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1. World Health Organization. Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae. 2012 (http://whqlibdoc.who.int/publications/2012/9789241503501_eng.pdf).
2. Lewis, DA. The gonococcus fights back: is this time a knock out? Sexually Transmitted Infections 2010; 86: 415421.
3. Koedijk, F, et al. Increasing trend in gonococcal resistance to ciprofloxacin in The Netherlands, 2006–8. Sexually Transmitted Infections 2010; 86: 4145.
4. Health Protection Agency. The Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) 2011 Report. HPA Gateway reference: HPA12–03. London, 2012.
5. Centers for Disease Control and Prevention. Update to CDC's sexually transmitted diseases treatment guidelines, 2010; Oral cephalosporins no longer a recommended treatment for gonococcal infections. Morbidity and Mortality Weekly Report 2012; 61: 590594.
6. Deguchi, T, et al. Treatment of uncomplicated gonococcal urethritis by double-dosing of 200 mg cefixime at at 6-h interval. Journal of Infection and Chemotherapy 2003; 9: 3539.
7. Unemo, M, et al. High-level cefixime- and ceftriaxone-resistant Neisseria gonorrhoeae in France: novel penA mosaic allele in a successful international clone causes treatment failure. Antimicrobial Agents and Chemotherapy 2012; 56: 1273–80.
8. Ohnishi, M, et al. Is Neisseria gonorrhoeae initiating a future era of untreatable gonorrhoea? Detailed characterization of the first strain with high-level resistance to ceftriaxone. Antimicrobial Agents and Chemotherapy 2011; 55: 35383545.
9. Cámara, J, et al. Molecular characterization of two high-level ceftriaxone-resistant Neisseria gonorrhoeae isolates detected in Catalonia, Spain. Journal of Antimicrobial Chemotherapy 2012; 67: 18581860.
10. Bonhoeffer, S, Lipsitch, M, Levin, BR. Evaluating treatment protocols to prevent antibiotic resistance. Proceedings of the National Academy of Sciences USA 1997; 94: 1210612111.
11. Chan, CH, McCabe, CJ, Fisman, DN. Core groups, antimicrobial resistance and rebound in gonorrhoea in North America. Sexually Transmitted Infections 2012; 88: 200204.
12. Turner, KME, Garnett, GP. The impact of the phase of an epidemic of sexually transmitted infection on the evolution of the organism. Sexually Transmitted Infections 2002; 78 (Suppl. I): i20i30.
13. Ferguson, NM, et al. A population-dynamic model for evaluating the potential spread of drug-resistant influenza virus infections during community-based use of antivirals. Journal of Antimicrobial Chemotherapy 2003; 51: 977990.
14. Kardas-Sloma, L, et al. Antibiotic reduction campaigns do not necessarily decrease bacterial resistance: the example of methicillin-resistant Staphylococcus aureus. Antimicrobial Agents and Chemotherapy 2013; 57: 44104416.
15. Lipsitch, M, Bergstrom, CT, Levin, BR. The epidemiology of antibiotic resistance in hospitals: paradoxes and prescriptions. Proceedings of the National Academy of Sciences USA 2000; 97: 19381943.
16. Handel, A, Regoes, RR, Antia, R. The role of compensatory mutations in the emergence of drug resistance. PLoS Computational Biology 2006; 2: e137.
17. Hall, RJ, Gubbins, S, Gilligan, CA. Invasion of drug and pesticide resistance is determined by a trade-off between treatment efficacy and relative fitness. Bulletin of Mathematical Biology 2004; 66: 825840.
18. Kouyos, RD, zur Wiesch, PA, Bonhoeffer, S. Informed switching strongly decreases the prevalence of antibiotic resistance in hospital wards. PLoS Computational Biology 2011; 7: e1001094.
19. Baggaley, RF, Garnett, GP, Ferguson, NM. Modelling the impact of antiretroviral use in resource-poor settings. PLoS Medicine 2006; 3: e124.
