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한국에서 세균성 성매개감염의 항생제 내성 역학

Epidemiology of Antimicrobial-Resistance in Sexually Transmitted Infections in Korea: Implications for Rational Treatment

장인호|김정훈
대한요로생식기감염학회|2012.11|Urogenital Tract Infection|제7권 제2호|pp. 106-121

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참고문헌

키워드

Antimicrobial drug resistanceBacterial sexually transmitted diseases
주제분류비뇨기과학

초록

Public health control of bacterial sexually transmitted infections (STIs) is dependent on the delivery of effective therapy and so will be compromised by the emergence of resistance. The scope of the problem and the implications for treatment that follow are discussed in this review. Emerging resistance has been documented in all the bacterial STIs, but is considered rare and unconfirmed in Chlamydia trachomatis whereas Neisseria gonorrhea is of global concern. Azithromycin resistance has now been recognized in Mycoplasma genitalium, Treponema pallidum and N. gonorrhoeae,bringing into question its widespread use for chlamydial infection and threatening its future use. Rapidly increasing levels of decreased susceptibility to the extended-spectrum cephalosporins in N. gonorrhoeae and emerging treatment failures to both cefixime and ceftriaxone, without an obvious alternative agent, are of considerable concern. Implications for treatment include choice and timing of any change in therapy,reintroduction of test of cure and definition of treatment failure in an era of molecular testing. Emerging resistance in all bacterial STIs and the particular problem of resistant gonorrhea will present a challenge to maintaining and prescribing antimicrobial therapy which is at the forefront of public health control.

Abstract

Public health control of bacterial sexually transmitted infections (STIs) is dependent on the delivery of effective therapy and so will be compromised by the emergence of resistance. The scope of the problem and the implications for treatment that follow are discussed in this review. Emerging resistance has been documented in all the bacterial STIs, but is considered rare and unconfirmed in Chlamydia trachomatis whereas Neisseria gonorrhea is of global concern. Azithromycin resistance has now been recognized in Mycoplasma genitalium, Treponema pallidum and N. gonorrhoeae,bringing into question its widespread use for chlamydial infection and threatening its future use. Rapidly increasing levels of decreased susceptibility to the extended-spectrum cephalosporins in N. gonorrhoeae and emerging treatment failures to both cefixime and ceftriaxone, without an obvious alternative agent, are of considerable concern. Implications for treatment include choice and timing of any change in therapy,reintroduction of test of cure and definition of treatment failure in an era of molecular testing. Emerging resistance in all bacterial STIs and the particular problem of resistant gonorrhea will present a challenge to maintaining and prescribing antimicrobial therapy which is at the forefront of public health control.

참고문헌 (72)

