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Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections

The aim of this study was to apply molecular epidemiology, antimicrobial surveillance, and PK/PD analysis to guide the antimicrobial treatment of gonococci infections in a region of the north of Spain. Antibiotic susceptibility testing was performed on all isolates (2017 to 2019, n = 202). A subset...

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Autores principales: Alonso, Rodrigo, Rodríguez-Achaerandio, Ainara, Aguirre-Quiñonero, Amaia, Artetxe, Aitor, Martínez-Ballesteros, Ilargi, Rodríguez-Gascón, Alicia, Garaizar, Javier, Canut, Andrés
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8541456/
https://www.ncbi.nlm.nih.gov/pubmed/34683991
http://dx.doi.org/10.3390/pharmaceutics13101699
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author Alonso, Rodrigo
Rodríguez-Achaerandio, Ainara
Aguirre-Quiñonero, Amaia
Artetxe, Aitor
Martínez-Ballesteros, Ilargi
Rodríguez-Gascón, Alicia
Garaizar, Javier
Canut, Andrés
author_facet Alonso, Rodrigo
Rodríguez-Achaerandio, Ainara
Aguirre-Quiñonero, Amaia
Artetxe, Aitor
Martínez-Ballesteros, Ilargi
Rodríguez-Gascón, Alicia
Garaizar, Javier
Canut, Andrés
author_sort Alonso, Rodrigo
collection PubMed
description The aim of this study was to apply molecular epidemiology, antimicrobial surveillance, and PK/PD analysis to guide the antimicrobial treatment of gonococci infections in a region of the north of Spain. Antibiotic susceptibility testing was performed on all isolates (2017 to 2019, n = 202). A subset of 35 isolates intermediate or resistant to at least two antimicrobials were selected to search for resistance genes and genotyping through WGS. By Monte Carlo simulation, we estimated the probability of target attainment (PTA) and the cumulative fraction of response (CFR) of the antimicrobials used to treat gonorrhea, both indicative of the probability of treatment success. In total, 2.0%, 6.4%, 5.4%, and 48.2% of the isolates were resistant to ceftriaxone, cefixime, azithromycin, and ciprofloxacin, respectively. Twenty sequence types were identified. Detected mutations were related to antibiotic resistance. PK/PD analysis showed high probability of treatment success of the cephalosporins. In conclusion, multiple populations of N. gonorrhoeae were identified. We can confirm that ceftriaxone (even at the lowest dose: 250 mg) and oral cefixime are good candidates to treat gonorrhea. For patients allergic to cephalosporins, ciprofloxacin should be only used if the MIC is known and ≤0.125 mg/L; this antimicrobial is not recommended for empirical treatment.
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spelling pubmed-85414562021-10-24 Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections Alonso, Rodrigo Rodríguez-Achaerandio, Ainara Aguirre-Quiñonero, Amaia Artetxe, Aitor Martínez-Ballesteros, Ilargi Rodríguez-Gascón, Alicia Garaizar, Javier Canut, Andrés Pharmaceutics Article The aim of this study was to apply molecular epidemiology, antimicrobial surveillance, and PK/PD analysis to guide the antimicrobial treatment of gonococci infections in a region of the north of Spain. Antibiotic susceptibility testing was performed on all isolates (2017 to 2019, n = 202). A subset of 35 isolates intermediate or resistant to at least two antimicrobials were selected to search for resistance genes and genotyping through WGS. By Monte Carlo simulation, we estimated the probability of target attainment (PTA) and the cumulative fraction of response (CFR) of the antimicrobials used to treat gonorrhea, both indicative of the probability of treatment success. In total, 2.0%, 6.4%, 5.4%, and 48.2% of the isolates were resistant to ceftriaxone, cefixime, azithromycin, and ciprofloxacin, respectively. Twenty sequence types were identified. Detected mutations were related to antibiotic resistance. PK/PD analysis showed high probability of treatment success of the cephalosporins. In conclusion, multiple populations of N. gonorrhoeae were identified. We can confirm that ceftriaxone (even at the lowest dose: 250 mg) and oral cefixime are good candidates to treat gonorrhea. For patients allergic to cephalosporins, ciprofloxacin should be only used if the MIC is known and ≤0.125 mg/L; this antimicrobial is not recommended for empirical treatment. MDPI 2021-10-15 /pmc/articles/PMC8541456/ /pubmed/34683991 http://dx.doi.org/10.3390/pharmaceutics13101699 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Alonso, Rodrigo
Rodríguez-Achaerandio, Ainara
Aguirre-Quiñonero, Amaia
Artetxe, Aitor
Martínez-Ballesteros, Ilargi
Rodríguez-Gascón, Alicia
Garaizar, Javier
Canut, Andrés
Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections
title Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections
title_full Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections
title_fullStr Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections
title_full_unstemmed Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections
title_short Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections
title_sort molecular epidemiology, antimicrobial surveillance, and pk/pd analysis to guide the treatment of neisseria gonorrhoeae infections
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8541456/
https://www.ncbi.nlm.nih.gov/pubmed/34683991
http://dx.doi.org/10.3390/pharmaceutics13101699
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