20. Lipsitch, M, Levin, BR. Population dynamics of tuberculosis treatment: mathematical models of the roles of non-compliance and bacterial heterogeneity in the evolution of drug resistance. International Journal Tuberculosis Lung Diseases 1998; 2: 187199.
21. Austin, DJ, Kakehashi, M, Anderson, RM. The transmission dynamics of antibiotic-resistant bacteria: the relationship between resistance in commensal organisms and antibiotic consumption. Proceedings of the Royal Society of London, Series B 1997; 264: 16291638.
22. Heathcote, HW, Yorke, JA. Gonorrhoea transmission dynamics and control. Lecture Notes in Biomathematics 56. 1984, New York: Springer.
23. Garnett, GP, et al. The transmission dynamics of gonorrhoea: modelling the reported behavior of infected patients from Newark, New Jersey. Philosophical Transactions of the Royal Society of London, Series B 1999; 354: 787797.
24. Kolader, ME, et al. Molecular epidemiology of Neisseria gonorrhoeae in Amsterdam, the Netherlands, shows distinct heterosexual and homosexual networks. Journal of Clinical Microbiology 2006; 44: 26892697.
25. Grad, YH, et al. Genomic epidemiology of Neisseria gonorrhoeae with reduced susceptibility to cefixime in the USA: a retrospective observational study. Lancet Infectious Diseases 2014; 14: 220226.
26. Xiridou, M, et al. Modelling the impact of chlamydia screening on the transmission of HIV among men who have sex with men. BMC Infectious Diseases 2013; 13: 436.
27. Schorer Foundation. Schorer Monitor 2006, 2007, 2008, 2009, 2010, 2011.
28. National Institute of Public Health and the Environment. Sexually transmitted infections, including HIV, in the Netherlands in 2011. RIVM report no. 201051001. Bilthoven, The Netherlands, 2012.
29. World Health Organization. Guidelines for the Management of Sexually Transmitted Diseases. Geneva: World Health Organization, 2003.
30. Koedijk, FDH, et al. Gonococci change faster than prescription-behaviour [in Dutch]. Nederlands Tijdschrift van Geneeskunde 2013; 157: A5642.
31. Parienti, J, et al. Hospital-wide modification of fluoroquinolone policy and meticillin-resistant Staphylococcus aureus rates: a 10-year interrupted time-series analysis. Journal of Hospital Infection 2011; 78: 118122.
32. Hooper, RR, et al. Cohort study of venereal disease. I: the risk of gonorrhoea transmission from infected women to men. American Journal of Epidemiology 1978; 108: 136144.
33. Hook, EW, Handsfield, HH. Gonococcal infections in the adult. In: Holmes, KK et al. (eds). Sexually Transmitted Disease, 2nd edn, 1990, New York: McGraw-Hill.
34. Sherrard, J, Barlow, D. Gonorrhoea in men: clinical and diagnostic aspects. Genitourinary Medicine 1996; 72: 422426.
35. Trindade, S, et al. Positive epistasis drives the acquisition of multidrug resistance. PLoS Genetics 2009; 5: e1000578.
36. Reynolds, MG. Compensatory evolution in rifampin-resistant Escherichia coli . Genetics 2000; 156: 14711481.
37. Maisnier-Patin, S, et al. Compensatory adaptation to the delerious effect of antibiotic resistance in Salmonella typhimurium . Molecular Microbiology 2002; 2: 355366.
38. Conti, S, et al. Modeling of the HIV infection epidemic in the Netherlands: a multi-parameter evidence synthesis approach. Annals of Applied Statistics 2011; 5: 23592384.

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Public health measures to control the spread of antimicrobial resistance in Neisseria gonorrhoeae in men who have sex with men

  • M. XIRIDOU (a1), L. C. SOETENS (a1), F. D. H. KOEDIJK (a1) (a2), M. A. B. VAN DER SANDE (a1) (a3) and J. WALLINGA (a1)...

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