“Sexually Transmitted Infections and Antibiotic Resistance: The Growing Threat of Neisseria Gonorrhoeae and Mycoplasma Genitalium”

2023-05-16 11:01:34

Antibiotics have put most sexually transmitted infections (STIs) out of the public eye. However, in times of increasing resistance to virtually all classes of antibiotics, this certainty may soon be lost. In particular, Neisseria gonorrhoeae and Mycoplasma genitalium are increasingly showing resistance to current treatment strategies.

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The bacterium Neisseria gonorrhoeae (gonococci) causes what is colloquially known as “gonococcus”, which in men almost always manifests as urethritis, itching, purulent discharge and dysuria. In contrast, 50 percent of infected women remain asymptomatic, but on the other hand they can also develop a more complex clinical picture with local inflammatory reactions of the urogenital tract up to and including acute abdomen. In addition to these local symptoms in a broader sense, disseminated gonococcal infections with hemorrhagic skin changes, sepsis and hematogenous spread of the pathogen, for example with septic arthritis, can also occur in both sexes. The gonorrhea is treated with a single dose of ceftriaxone, also combined with azithromycin depending on local recommendations. For disseminated infections, treatment is more complex and includes parenteral ceftriaxone until symptoms resolve, followed by oral antibiotic therapy for a week.

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