Antibiotic resistance in Neisseria gonorrhoeae: origin, evolution, and lessons learned for the future

• Type of Material: Conference Paper
• Authors: Magnus Unemo, Orebro University; William Shafer, Emory University
• Language: English
• Date: 2011-01-01
• Publisher: Emory University Libraries
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2011 New York Academy of Sciences.
• Final Published Version (URL): http://dx.doi.org/10.1111/j.1749-6632.2011.06215.x
• Title of Journal or Parent Work: EVOLUTION OF INFECTIOUS AGENTS IN RELATION TO SEX
• Conference or Event Name: Conference on the Evolution of Infectious Agents in Relation to Sex
• Volume: 1230
• Issue: 1
• Start Page: E19
• End Page: E28
• Keywords: antimicrobial resistance; DECREASED SUSCEPTIBILITY; MOSAIC-LIKE STRUCTURE; LEVEL RESISTANCE; CEFTRIAXONE; ANTIMICROBIAL RESISTANCE; Neisseria gonorrhoeae; Multidisciplinary Sciences; genetics; Infectious Diseases; REDUCED SUSCEPTIBILITY; gonorrhea; Science & Technology; MTRE EFFLUX-PUMP; PENICILLIN-BINDING PROTEIN-2; evolution; SPECTRUM CEPHALOSPORINS; Life Sciences & Biomedicine; Science & Technology - Other Topics; CEFIXIME
• Research Categories: Biology, Genetics; Biology, Virology

Abstract

The strict human pathogen Neisseria gonorrhoeae has caused gonorrhea for thousands of years, and currently gonorrhea is the second most prevalent bacterial sexually transmitted infection worldwide. Given the ancient nature of N. gonorrhoeae and its unique obligate relationship with humankind over the millennia, its remarkable ability to adapt to the host immune system and cause repeated infections, and its propensity to develop resistance to all clinically useful antibiotics, the gonococcus is an ideal pathogen on which to study the evolution of bacterial pathogenesis, including antimicrobial resistance, over the long term and within the host during infection. Recently, the first gonococcus displaying high-level resistance to ceftriaxone, identified in Japan, was characterized in detail. Ceftriaxone is the last remaining option for empirical first-line treatment, and N. gonorrhoeae now seems to be evolving into a true "superbug." In the near future, gonorrhea may become untreatable in certain circumstances. Herein, the history of antibiotics used for treatment of gonorrhea, the evolution of resistance emergence in N. gonorrhoeae, the linkage between resistance and biological fitness of N. gonorrhoeae, lessons learned, and future perspectives are reviewed and discussed. © 2011 New York Academy of Sciences.