Adaptive guidelines for the treatment of gonorrhea to increase the effective life span of antibiotics among men who have sex with men in the United States: A mathematical modeling study
Autoři:
Reza Yaesoubi aff001; Ted Cohen aff002; Katherine Hsu aff003; Thomas L. Gift aff004; Harrell Chesson aff004; Joshua A. Salomon aff005; Yonatan H. Grad aff006
Působiště autorů:
Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, United States of America
aff001; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
aff002; Massachusetts Department of Public Health, Boston, Massachusetts, United States of America
aff003; Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
aff004; Center for Primary Care & Outcomes Research, School of Medicine, Stanford University, Stanford, California, United States of America
aff005; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
aff006
Vyšlo v časopise:
Adaptive guidelines for the treatment of gonorrhea to increase the effective life span of antibiotics among men who have sex with men in the United States: A mathematical modeling study. PLoS Med 17(4): e32767. doi:10.1371/journal.pmed.1003077
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pmed.1003077
Souhrn
Background
The rise of gonococcal antimicrobial resistance highlights the need for strategies that extend the clinically useful life span of antibiotics. Because there is limited evidence to support the current practice of switching empiric first-line antibiotic when resistance exceeds 5% in the population, our objective was to compare the impact of alternative strategies on the effective life spans of antibiotics and the overall burden of gonorrhea.
Methods and findings
We developed and calibrated a mathematical model of gonorrhea transmission among men who have sex with men (MSM) in the United States. We calibrated the model to the estimated prevalence of gonorrhea, the rate of gonorrhea cases, and the proportion of cases presenting symptoms among MSM in the US. We used this model to project the effective life span of antibiotics and the number of gonorrhea cases expected under current and alternative surveillance strategies over a 50-year simulation period. We demonstrate that compared to the current practice, a strategy that uses quarterly (as opposed to yearly) surveillance estimates and incorporates both the estimated prevalence of resistance and the trend in the prevalence of resistance to determine treatment guidelines could extend the effective life span of antibiotics by 0.83 years. This is equivalent to successfully treating an additional 80.1 (95% uncertainty interval: [47.7, 111.9]) gonorrhea cases per 100,000 MSM population each year with the first-line antibiotics without worsening the burden of gonorrhea. If the annual number of isolates tested for drug susceptibility is doubled, this strategy could increase the effective life span of antibiotics by 0.94 years, which is equivalent to successfully treating an additional 91.1 (54.3, 127.3) gonorrhea cases per 100,000 MSM population each year without increasing the incidence of gonorrhea. Study limitations include that our conclusions might not be generalizable to other settings because our model describes the transmission of gonorrhea among the US MSM population, and, to better capture uncertainty in the characteristics of current and future antibiotics, we chose to model hypothetical drugs with characteristics similar to the antibiotics commonly used in gonorrhea treatment.
Conclusions
Our results suggest that use of data from surveillance programs could be expanded to prolong the clinical effectiveness of antibiotics without increasing the burden of the disease. This highlights the importance of maintaining effective surveillance systems and the engagement of policy makers to turn surveillance findings into timely and effective decisions.
Klíčová slova:
Antibiotic resistance – Antibiotics – Antimicrobial resistance – Drug information – Drug therapy – Gonorrhea – Men who have sex with men – Treatment guidelines
Zdroje
1. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2017. Atlanta, GA: US Department of Health and Human Services; 2018.
2. World Health Organization. Report on global sexually transmitted infection surveillance, 2018. Geneva: World Health Organization; 2018.
3. Eyre DW, Sanderson ND, Lord E, Regisford-Reimmer N, Chau K, Barker L, et al. Gonorrhoea treatment failure caused by a Neisseria gonorrhoeae strain with combined ceftriaxone and high-level azithromycin resistance, England, February 2018. Euro Surveill. 2018;23(27). doi: 10.2807/1560-7917.ES.2018.23.27.1800323 29991383; PubMed Central PMCID: PMC6152157.
4. Jennison AV, Whiley D, Lahra MM, Graham RM, Cole MJ, Hughes G, et al. Genetic relatedness of ceftriaxone-resistant and high-level azithromycin resistant Neisseria gonorrhoeae cases, United Kingdom and Australia, February to April 2018. Euro Surveill. 2019;24(8). doi: 10.2807/1560-7917.ES.2019.24.8.1900118 30808445; PubMed Central PMCID: PMC6446956.
