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1. World Health Organization Enhanced Gonococcal Antimicrobial Surveillance Programme, Cambodia, 2023

Author

Ouk, Vichea, Say, Heng Lon, Virak, Mot, Deng, Serakea, Frankson, Rebekah, McDonald, Robert, Kersh, Ellen N., Wi, Teodora, Maatouk, Ismael, van Hal, Sebastiaan, and Lahra, Monica M.

Subjects
Neisseria infections -- Risk factors, Drug resistance in microorganisms -- Risk factors, Neisseria gonorrhoeae -- Identification and classification -- Genetic aspects, Sentinel health events -- Methods, Health
Abstract

The World Health Organization (WHO) Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) was established in Cambodia in 2020. The program is led by the National Center for HIV/AIDS, Dermatology and Sexually [...]

Published
2024
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2. Whole-Genome Sequencing to Predict Antimicrobial Susceptibility Profiles in Neisseria gonorrhoeae

Author

Bristow, Claire C, Mortimer, Tatum D, Morris, Sheldon, Grad, Yonatan H, Soge, Olusegun O, Wakatake, Erika, Pascual, Rushlenne, Murphy, Sara McCurdy, Fryling, Kyra E, Adamson, Paul C, Dillon, Jo-Anne, Parmar, Nidhi R, Le, Hai Ha Long, Van Le, Hung, Ureña, Reyna Margarita Ovalles, Mitchev, Nireshni, Mlisana, Koleka, Wi, Teodora, Dickson, Samuel P, and Klausner, Jeffrey D

Subjects
Biological Sciences, Biomedical and Clinical Sciences, Microbiology, Clinical Sciences, Medical Microbiology, Oncology and Carcinogenesis, Sexually Transmitted Infections, Antimicrobial Resistance, Biodefense, Biotechnology, Genetics, Infectious Diseases, Emerging Infectious Diseases, Clinical Research, Infection, Good Health and Well Being, Humans, Neisseria gonorrhoeae, Anti-Bacterial Agents, Gonorrhea, Ciprofloxacin, Anti-Infective Agents, Microbial Sensitivity Tests, Drug Resistance, Bacterial, Azithromycin, antimicrobial susceptibility testing, whole-genome sequencing, Medical and Health Sciences, Biological sciences, Biomedical and clinical sciences, Health sciences
Abstract

BackgroundNeisseria gonorrhoeae is a major public health problem due to increasing incidence and antimicrobial resistance. Genetic markers of reduced susceptibility have been identified; the extent to which those are representative of global antimicrobial resistance is unknown. We evaluated the performance of whole-genome sequencing (WGS) used to predict susceptibility to ciprofloxacin and other antimicrobials using a global collection of N. gonorrhoeae isolates.MethodsSusceptibility testing of common antimicrobials and the recently developed zolifodacin was performed using agar dilution to determine minimum inhibitory concentrations (MICs). We identified resistance alleles at loci known to contribute to antimicrobial resistance in N. gonorrhoeae from WGS data. We tested the ability of each locus to predict antimicrobial susceptibility.ResultsA total of 481 N. gonorrhoeae isolates, collected between 2004 and 2019 and making up 457 unique genomes, were sourced from 5 countries. All isolates with demonstrated susceptibility to ciprofloxacin (MIC ≤0.06 μg/mL) had a wild-type gyrA codon 91. Multilocus approaches were needed to predict susceptibility to other antimicrobials. All isolates were susceptible to zoliflodacin, defined by an MIC ≤0.25 μg/mL.ConclusionsSingle marker prediction can be used to inform ciprofloxacin treatment of N. gonorrhoeae infection. A combination of molecular markers may be needed to determine susceptibility for other antimicrobials.

