PMID: 11927047Apr 3, 2002Paper

Update on Quinolone Resistance in Neisseria gonorrhoeae

Current Infectious Disease Reports
J M Zenilman

Abstract

Quinolones are widely used for treating gonococcal infections, typically in single-dose, oral regimens. However, in the 1990s, quinolone-resistant Neisseria gonorrhoeae emerged, potentially compromising the utility of this drug class. In the past year, these strains have widely disseminated, accounting for over half of isolates in parts of Southeast Asia. The molecular mechanism of resistance has been localized to multiple mutations in genes coding for the bacterial DNA gyrase and topoisomerase enzymes. These mutations accumulate until the minimum inhibitory concentration is 4.0 g/mL or more, which in clinical studies appears to be the threshold for clinical treatment failure. Quinolone-resistant N. gonorrhoeae is independent from other plasmid- and chromosomally-mediated resistance determinants; nearly all isolates to date have been sensitive to cephalosporins and spectinomycin. Nevertheless, designing public health strategies to contain quinolone-resistant N. gonorrhoeae will be difficult.

References

Sep 30, 2000·MMWR. Morbidity and Mortality Weekly Report·UNKNOWN Centers for Disease Control and Prevention (CDC)
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Mar 15, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·M RahmanM J Albert
Mar 27, 2001·Emerging Infectious Diseases·M DanB Sheinberg
Apr 5, 2001·Current Infectious Disease Reports·Janine R. Tompkins, Jonathan M. Zenilman
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Jun 13, 2001·Sexually Transmitted Infections·E LkhamsurenJ W Tapsall
Jun 26, 2001·Lancet·P Moodley, A W Sturm

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Citations

Apr 23, 2004·Expert Opinion on Pharmacotherapy·Michael Dan

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