Antimicrobial-resistant sexually transmitted infections: gonorrhoea and Mycoplasma genitalium
Magnus Unemo1, Jorgen S Jensen2
1WHO Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, SE-701 85 Örebro, Sweden.
Abstract:
The emergence of antimicrobial resistance (AMR) is a major concern worldwide and already compromises treatment effectiveness and control of several bacterial sexually transmitted infections (STIs). Neisseria gonorrhoeae and Mycoplasma genitalium are evolving into so-called superbugs that can become resistant, both in vitro and clinically, to essentially all antimicrobials available for treatment, causing exceedingly difficult-to-treat or untreatable STIs and threatening global public health. Widespread AMR in these bacteria is likely to persist and even worsen in the future, owing to the high number of infections, widespread and uncontrolled use of antimicrobials, limited surveillance of AMR and clinical failures, as well as the extraordinary capacity of these bacteria to develop AMR. This development would not only result in an increased prevalence of N. gonorrhoeae and M. genitalium infections but also in a considerably increasing number of severe complications affecting reproductive health. To combat this threat, clinicians need to be aware of the current guidelines on diagnostic procedures, recommended treatment regimens, as well as therapeutic options for multidrug-resistant bacteria. AMR testing needs to be more frequently performed, inform treatment decisions and elucidate how AMRs compromise treatment effectiveness, guiding research for effective future therapies.
Insights
Antimicrobial resistance (AMR) in bacteria like Neisseria gonorrhoeae and Mycoplasma genitalium is creating untreatable sexually transmitted infections (STIs). Urgent action is needed to improve diagnostics, treatment, and surveillance to combat this global health threat.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Antimicrobial resistance (AMR) is a significant global health concern, particularly impacting the treatment and control of bacterial sexually transmitted infections (STIs).
- Neisseria gonorrhoeae and Mycoplasma genitalium are developing resistance to nearly all available antimicrobials, leading to difficult-to-treat or untreatable infections.
- The prevalence of AMR in these bacteria is expected to increase due to high infection rates, extensive antimicrobial use, and limited surveillance.
Purpose of the Study:
- To highlight the growing threat of AMR in N. gonorrhoeae and M. genitalium.
- To emphasize the potential for severe reproductive health complications.
- To underscore the need for updated clinical awareness and improved AMR testing.
Main Methods:
- Review of current literature on AMR in STIs.
- Analysis of the factors contributing to the persistence and worsening of AMR.
- Discussion of clinical implications and future research directions.
Main Results:
- AMR in N. gonorrhoeae and M. genitalium is rendering current treatments ineffective.
- Untreatable STIs pose a significant risk to reproductive health.
- Existing strategies for AMR control are insufficient.
Conclusions:
- Clinicians must be updated on diagnostic procedures, treatment guidelines, and options for multidrug-resistant bacteria.
- Increased AMR testing is crucial for informing treatment decisions and guiding the development of novel therapies.
- Combating AMR in STIs requires a multi-faceted approach involving surveillance, treatment, and research.
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