Published
2023

3. WHO global research priorities for antimicrobial resistance in human health

Author

Aanensen, David, Alanio, Alexandre, Alastruey-Izquierdo, Ana, Alemayehu, Tinsae, Al-Hasan, Majdi, Allegaert, Karel, Al-Maani, Amal Saif, Al-Salman, Jameela, Alshukairi, Abeer Nizar, Amir, Afreenish, Applegate, Tanya, Araj, George F, Villalobos, Marlen Arce, Årdal, Christine, Ashiru-Oredope, Diane, Ashley, Elizabeth A, Babin, François-Xavier, Bachmann, Laura H, Bachmann, Till, Baker, Kate Susan, Balasegaram, Manica, Bamford, Colleen, Baquero, Fernando, Barcelona, Laura Isabel, Bassat, Quique, Bassetti, Matteo, Basu, Sulagna, Beardsley, Justin, Vásquez, Grey Benoit, Berkley, James A, Bhatnagar, Anuj K, Bielicki, Julia, Bines, Julie, Bongomin, Felix, Bonomo, Robert A, Bradley, John S, Bradshaw, Catriona, Brett, Ana, Brink, Adrian, Brown, Colin, Brown, Jeremy, Buising, Kirsty, Carson, Carolee, Carvalho, Anna Cristina, Castagnola, Elio, Cavaleri, Marco, Cecchini, Michele, Chabala, Chishala, Chaisson, Richard E, Chakrabarti, Arunaloke, Chandler, Clare, Chandy, Sujith John, Charani, Esmita, Chen, Lisa, Chiara, Francesca, Chowdhary, Anuradha, Chua, Arlene, Chuki, Pem, Chun, Doo Ryeon, Churchyard, Gavin, Cirillo, Daniela, Clack, Lauren, Coffin, Susan E, Cohn, Jennifer, Cole, Michelle, Conly, John, Cooper, Ben, Corso, Alejandra, Cosgrove, Sara E, Cox, Helen, Daley, Charles L, Darboe, Saffiatou, Darton, Tom, Davies, Gerry, de Egea, Viviana, Dedeić-Ljubović, Amela, Deeves, Miranda, Denkinger, Claudia, Dillon, Jo-Anne R, Dramowski, Angela, Eley, Brian, Roberta Esposito, Susanna Maria, Essack, Sabiha Y, Farida, Helmia, Farooqi, Joveria, Feasey, Nicholas, Ferreyra, Cecilia, Fifer, Helen, Finlayson, Heather, Frick, Mike, Gales, Ana Cristina, Galli, Luisa, Gandra, Sumanth, Gerber, Jeffrey S, Giske, Christian, Gordon, Bruce, Govender, Nelesh, Guessennd, Nathalie, Guindo, Ibrehima, Gurbanova, Elmira, Gwee, Amanda, Hagen, Ferry, Harbarth, Stephan, Haze, John, Heim, Jutta, Hendriksen, Rene, Heyderman, Robert Simon, Holt, Kathryn Elizabeth, Hönigl, Martin, Hook, Edward W, Hope, William, Hopkins, Heidi, Hughes, Gwenda, Ismail, Ghada, Issack, Mohammad Iqbal, Jacobs, Jan, Jasovský, Dušan, Jehan, Fyeza, Pearson, Antonieta Jimenez, Jones, Makoto, Joshi, Mohan P, Kapil, Arti, Kariuki, Samuel, Karkey, Abhilasha, Kearns, Gregory L, Keddy, Karen Helena, Khanna, Nina, Kitamura, Akiko, Kolho, Kaija-Leena, Kontoyiannis, Dimitrios P, Kotwani, Anita, Kozlov, Roman S, Kranzer, Katharina, Kularatne, Ranmini, Lahra, Monica M, Langford, Bradley J, Laniado-Laborin, Rafael, Larsson, Joakim, Lass-Flörl, Cornelia, Le Doare, Kirsty, Lee, Hyukmin, Lessa, Fernanda, Levin, Anna S, Limmathurotsakul, Direk, Lincopan, Nilton, Lo Vecchio, Andrea, Lodha, Rakesh, Loeb, Mark, Longtin, Yves, Lye, David Chien, Mahmud, Asif Mujtaba, Manaia, Célia, Manderson, Lenore, Mareković, Ivana, Marimuthu, Kalisvar, Martin, Irene, Mashe, Tapfumanei, Mei, Zeng, Meis, Jacques F, Lyra Tavares De Melo, Flávio Augusto, Mendelson, Marc, Miranda, Angelica Espinosa, Moore, David, Morel, Chantal, Moremi, Nyambura, Moro, Maria Luisa, Moussy, Francis, Mshana, Stephen, Mueller, Arno, Ndow, Francis J, Nicol, Mark, Nunn, Andrew, Obaro, Stephen, Obiero, Christina W, Okeke, Iruka N, Okomo, Uduak, Okwor, Tochi J, Oladele, Rita, Omulo, Sylvia, Ondoa, Pascale, Ortellado de Canese, Juana Medarda, Ostrosky-Zeichner, Luis, Padoveze, Maria Clara, Pai, Madhukar, Park, Benjamin, Parkhill, Julian, Parry, Christopher M, Peeling, Rosanna, Sobreira Vieira Peixe, Luísa Maria, Perovic, Olga, Pettigrew, Melinda M, Principi, Nicola, Pulcini, Céline, Puspandari, Nelly, Rawson, Timothy, Reddy, Denasha Lavanya, Reddy, Kessendri, Redner, Paulo, Rodríguez Tudela, Juan Luis, Rodríguez-Baño, Jesús, Van Katwyk, Susan Rogers, Roilides, Emmanuel, Rollier, Christine, Rollock, Leslie, Ronat, Jean-Baptiste, Ruppe, Etienne, Sadarangani, Manish, Salisbury, David, Salou, Mounerou, Samison, Luc Hervé, Sanguinetti, Maurizio, Sartelli, Massimo, Schellack, Natalie, Schouten, Jeroen, Schwaber, Mitchell J, Seni, Jeremiah, Senok, Abiola, Shafer, William M, Shakoor, Sadia, Sheppard, Donald, Shin, Jong-Hee, Sia, Sonia, Sievert, Dawn, Singh, Ishwar, Singla, Rupak, Skov, Robert Leo, Soge, Olusegun O, Sprute, Rosanne, Srinivasan, Arjun, Srinivasan, Subasree, Sundsfjord, Arnfinn, Tacconelli, Evelina, Tahseen, Sabira, Tangcharoensathien, Viroj, Tängdén, Thomas, Thursky, Karin, Thwaites, Guy, Tigulini de Souza Peral, Renata, Tong, Deborah, Tootla, Hafsah Deepa, Tsioutis, Constantinos, Turner, Katy M, Turner, Paul, Omar, Shaheed Vally, van de Sande, Wendy WJ, van den Hof, Susan, van Doorn, Rogier, Veeraraghavan, Balaji, Verweij, Paul, Wahyuningsih, Retno, Wang, Hui, Warris, Adilia, Weinstock, Hillard, Wesangula, Evelyn, Whiley, David, White, Peter J, Williams, Phoebe, Xiao, Yonghong, Moscoso, Martin Yagui, Yang, Hsu Li, Yoshida, Sachiyo, Yu, Yunsong, Żabicka, Dorota, Zignol, Matteo, Rudan, Igor, Bertagnolio, Silvia, Dobreva, Zlatina, Centner, Chad M, Olaru, Ioana Diana, Donà, Daniele, Burzo, Stefano, Huttner, Benedikt D, Chaillon, Antoine, Gebreselassie, Nebiat, Wi, Teodora, Hasso-Agopsowicz, Mateusz, Allegranzi, Benedetta, Sati, Hatim, Ivanovska, Verica, Kothari, Kavita U, Balkhy, Hanan H, Cassini, Alessandro, Hamers, Raph L, and Weezenbeek, Kitty Van

