BACKGROUND: Gonorrhea, a sexually transmitted infection, is most common after genital chlamydial infection. The bacterium, Neisseria gonorrhoeae, is the causative agent of gonorrhea. It also causes urethritis and cervicitis, which are usually asymptomatic and can lead to pelvic inflammatory diseases and infertility in women. Gonorrhea has become a major health problem in the world because of treatment failure due to antimicrobial resistance, ping pong infection, and double infection with Chlamydia. In this paper, we described the incidence of gonorrhea and antimicrobial susceptibility in Korea from 2013 to 2015.
STATUS: The number of gonorrhea cases reported to the Korean Center for Disease Control (KCDC) was 1,613 in 2013, 1,698 in 2014, and 2,331 in 2015. The number of N. gonorrhoeae collected from 46 public health centers and medical institutions in Korea was 78 in 2013, 78 in 2014, and 40 in 2015. The result of the antimicrobial susceptibility test showed that almost all strains were non-susceptible to penicillin, tetracycline, and ciprofloxacin. Non-susceptible strains to cefpodoxime increased from 11% in 2013 to 50% in 2015. However, there were few non-susceptible strains to cefixime, ceftriaxone, and spectinomycin. Multidrug non-susceptibility rate, which is the rate of non-susceptible strains to three and four antimicrobial agents, changed from 81% and 40% in 2013 to 40% and 50% in 2015, respectively.
PROSPECTS: The most serious problem of gonococcal infection is treatment failure due to antimicrobial resistance. Based on the guideline of the Clinical and Laboratory Standard Institute (CLSI), all isolates were susceptible to ceftriaxone, the first-line treatment, but a non-susceptible strain was found based on the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. According to reports in Europe, decreased susceptibility to ceftriaxone may cause treatment failure. Also high-level ceftriaxone resistant N. gonorrhoeae were found in patients with pharyngeal gonorrhea in Japan. Thus, it is necessary to monitor and manage pharyngeal gonorrhea, as well as, genital infection.
|