  1. 이임순, "특집", 성매개 질환 발생에 관한 시대적 변천과 현황, 2008, pp.51(10), 868~874[DOI]
  2. Korea Association of Urogenital Tract Infection and Inflammation, "Sexually transmitted infections Korean guidelines", ~ (2011)
  3. M. Grabe, "Guidelines on Urological infections", ~ (2010)
  4. WHO, "The Global strategy for the prevention and control of sexually transmitted infections", pp.2006~2015 (2007)
  5. Homma T, "Demographic and behavioral characteristics of male sexually transmitted disease patients in Japan: a nationwide case-control study", Sex Transm Dis, 35(12), pp.990~996 (2008)
  6. CDC, "Trends in reportable sexually transmitted diseases in the United States, 2006", Sexually Transmitted Disease Surveillance, ~ (2006)
  7. CDC, "Sexually transmitted diseases treatment guidelines, 2006", MMWR, 55(RR-11), pp.1~94 (2006)
  8. Korea Centers for Disease Control and Prevention, "Department of AIDS and Tuberculosis control", ~ (2011)
  9. Hogan RJ, "Chlamydial persistence: beyond the biphasic paradigm", Infect Immun, 72(4), pp.1843~1855 (2004)
  10. Bhengraj AR, "Decreased susceptibility to azithromycin and doxycycline in clinical isolates of chlamydia trachomatis obtained from recurrently infected female patients in India", Chemotherapy, 56(5), pp.371~377 (2010)
  11. Misyurina OY, "Mutations in a 23S rRNA gene of chlamydia trachomatis associated with resistance to macrolides", Antimicrob Agents Chemother, 48(4), pp.1347~1349 (2004)
  12. Somani J, "Multiple drug-resistant chlamydia trachomatis associated with clinical treatment failure", J Infect Dis, 181(4), pp.1421~1427 (2000)
  13. Jensen JS, "Azithromycin treatment failure in Mycoplasma genitalium-positive patients with nongonococcal urethritis is associated with induced macrolide resistance", Clin Infect Dis, 47(12), pp.1546~1553 (2008)
  14. Jensen JS, "Single-dose azithromycin treatment for mycoplasma genitalium-positive urethritis: best but not good enough", Clin Infect Dis, 48(12), pp.1655~1656 (2009)
  15. Schwebke JR, "Re-evaluating the treatment of nongonococcal urethritis: emphasizing emerging pathogens-a randomized clinical trial", Clin Infect Dis, 52(2), pp.163~170 (2011)
  16. Mena LA, "A randomized comparison of azithromycin and doxycycline for the treatment of mycoplasma genitalium-positive urethritis in men", Clin Infect Dis, 48(12), pp.1649~1654 (2009)
  17. Taylor-Robinson D, "Mycoplasma genitalium: from chrysalis to multicolored butterfly", Clin Microbiol Rev, 24(3), pp.498~514 (2011)
  18. Stamm LV, "Global challenge of antibiotic-resistant treponema pallidum", Antimicrob Agents Chemother, 54(2), pp.583~589 (2010)
  19. Katz KA, "Azithromycin resistance in treponema pallidum", Curr Opin Infect Dis, 21, pp.83~91 (2008)
  20. Tapsall JW, "Meeting the public health challenge of multidrugand extensively drug-resistant neisseria gonorrhoeae", Expert Rev Anti Infect Ther, 7(7), pp.821~834 (2009)
  21. Kirkcaldy RD, "Gonococcal resistance: are cephalosporins next?", Curr Infect Dis Rep, 13(2), pp.196~204 (2011)
  22. Lewis DA, "The Gonococcus fights back: is this time a knock out?", Sex Transm Infect, 86(6), pp.415~421 (2010)
  23. Morais Cabral JH, "Crystal structure of the breakage-reunion domain of DNA gyrase", Nature, 388(6645), pp.903~906 (1997)
  24. Friedman SM, "Mutation in the DNA gyrase a Gene of Escherichia coli that expands the quinolone resistance-determining region", Antimicrob Agents Chemother, 45(8), pp.2378~2380 (2001)
  25. Ng EY, "Quinolone resistance mutations in topoisomerase IV: relationship to the flqA locus and genetic evidence that topoisomerase IV is the primary target and DNA gyrase is the secondary target of fluoroquinolones in staphylococcus aureus", Antimicrob Agents Chemother, 40(8), pp.1881~1888 (1996)
  26. Eliopoulos GM, "Quinolone resistance mechanisms in pneumococci", Clin Infect Dis, 38(Suppl 4), pp.S350~S356 (2004)