Published
2024
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4. WHO global research priorities for sexually transmitted infections

Author

Gottlieb, Sami L, Spielman, Erica, Abu-Raddad, Laith, Aderoba, Adeniyi Kolade, Bachmann, Laura H, Blondeel, Karel, Chen, Xiang-Sheng, Crucitti, Tania, Camacho, Gabriela Garcia, Godbole, Sheela, de Leon, Rodolfo Gómez Ponce, Gupta, Somesh, Hermez, Joumana, Ishikawa, Naoko, Klausner, Jeffrey D, Kurbonov, Firdavs, Maatouk, Ismael, Mandil, Ahmed, Mello, Maeve B, Miranda, Angelica Espinosa, Mosha, Fausta Shakiwa, Okeibunor, Joseph Chukwudi, Ong, Jason J, Peters, Remco P H, Pérez, Freddy, Seguy, Nicole, Seib, Kate L, Sharma, Mukta, Sladden, Tim, Van Der Pol, Barbara, White, Peter J, Wi, Teodora, and Broutet, Nathalie

Published
2024
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5. Antimicrobial Resistance in Neisseria gonorrhoeae

Author

Cristillo, Anthony D, Bristow, Claire C, Torrone, Elizabeth, Dillon, Jo-Anne, Kirkcaldy, Robert D, Dong, Huan, Grad, Yonatan H, Nicholas, Robert A, Rice, Peter A, Lawrence, Kenneth, Oldach, David, Shafer, William Maurice, Zhou, Pei, Wi, Teodora E, Morris, Sheldon R, and Klausner, Jeffrey D