5. Kirkcaldy RD, Harvey A, Papp JR, Del Rio C, Soge OO, Holmes KK, et al. Neisseria gonorrhoeae Antimicrobial Susceptibility Surveillance—The Gonococcal Isolate Surveillance Project, 27 Sites, United States, 2014. MMWR Surveill Summ. 2016;65(7):1–19. doi: 10.15585/mmwr.ss6507a1 27414503.
6. Low N, Unemo M, Skov Jensen J, Breuer J, Stephenson JM. Molecular diagnostics for gonorrhoea: implications for antimicrobial resistance and the threat of untreatable gonorrhoea. PLoS Med. 2014;11(2):e1001598. doi: 10.1371/journal.pmed.1001598 24503544; PubMed Central PMCID: PMC3913554.
7. Blank S, Daskalakis DC. Neisseria gonorrhoeae—Rising Infection Rates, Dwindling Treatment Options. N Engl J Med. 2018;379(19):1795–7. doi: 10.1056/NEJMp1812269 30403946.
8. Bolan GA, Sparling PF, Wasserheit JN. The emerging threat of untreatable gonococcal infection. N Engl J Med. 2012;366(6):485–7. doi: 10.1056/NEJMp1112456 22316442.
9. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2015: Gonococcal Isolate Surveillance Project (GISP) Supplement and Profiles. Atlanta, GA: Department of Health and Human Services; 2017.
10. World Health Organization. Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae. Geneva: World Health Organization; 2012.
11. Centers for Disease Control and Prevention. Update to CDC's Sexually transmitted diseases treatment guidelines, 2010: oral cephalosporins no longer a recommended treatment for gonococcal infections. MMWR Morb Mortal Wkly Rep. 2012;61(31):590–4. 22874837.
12. Workowski KA, Bolan GA, Centers for Disease C, Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(RR-03):1–137. 26042815; PubMed Central PMCID: PMC5885289.
13. Taylor SN, Marrazzo J, Batteiger BE, Hook EW 3rd, Sena AC, Long J, et al. Single-Dose Zoliflodacin (ETX0914) for Treatment of Urogenital Gonorrhea. N Engl J Med. 2018;379(19):1835–45. doi: 10.1056/NEJMoa1706988 30403954.
14. O'Riordan W, Tiffany C, Scangarella-Oman N, Perry C, Hossain M, Ashton T, et al. Efficacy, Safety, and Tolerability of Gepotidacin (GSK2140944) in the Treatment of Patients with Suspected or Confirmed Gram-Positive Acute Bacterial Skin and Skin Structure Infections. Antimicrob Agents Chemother. 2017;61(6). doi: 10.1128/AAC.02095-16 28373199; PubMed Central PMCID: PMC5444153.
15. Tuite AR, Gift TL, Chesson HW, Hsu K, Salomon JA, Grad YH. Impact of Rapid Susceptibility Testing and Antibiotic Selection Strategy on the Emergence and Spread of Antibiotic Resistance in Gonorrhea. J Infect Dis. 2017;216(9):1141–9. doi: 10.1093/infdis/jix450 28968710; PubMed Central PMCID: PMC5853443.
16. Andersson DI, Hughes D. Antibiotic resistance and its cost: is it possible to reverse resistance? Nat Rev Microbiol. 2010;8(4):260–71. doi: 10.1038/nrmicro2319 20208551.
17. Menzies NA, Soeteman DI, Pandya A, Kim JJ. Bayesian Methods for Calibrating Health Policy Models: A Tutorial. Pharmacoeconomics. 2017;35(6):613–624. doi: 10.1007/s40273-017-0494-4 28247184.
18. Fingerhuth SM, Bonhoeffer S, Low N, Althaus CL. Antibiotic-Resistant Neisseria gonorrhoeae Spread Faster with More Treatment, Not More Sexual Partners. PLoS Pathog. 2016;12(5):e1005611. doi: 10.1371/journal.ppat.1005611 27196299; PubMed Central PMCID: PMC4872991.
19. Grov C, Cain D, Rendina HJ, Ventuneac A, Parsons JT. Characteristics Associated With Urethral and Rectal Gonorrhea and Chlamydia Diagnoses in a US National Sample of Gay and Bisexual Men: Results From the One Thousand Strong Panel. Sex Transm Dis. 2016;43(3):165–71. doi: 10.1097/OLQ.0000000000000410 26859803; PubMed Central PMCID: PMC4748382.