  27. Lee H, "Trends in Antimicrobial Resistance of Neisseria gonorrhoeae Isolated From Korean Patients From 2000 to 2006", Sex Transm Dis, 38(11), pp.1082~1086 (2011)
  28. Lukehart SA, "Macrolide resistance in treponema pallidum in the United States and Ireland", N Engl J Med, 351(2), pp.154~158 (2004)
  29. Tipple C, "High prevalence of macrolide resistant treponema pallidum strains in a London centre", Sex Transm Infect, 87(6), pp.486~488 (2011)
  30. Galarza PG, "New mutation in 23S rRNA gene associated with high level of azithromycin resistance in Neisseria gonorrhoeae", Antimicrob Agents Chemother, 54(4), pp.1652~1653 (2010)
  31. Chisholm SA, "High-level azithromycin resistance occurs in neisseria gonorrhoeae as a result of a single point mutation in the 23S rRNA genes", Antimicrob Agents Chemother, 54(9), pp.3812~3816 (2010)
  32. Handsfield HH, "A comparison of single-dose cefixime with ceftriaxone as treatment for uncomplicated gonorrhea. The Gonorrhea Treatment Study Group", N Engl J Med, 325(19), pp.1337~1341 (1991)
  33. Unemo M, "Two cases of verified clinical failures using internationally recommended first-line cefixime for gonorrhoea treatment, Norway, 2010", Euro Surveill, 15(47), pp.pii:19721~ (2010)
  34. Ison CA, "Gonorrhoea treatment failures to cefixime and azithromycin in England, 2010", Euro Surveill, 16(14), pp.pii:19833~ (2011)
  35. Unemo M, "Ceftriaxone treatment failure of pharyngeal gonorrhoea verifiedby international recommendations, Sweden, July 2010", Euro Surveill, 16(6), pp.pii:19792~ (2011)
  36. Ohnishi M, "Is neisseria gonorrhoeae initiating a future era of untreatable gonorrhea?: detailed characterization of the first strain with high-level resistance to ceftriaxone", Antimicrob Agents Chemother, 55(7), pp.3538~3545 (2011)
  37. Andrews JM, "BSAC standardized disc susceptibility testing method (version 8)", J Antimicrob Chemother, 64(3), pp.454~489 (2009)
  38. Ameyama S, "Mosaic-like structure of penicillin-binding protein 2 gene (penA) in clinical isolates of Neisseria gonorrhoeae with reduced susceptibility to cefixime", Antimicrob Agents Chemother, 46(12), pp.3744~3749 (2002)
  39. Lindberg R, "Neisseria gonorrhoeae isolates with reduced susceptibility to cefixime and ceftriaxone: association with genetic polymorphisms in penA, mtrR, porB1b, and ponA", Antimicrob Agents Chemother, 51(6), pp.2117~2122 (2007)
  40. Lo JY, "Ceftibuten resistance and treatment failure of Neisseria gonorrhoeae infection", Antimicrob Agents Chemother, 52(10), pp.3564~3567 (2008)
  41. Workowski KA, "The 1998 CDC Sexually Transmitted Diseases Treatment Guidelines", Curr Infect Dis Rep, 2(1), pp.44~50 (2000)
  42. Belland RJ, "Neisseria gonorrhoeae acquires mutations in analogous regions of gyrA and parC in fluoroquinolone-resistant isolates", Mol Microbiol, 14(2), pp.371~380 (1994)
  43. Yong D, "Epidemiological characteristics and molecular basis of fluoroquinolone-resistant neisseria gonorrhoeae strains isolated in Korea and nearby countries", J Antimicrob Chemother, 54(2), pp.451~455 (2004)
  44. CDC, "Fluoroquinolone-resistance in Neisseria gonorrhoeae, Hawaii, 1999, and decreased susceptibility to azithromycin in N. gonorrhoeae, Missouri, 1999", MMWR Morb Mortal Wkly Rep, 49(37), pp.833~837 (2000)
  45. Korea Centers for Disease Control and Prevention, "Guidelines of sexual transmitted diseases", ~ (2008)
  46. Workowski KA, "Sexually transmitted diseases treatment guidelines, 2010", MMWR Recomm Rep, 59(RR-12), pp.1~110 (2010)
  47. Centers for Disease Control and Prevention (CDC), "Cephalosporin susceptibility among neisseria gonorrhoeae isolates-United States, 2000-2010", MMWR Morb Mortal Wkly Rep, 60(26), pp.873~877 (2011)
  48. Ohnishi M, "Ceftriaxone-resistant neisseria gonorrhoeae, Japan", Emerg Infect Dis, 17(1), pp.148~149 (2011)