Subjects
Medical Microbiology, Biomedical and Clinical Sciences, Clinical Sciences, Immunization, Biodefense, Vaccine Related, Prevention, Antimicrobial Resistance, Urologic Diseases, Sexually Transmitted Infections, Biotechnology, Infectious Diseases, Infection, Good Health and Well Being, Anti-Bacterial Agents, Antimicrobial Stewardship, Bacterial Vaccines, Barbiturates, Drug Resistance, Multiple, Bacterial, Epidemiological Monitoring, Gonorrhea, Group Processes, Humans, Isoxazoles, Macrolides, Microbial Sensitivity Tests, Morpholines, Mutation, Neisseria gonorrhoeae, Oxazolidinones, Public Health, Sexually Transmitted Diseases, Spiro Compounds, Topoisomerase Inhibitors, Triazoles, World Health Organization, Biological Sciences, Medical and Health Sciences, Clinical sciences, Epidemiology, Public health
Abstract

The goal of the Sexually Transmitted Infection Clinical Trial Group's Antimicrobial Resistance (AMR) in Neisseria gonorrhoeae (NG) meeting was to assemble experts from academia, government, nonprofit and industry to discuss the current state of research, gaps and challenges in research and technology and priorities and new directions to address the continued emergence of multidrug-resistant NG infections. Topics discussed at the meeting, which will be the focus of this article, include AMR NG global surveillance initiatives, the use of whole genome sequencing and bioinformatics to understand mutations associated with AMR, mechanisms of AMR, and novel antibiotics, vaccines and other methods to treat AMR NG. Key points highlighted during the meeting include: (i) US and International surveillance programs to understand AMR in NG; (ii) the US National Strategy for combating antimicrobial-resistant bacteria; (iii) surveillance needs, challenges, and novel technologies; (iv) plasmid-mediated and chromosomally mediated mechanisms of AMR in NG; (v) novel therapeutic (eg, sialic acid analogs, factor H [FH]/Fc fusion molecule, monoclonal antibodies, topoisomerase inhibitors, fluoroketolides, LpxC inhibitors) and preventative (eg, peptide mimic) strategies to combat infection. The way forward will require renewed political will, new funding initiatives, and collaborations across academic and commercial research and public health programs.

Published
2019

8. US Food and Drug Administration, Centers for Disease Control and Prevention, and National Institutes of Health Co-Sponsored Public Workshop Summary-Development Considerations of Antimicrobial Drugs for the Treatment of Gonorrhea

Author

Hiruy, Hiwot, Bala, Shukal, Byrne, James M., Roche, Kerian Grande, Jang, Seong H., Kim, Peter, Nambiar, Sumathi, Rubin, Dan, Yasinskaya, Yuliya, Bachmann, Laura H., Bernstein, Kyle, Botgros, Radu, Cammarata, Sue, Chaves, Ricardo L., Deal, Carolyn D., Drusano, George L., Duffy, Erin M., Eakin, Ann E., Gelone, Steve, Hiltke, Thomas, Hook Iii, Edward W., Jerse, Ann E., McNeil, Candice J., Newman, Lori, O'Brien, Seamus, Perry, Caroline, Reno, Hilary E. L., Romaguera, Raul A., Sato, Junko, Unemo, Magnus, Wi, Teodora E. C., Workowski, Kimberly, O'May, Graeme A., Shukla, Sunita J., Farley, John J., Hiruy, Hiwot, Bala, Shukal, Byrne, James M., Roche, Kerian Grande, Jang, Seong H., Kim, Peter, Nambiar, Sumathi, Rubin, Dan, Yasinskaya, Yuliya, Bachmann, Laura H., Bernstein, Kyle, Botgros, Radu, Cammarata, Sue, Chaves, Ricardo L., Deal, Carolyn D., Drusano, George L., Duffy, Erin M., Eakin, Ann E., Gelone, Steve, Hiltke, Thomas, Hook Iii, Edward W., Jerse, Ann E., McNeil, Candice J., Newman, Lori, O'Brien, Seamus, Perry, Caroline, Reno, Hilary E. L., Romaguera, Raul A., Sato, Junko, Unemo, Magnus, Wi, Teodora E. C., Workowski, Kimberly, O'May, Graeme A., Shukla, Sunita J., and Farley, John J.