20. Newman LM, Dowell D, Bernstein K, Donnelly J, Martins S, Stenger M, et al. A tale of two gonorrhea epidemics: results from the STD surveillance network. Public Health Rep. 2012;127(3):282–92. doi: 10.1177/003335491212700308 22547859; PubMed Central PMCID: PMC3314072.
21. Clinical Effectiveness Group. BASHH Guidelines 2019. 2019 [cited 2019 Jun 1]. Available from: https://www.bashhguidelines.org/current-guidelines/urethritis-and-cervicitis/gonorrhoea-2019/.
22. Thakur SD, Parmar NR, Dillon JR. Time to Develop Standardized Molecular Diagnostics for the Simultaneous Detection of Neisseria gonorrhoeae and Its Antimicrobial Resistance. Sex Transm Dis. 2018;45(5):316–8. doi: 10.1097/OLQ.0000000000000834 29528994.
23. Whittles LK, White PJ, Didelot X. Estimating the fitness cost and benefit of cefixime resistance in Neisseria gonorrhoeae to inform prescription policy: A modelling study. PLoS Med. 2017;14(10):e1002416. doi: 10.1371/journal.pmed.1002416 29088226; PubMed Central PMCID: PMC5663337.
24. Barbee LA, Khosropour CM, Dombrowski JC, Manhart LE, Golden MR. An estimate of the proportion of symptomatic gonococcal, chlamydial and non-gonococcal non-chlamydial urethritis attributable to oral sex among men who have sex with men: a case-control study. Sex Transm Infect. 2016;92(2):155–60. Epub 2015 Aug 21. doi: 10.1136/sextrans-2015-052214 26297719; PubMed Central PMCID: PMC4861816.
25. Johnson LF, Alkema L, Dorrington RE. A Bayesian approach to uncertainty analysis of sexually transmitted infection models. Sex Transm Infect. 2010;86(3):169–74. Epub 2009 Nov 1. doi: 10.1136/sti.2009.037341 19880971; PubMed Central PMCID: PMC2953461.
26. Bissessor M, Tabrizi SN, Fairley CK, Danielewski J, Whitton B, Bird S, et al. Differing Neisseria gonorrhoeae bacterial loads in the pharynx and rectum in men who have sex with men: implications for gonococcal detection, transmission, and control. J Clin Microbiol. 2011;49(12):4304–6. doi: 10.1128/JCM.05341-11 21956992; PubMed Central PMCID: PMC3232985.
27. Boyajian AJ, Murray M, Tucker M, Neu N. Identifying variations in adherence to the CDC sexually transmitted disease treatment guidelines of Neisseria gonorrhoeae. Public Health. 2016;136:161–5. Epub 2016/05/18. doi: 10.1016/j.puhe.2016.04.004 27179879.
28. Lewis DA. Antimicrobial Resistance Surveillance for Neisseria gonorrhoeae-What Do We Really Need to Know to Guide Public Health Interventions? Sex Transm Dis. 2017;44(4):202–4. Epub 2017/03/11. doi: 10.1097/OLQ.0000000000000609 28282365.
Článek vyšel v časopise
PLOS Medicine
2020 Číslo 4
- S diagnostikou Parkinsonovy nemoci může nově pomoci AI nástroj pro hodnocení mrkacího reflexu
- Proč při poslechu některé muziky prostě musíme tančit?
- Chůze do schodů pomáhá prodloužit život a vyhnout se srdečním chorobám
- „Jednohubky“ z klinického výzkumu – 2024/44
- Je libo čepici místo mozkového implantátu?
Nejčtenější v tomto čísle
- Pre-exposure prophylaxis for preventing acquisition of HIV: A cross-sectional study of patients, prescribers, uptake, and spending in the United States, 2015–2016
- Pandemic responses: Planning to neutralize SARS-CoV-2 and prepare for future outbreaks
- HIV testing and treatment coverage achieved after 4 years across 14 urban and peri-urban communities in Zambia and South Africa: An analysis of findings from the HPTN 071 (PopART) trial
- Hepatitis B virus seroepidemiology data for Africa: Modelling intervention strategies based on a systematic review and meta-analysis
