One confirmed and one suspected case of pharyngeal gonorrhoea treatment failure following 500mg ceftriaxone in Sydney, Australia

Read, P.J., Limnios, E.A., McNulty, A., Whiley, D. and Lahra, M.M. (2013) One confirmed and one suspected case of pharyngeal gonorrhoea treatment failure following 500mg ceftriaxone in Sydney, Australia. Sexual Health, 10 5: 460-462. doi:10.1071/SH13077


Author Read, P.J.
Limnios, E.A.
McNulty, A.
Whiley, D.
Lahra, M.M.
Title One confirmed and one suspected case of pharyngeal gonorrhoea treatment failure following 500mg ceftriaxone in Sydney, Australia
Journal name Sexual Health   Check publisher's open access policy
ISSN 1448-5028
1449-8987
Publication date 2013-01-01
Sub-type Article (original research)
DOI 10.1071/SH13077
Volume 10
Issue 5
Start page 460
End page 462
Total pages 3
Place of publication Collingwood, VIC, Australia
Publisher C S I R O Publishing
Language eng
Subject 2725 Infectious Diseases
2739 Public Health, Environmental and Occupational Health
Abstract Emerging antimicrobial resistance within Neisseria gonorrhoeae (NG) is a significant global public health threat. Detection and investigation of treatment failures is a crucial component of the World Health Organisation's response to this challenge. We report the cases of two homosexual men, both treated for pharyngeal NG with 500mg intramuscular ceftriaxone, in whom a test of cure 1 week after treatment showed persisting infection. Both men denied further sexual activity. In the first case, treatment failure was confirmed, since the isolates before and after treatment were identical by auxotype, antibiogram, multilocus sequence type (MLST) and multi-antigen sequence type (NG-MAST). In the second case, the MLSTs before and after treatment were identical, but NG-MAST results were similar but not indistinguishable. These cases underline the importance of test-of-cure and molecular investigations in identifying treatment failure, but also highlight the complexity of distinguishing treatment failure from reinfection when relying on highly variable molecular targets that may be subject to drug pressure.
Keyword cephalosporin
drug resistance
multiantigen sequence type
multilocus sequence type
Q-Index Code CX
Q-Index Status Confirmed Code
Institutional Status UQ

 
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