Abstract

There is an unmet need for developing drugs for the treatment of gonorrhea, due to rapidly evolving resistance of Neisseria gonorrhoeae against antimicrobial drugs used for empiric therapy, an increase in globally reported multidrug resistant cases, and the limited available therapeutic options. Furthermore, few drugs are under development. Development of antimicrobials is hampered by challenges in clinical trial design, limitations of available diagnostics, changes in and varying standards of care, lack of robust animal models, and clinically relevant pharmacodynamic targets. On April 23, 2021, the U.S. Food and Drug Administration; Centers for Disease Control and Prevention; and National Institute of Allergy and Infectious Diseases, National Institutes of Health co-sponsored a workshop with stakeholders from academia, industry, and regulatory agencies to discuss the challenges and strategies, including potential collaborations and incentives, to facilitate the development of drugs for the treatment of gonorrhea. This article provides a summary of the workshop., This workshop was supported by the Center for Drug Evaluation and Research, US Food and Drug Administration. Research on Debio 1453 reported in this article is supported by CARB-X. CARB-X’s funding for this project is provided in part by federal funds from the US Department of Health and Human Services, Administration for Strategic Preparedness and Response, Biomedical Advanced Research and Development Authority (agreement 75A50122C00028). It is also supported by awards from the Wellcome Trust (WT224842) and the Federal Ministry of Education and Research (BMBF) of the Federal Republic of Germany.

Published
2024
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9. WHO global research priorities for antimicrobial resistance in human health

