Details:

Alternative Title:
J Infect Dis
Personal Author:
Tuite, Ashleigh R. ; Gift, Thomas L. ; Chesson, Harrell W. ; Hsu, Katherine ; Salomon, Joshua A. ; ... More +
Tuite, Ashleigh R. ; Gift, Thomas L. ; Chesson, Harrell W. ; Hsu, Katherine ; Salomon, Joshua A. ; Grad, Yonatan H. Less -
Description:
Background

Increasing antibiotic resistance limits treatment options for gonorrhea. We examined the impact of a hypothetical point-of-care (POC) test reporting antibiotic susceptibility profiles on slowing resistance spread.

Methods

A mathematical model describing gonorrhea transmission incorporated resistance emergence probabilities and fitness costs associated with resistance based on characteristics of ciprofloxacin (A), azithromycin (B), and ceftriaxone (C). We evaluated time to 1% and 5% prevalence of resistant strains among all isolates with the following: (1) empiric treatment (B and C), and treatment guided by POC tests determining susceptibility to (2) A only and (3) all 3 antibiotics.

Results

Continued empiric treatment without POC testing was projected to result in >5% of isolates being resistant to both B and C within 15 years. Use of either POC test in 10% of identified cases delayed this by 5 years. The 3 antibiotic POC test delayed the time to reach 1% prevalence of triply-resistant strains by 6 years, whereas the A-only test resulted in no delay. Results were less sensitive to assumptions about fitness costs and test characteristics with increasing test uptake.

Conclusions

Rapid diagnostics reporting antibiotic susceptibility may extend the usefulness of existing antibiotics for gonorrhea treatment, but ongoing monitoring of resistance patterns will be critical.


Subject:
[+]
Anti-Bacterial Agents
Antibiotic Resistance
Azithromycin
Ceftriaxone
Ciprofloxacin
Disease Transmission, Infectious
Drug Resistance, Microbial
Gonorrhea
Humans
Major Articles And Brief Reports
Mathematical Model
Microbial Sensitivity Tests
Models, Theoretical
Neisseria Gonorrhoeae
Point-of-Care Systems
Point-of-care Test
Gonorrhea

Source:
J Infect Dis. 2017; 216(9):1141-1149.
Pubmed ID:
28968710
Pubmed Central ID:
PMC5853443
Document Type:
Journal Article
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:28d1bd4b361a8073d5bf0bf180a5766991889d1566030373acc4c1d63df4cf86
File Type:

Supporting Files

• 	jix450_suppl_technical_appendix.pdf	pdf
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  	jix450_suppl_supplementary_figures_and_tables.pdf	pdf

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