  49. Takahashi S, "Pharyngeal Neisseria gonorrhoeae detection in oral-throat wash specimens of male patients with urethritis", J Infect Chemother, 14(6), pp.442~444 (2008)
  50. Korea Centers for Disease Control and Prevention, "Antimicrobial susceptibility of Neisseria gonorrhoeae in Korea", ~ (2011)
  51. Lee SG, "Various penA mutations together with mtrR, porB and ponA mutations in Neisseria gonorrhoeae isolates with reduced susceptibility to cefixime or ceftriaxone", J Antimicrob Chemother, 65(4), pp.669~675 (2010)
  52. Yoon HN, "2007 UK national guideline on the management of non-gonococcal urethritis", Korean J UTII, 4(1), pp.134~139 (2009)
  53. Deguchi T, "Association of ureaplasma urealyticum (biovar 2) with nongonococcal urethritis", Sex Transm Dis, 31(3), pp.192~195 (2004)
  54. Deguchi T, "Non-chlamydial non-gonococcal urethritis", Nihon Rinsho, 67(1), pp.167~171 (2009)
  55. Deguchi T, "Mycoplasma genitalium: another important pathogen of nongonococcal urethritis", J Urol, 167(3), pp.1210~1217 (2002)
  56. Ross JD, "Mycoplasma genitalium as a sexually transmitted infection: implications for screening, testing, and treatment", Sex Transm Infect, 82(4), pp.269~271 (2006)
  57. Povlsen K, "Relationship of ureaplasma urealyticum biovar 2 to nongonococcal urethritis", Eur J Clin Microbiol Infect Dis, 21(2), pp.97~101 (2002)
  58. Bradshaw CS, "Etiologies of nongonococcal urethritis: bacteria, viruses, and the association with orogenital exposure", J Infect Dis, 193(3), pp.336~345 (2006)
  59. Madeb R, "Need for diagnostic screening of Herpes simplex virus in patients with nongonococcal urethritis", Clin Infect Dis, 30통권 : 6, pp.982~983 (2000)
  60. Martin DH, "Nongonococcal urethritis: new views through the prism of modern molecular microbiology", Curr Infect Dis Rep, 10(2), pp.128~132 (2008)
  61. Workowski KA, "Sexually transmitted diseases treatment guidelines, 2010", MMWR Recomm Rep, 59(RR-12), pp.1~110 (2010)
  62. Jensen JS, "Mycoplasma genitalium: the aetiological agent of urethritis and other sexually transmitted diseases", J Eur Acad Dermatol Venereol, 18(1), pp.1~11 (2004)
  63. Jensen JS, "Comparison of first void urine and urogenital swab specimens for detection of mycoplasma genitalium and chlamydia trachomatis by polymerase chain reaction in patients attending a sexually transmitted disease clinic", Sex Transm Dis, 31(8), pp.499~507 (2004)
  64. Mena L, "Mycoplasma genitalium infections in asymptomatic men and men with urethritis attending a sexually transmitted diseases clinic in new orleans", Clin Infect Dis, 35(10), pp.1167~1173 (2002)
  65. Chernesky M, "Impact of urine collection order on the ability of assays to identify chlamydia trachomatis infections in men", Sex Transm Dis, 30(4), pp.345~347 (2003)
  66. Falk L, "Tetracycline treatment does not eradicate Mycoplasma genitalium", Sex Transm Infect, 79(4), pp.318~319 (2003)
  67. Wikström A, "Mycoplasma genitalium: a common cause of persistent urethritis among men treated with doxycycline", Sex Transm Infect, 82(4), pp.276~279 (2006)
  68. Björnelius E, "Antibiotic treatment of symptomatic mycoplasma genitalium infection in scandinavia: a controlled clinical trial", Sex Transm Infect, 84(1), pp.72~76 (2008)
  69. Hooton TM, "Ofloxacin versus doxycycline for treatment of cervical infection with chlamydia trachomatis", Antimicrob Agents Chemother, 36(5), pp.1144~1146 (1992)
  70. Kitchen VS, "Comparison of ofloxacin with doxycycline in the treatment of non-gonococcal urethritis and cervical chlamydial infection", J Antimicrob Chemother, 26(Suppl D), pp.99~105 (1990)
  71. Mogabgab WJ, "Randomized comparison of ofloxacin and doxycycline for chlamydia and ureaplasma urethritis and cervicitis", Chemotherapy, 36(1), pp.70~76 (1990)
  72. Romanowski B, "Serologic response to treatment of infectious syphilis", Ann Intern Med, 114(12), pp.1005~1009 (1991)

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