Author

Bertagnolio, Silvia, Dobreva, Zlatina, Centner, Chad M, Olaru, Ioana Diana, Donà, Daniele, Burzo, Stefano, Huttner, Benedikt D, Chaillon, Antoine, Gebreselassie, Nebiat, Wi, Teodora, Hasso-Agopsowicz, Mateusz, Allegranzi, Benedetta, Sati, Hatim, Ivanovska, Verica, Kothari, Kavita U, Balkhy, Hanan H, Cassini, Alessandro, Hamers, Raph L, Weezenbeek, Kitty Van, Aanensen, David, Alanio, Alexandre, Alastruey-Izquierdo, Ana, Alemayehu, Tinsae, Al-Hasan, Majdi, Allegaert, Karel, Al-Maani, Amal Saif, Al-Salman, Jameela, Alshukairi, Abeer Nizar, Amir, Afreenish, Applegate, Tanya, Araj, George F, Villalobos, Marlen Arce, Årdal, Christine, Ashiru-Oredope, Diane, Ashley, Elizabeth A, Babin, François-Xavier, Bachmann, Laura H, Bachmann, Till, Baker, Kate Susan, Balasegaram, Manica, Bamford, Colleen, Baquero, Fernando, Barcelona, Laura Isabel, Bassat, Quique, Bassetti, Matteo, Basu, Sulagna, Beardsley, Justin, Vásquez, Grey Benoit, Berkley, James A, Bhatnagar, Anuj K, Bielicki, Julia, Bines, Julie, Bongomin, Felix, Bonomo, Robert A, Bradley, John S, Bradshaw, Catriona, Brett, Ana, Brink, Adrian, Brown, Colin, Brown, Jeremy, Buising, Kirsty, Carson, Carolee, Carvalho, Anna Cristina, Castagnola, Elio, Cavaleri, Marco, Cecchini, Michele, Chabala, Chishala, Chaisson, Richard E, Chakrabarti, Arunaloke, Chandler, Clare, Chandy, Sujith John, Charani, Esmita, Chen, Lisa, Chiara, Francesca, Chowdhary, Anuradha, Chua, Arlene, Chuki, Pem, Chun, Doo Ryeon, Churchyard, Gavin, Cirillo, Daniela, Clack, Lauren, Coffin, Susan E, Cohn, Jennifer, Cole, Michelle, Conly, John, Cooper, Ben, Corso, Alejandra, Cosgrove, Sara E, Cox, Helen, Daley, Charles L, Darboe, Saffiatou, Darton, Tom, Davies, Gerry, de Egea, Viviana, Dedeić-Ljubović, Amela, Deeves, Miranda, Denkinger, Claudia, Dillon, Jo-Anne R, Dramowski, Angela, Eley, Brian, Roberta Esposito, Susanna Maria, Essack, Sabiha Y, Farida, Helmia, Farooqi, Joveria, Feasey, Nicholas, Ferreyra, Cecilia, Fifer, Helen, Finlayson, Heather, Frick, Mike, Gales, Ana Cristina, Galli, Luisa, Gandra, Sumanth, Gerber, Jeffrey S, Giske, Christian, Gordon, Bruce, Govender, Nelesh, Guessennd, Nathalie, Guindo, Ibrehima, Gurbanova, Elmira, Gwee, Amanda, Hagen, Ferry, Harbarth, Stephan, Haze, John, Heim, Jutta, Hendriksen, Rene, Heyderman, Robert Simon, Holt, Kathryn Elizabeth, Hönigl, Martin, Hook, Edward W, Hope, William, Hopkins, Heidi, Hughes, Gwenda, Ismail, Ghada, Issack, Mohammad Iqbal, Jacobs, Jan, Jasovský, Dušan, Jehan, Fyeza, Pearson, Antonieta Jimenez, Jones, Makoto, Joshi, Mohan P, Kapil, Arti, Kariuki, Samuel, Karkey, Abhilasha, Kearns, Gregory L, Keddy, Karen Helena, Khanna, Nina, Kitamura, Akiko, Kolho, Kaija-Leena, Kontoyiannis, Dimitrios P, Kotwani, Anita, Kozlov, Roman S, Kranzer, Katharina, Kularatne, Ranmini, Lahra, Monica M, Langford, Bradley J, Laniado-Laborin, Rafael, Larsson, Joakim, Lass-Flörl, Cornelia, Le Doare, Kirsty, Lee, Hyukmin, Lessa, Fernanda, Levin, Anna S, Limmathurotsakul, Direk, Lincopan, Nilton, Lo Vecchio, Andrea, Lodha, Rakesh, Loeb, Mark, Longtin, Yves, Lye, David Chien, Mahmud, Asif Mujtaba, Manaia, Célia, Manderson, Lenore, Mareković, Ivana, Marimuthu, Kalisvar, Martin, Irene, Mashe, Tapfumanei, Mei, Zeng, Meis, Jacques F, Lyra Tavares De Melo, Flávio Augusto, Mendelson, Marc, Miranda, Angelica Espinosa, Moore, David, Morel, Chantal, Moremi, Nyambura, Moro, Maria Luisa, Moussy, Francis, Mshana, Stephen, Mueller, Arno, Ndow, Francis J, Nicol, Mark, Nunn, Andrew, Obaro, Stephen, Obiero, Christina W, Okeke, Iruka