Where have all the susceptible gonococci gone? A historical review of changes in MIC distribution over the past 75 years.
BMC Infect Dis
; 19(1): 1085, 2019 Dec 27.
Article
de En
| MEDLINE
| ID: mdl-31881862
ABSTRACT
BACKGROUND:
Does the emergence of antimicrobial resistance in Neisseria gonorrhoeae include the erasure of highly susceptible strains or does it merely involve a stretching of the MIC distribution? If it was the former this would be important to know as it would increase the probability that the loss of susceptibility is irreversible.METHODS:
We conducted a historical analysis based on a literature review of changes of N. gonorrhoeae MIC distribution over the past 75 years for 3 antimicrobials (benzylpenicillin, ceftriaxone and azithromycin) in five countries (Denmark, Japan, South Africa, the United Kingdom and the United States).RESULTS:
Changes in MIC distribution were most marked for benzylpenicillin and showed evidence of a right shifting of MIC distribution that was associated with a reduction/elimination of susceptible strains in all countries. In the case of ceftriaxone and azithromycin, where only more recent data was available, right shifting was also found in all countries but the extent of right shifting varied and the evidence for the elimination of susceptible strains was more mixed.CONCLUSIONS:
The finding of right shifting of MIC distribution combined with reduction/elimination of susceptible strains is of concern since it suggests that this shifting may not be reversible. Since excess antimicrobial consumption is likely to be responsible for this right shifting, this insight provides additional impetus to promote antimicrobial stewardship.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Benzylpénicilline
/
Ceftriaxone
/
Gonorrhée
/
Tests de sensibilité microbienne
/
Azithromycine
/
Résistance bactérienne aux médicaments
/
Antibactériens
/
Neisseria gonorrhoeae
Limites:
Humans
Pays/Région comme sujet:
Africa
/
America do norte
/
Asia
/
Europa
Langue:
En
Journal:
BMC Infect Dis
Sujet du journal:
DOENCAS TRANSMISSIVEIS
Année:
2019
Type de document:
Article
Pays d'affiliation:
Belgique