N, Okomo, Uduak, Okwor, Tochi J, Oladele, Rita, Omulo, Sylvia, Ondoa, Pascale, Ortellado de Canese, Juana Medarda, Ostrosky-Zeichner, Luis, Padoveze, Maria Clara, Pai, Madhukar, Park, Benjamin, Parkhill, Julian, Parry, Christopher M, Peeling, Rosanna, Sobreira Vieira Peixe, Luísa Maria, Perovic, Olga, Pettigrew, Melinda M, Principi, Nicola, Pulcini, Céline, Puspandari, Nelly, Rawson, Timothy, Reddy, Denasha Lavanya, Reddy, Kessendri, Redner, Paulo, Rodríguez Tudela, Juan Luis, Rodríguez-Baño, Jesús, Van Katwyk, Susan Rogers, Roilides, Emmanuel, Rollier, Christine, Rollock, Leslie, Ronat, Jean-Baptiste, Ruppe, Etienne, Sadarangani, Manish, Salisbury, David, Salou, Mounerou, Samison, Luc Hervé, Sanguinetti, Maurizio, Sartelli, Massimo, Schellack, Natalie, Schouten, Jeroen, Schwaber, Mitchell J, Seni, Jeremiah, Senok, Abiola, Shafer, William M, Shakoor, Sadia, Sheppard, Donald, Shin, Jong-Hee, Sia, Sonia, Sievert, Dawn, Singh, Ishwar, Singla, Rupak, Skov, Robert Leo, Soge, Olusegun O, Sprute, Rosanne, Srinivasan, Arjun, Srinivasan, Subasree, Sundsfjord, Arnfinn, Tacconelli, Evelina, Tahseen, Sabira, Tangcharoensathien, Viroj, Tängdén, Thomas, Thursky, Karin, Thwaites, Guy, Tigulini de Souza Peral, Renata, Tong, Deborah, Tootla, Hafsah Deepa, Tsioutis, Constantinos, Turner, Katy M, Turner, Paul, Omar, Shaheed Vally, van de Sande, Wendy WJ, van den Hof, Susan, van Doorn, Rogier, Veeraraghavan, Balaji, Verweij, Paul, Wahyuningsih, Retno, Wang, Hui, Warris, Adilia, Weinstock, Hillard, Wesangula, Evelyn, Whiley, David, White, Peter J, Williams, Phoebe, Xiao, Yonghong, Moscoso, Martin Yagui, Yang, Hsu Li, Yoshida, Sachiyo, Yu, Yunsong, Żabicka, Dorota, Zignol, Matteo, Bertagnolio, Silvia, Dobreva, Zlatina, Centner, Chad M, Olaru, Ioana Diana, Donà, Daniele, Burzo, Stefano, Huttner, Benedikt D, Chaillon, Antoine, Gebreselassie, Nebiat, Wi, Teodora, Hasso-Agopsowicz, Mateusz, Allegranzi, Benedetta, Sati, Hatim, Ivanovska, Verica, Kothari, Kavita U, Balkhy, Hanan H, Cassini, Alessandro, Hamers, Raph L, Weezenbeek, Kitty Van, Aanensen, David, Alanio, Alexandre, Alastruey-Izquierdo, Ana, Alemayehu, Tinsae, Al-Hasan, Majdi, Allegaert, Karel, Al-Maani, Amal Saif, Al-Salman, Jameela, Alshukairi, Abeer Nizar, Amir, Afreenish, Applegate, Tanya, Araj, George F, Villalobos, Marlen Arce, Årdal, Christine, Ashiru-Oredope, Diane, Ashley, Elizabeth A, Babin, François-Xavier, Bachmann, Laura H, Bachmann, Till, Baker, Kate Susan, Balasegaram, Manica, Bamford, Colleen, Baquero, Fernando, Barcelona, Laura Isabel, Bassat, Quique, Bassetti, Matteo, Basu, Sulagna, Beardsley, Justin, Vásquez, Grey Benoit, Berkley, James A, Bhatnagar, Anuj K, Bielicki, Julia, Bines, Julie, Bongomin, Felix, Bonomo, Robert A, Bradley, John S, Bradshaw, Catriona, Brett, Ana, Brink, Adrian, Brown, Colin, Brown, Jeremy, Buising, Kirsty, Carson, Carolee, Carvalho, Anna Cristina, Castagnola, Elio, Cavaleri, Marco, Cecchini, Michele, Chabala, Chishala, Chaisson, Richard E, Chakrabarti, Arunaloke, Chandler, Clare, Chandy, Sujith John, Charani, Esmita, Chen, Lisa, Chiara, Francesca, Chowdhary, Anuradha, Chua, Arlene, Chuki, Pem, Chun, Doo Ryeon, Churchyard, Gavin, Cirillo, Daniela, Clack, Lauren, Coffin, Susan E, Cohn, Jennifer, Cole, Michelle, Conly, John, Cooper, Ben, Corso, Alejandra, Cosgrove, Sara E, Cox, Helen, Daley, Charles L, Darboe, Saffiatou, Darton, Tom, Davies, Gerry, de Egea, Viviana, Dedeić-Ljubović, Amela, Deeves, Miranda, Denkinger, Claudia, Dillon, Jo-Anne R, Dramowski, Angela, Eley, Brian, Roberta Esposito, Susanna Maria, Essack, Sabiha Y, Farida, Helmia, Farooqi, Joveria, Feasey, Nicholas, Ferreyra, Cecilia, Fifer, Helen, Finlayson, Heather, Frick, Mike, Gales, Ana Cristina, Galli, Luisa, Gandra, Sumanth, Gerber, Jeffrey S, Giske, Christian, Gordon, Bruce, Govender, Nelesh, Guessennd, Nathalie, Guindo, Ibrehima, Gurbanova, Elmira, Gwee, Amanda, Hagen, Ferry, Harbarth, Stephan, Haze, John, Heim, Jutta, Hendriksen, Rene, Heyderman, Robert Simon, Holt, Kathryn Elizabeth, Hönigl, Martin, Hook, Edward W, Hope, William, Hopkins, Heidi, Hughes, Gwenda, Ismail, Ghada, Issack, Mohammad Iqbal, Jacobs, Jan, Jasovský, Dušan, Jehan, Fyeza, Pearson, Antonieta Jimenez, Jones, Makoto, Joshi, Mohan P, Kapil, Arti, Kariuki, Samuel, Karkey, Abhilasha, Kearns, Gregory L, Keddy, Karen Helena, Khanna, Nina, Kitamura, Akiko, Kolho, Kaija-Leena, Kontoyiannis, Dimitrios P, Kotwani, Anita, Kozlov, Roman S, Kranzer, Katharina, Kularatne, Ranmini, Lahra, Monica M, Langford, Bradley J, Laniado-Laborin, Rafael, Larsson, Joakim, Lass-Flörl, Cornelia, Le Doare, Kirsty, Lee, Hyukmin, Lessa, Fernanda, Levin, Anna S, Limmathurotsakul, Direk, Lincopan, Nilton, Lo Vecchio, Andrea, Lodha, Rakesh, Loeb, Mark, Longtin, Yves, Lye, David Chien, Mahmud, Asif Mujtaba, Manaia, Célia, Manderson, Lenore, Mareković, Ivana, Marimuthu, Kalisvar, Martin, Irene, Mashe, Tapfumanei, Mei, Zeng, Meis, Jacques F, Lyra Tavares De Melo, Flávio Augusto, Mendelson, Marc, Miranda, Angelica Espinosa, Moore, David, Morel, Chantal, Moremi, Nyambura, Moro, Maria Luisa, Moussy, Francis, Mshana, Stephen, Mueller, Arno, Ndow, Francis J, Nicol, Mark, Nunn, Andrew, Obaro, Stephen, Obiero, Christina W, Okeke, Iruka N, Okomo, Uduak, Okwor, Tochi J, Oladele, Rita, Omulo, Sylvia, Ondoa, Pascale, Ortellado de Canese, Juana Medarda, Ostrosky-Zeichner, Luis, Padoveze, Maria Clara, Pai, Madhukar, Park, Benjamin, Parkhill, Julian, Parry, Christopher M, Peeling, Rosanna, Sobreira Vieira Peixe, Luísa Maria, Perovic, Olga, Pettigrew, Melinda M, Principi, Nicola, Pulcini, Céline, Puspandari, Nelly, Rawson, Timothy, Reddy, Denasha Lavanya, Reddy, Kessendri, Redner, Paulo, Rodríguez Tudela, Juan Luis, Rodríguez-Baño, Jesús, Van Katwyk, Susan Rogers, Roilides, Emmanuel, Rollier, Christine, Rollock, Leslie, Ronat, Jean-Baptiste, Ruppe, Etienne, Sadarangani, Manish, Salisbury, David, Salou, Mounerou, Samison, Luc Hervé, Sanguinetti, Maurizio, Sartelli, Massimo, Schellack, Natalie, Schouten, Jeroen, Schwaber, Mitchell J, Seni, Jeremiah, Senok, Abiola, Shafer, William M, Shakoor, Sadia, Sheppard, Donald, Shin, Jong-Hee, Sia, Sonia, Sievert, Dawn, Singh, Ishwar, Singla, Rupak, Skov, Robert Leo, Soge, Olusegun O, Sprute, Rosanne, Srinivasan, Arjun, Srinivasan, Subasree, Sundsfjord, Arnfinn, Tacconelli, Evelina, Tahseen, Sabira, Tangcharoensathien, Viroj, Tängdén, Thomas, Thursky, Karin, Thwaites, Guy, Tigulini de Souza Peral, Renata, Tong, Deborah, Tootla, Hafsah Deepa, Tsioutis, Constantinos, Turner, Katy M, Turner, Paul, Omar, Shaheed Vally, van de Sande, Wendy WJ, van den Hof, Susan, van Doorn, Rogier, Veeraraghavan, Balaji, Verweij, Paul, Wahyuningsih, Retno, Wang, Hui, Warris, Adilia, Weinstock, Hillard, Wesangula, Evelyn, Whiley, David, White, Peter J, Williams, Phoebe, Xiao, Yonghong, Moscoso, Martin Yagui, Yang, Hsu Li, Yoshida, Sachiyo, Yu, Yunsong, Żabicka, Dorota, and Zignol, Matteo

Abstract

The WHO research agenda for antimicrobial resistance (AMR) in human health has identified 40 research priorities to be addressed by the year 2030. These priorities focus on bacterial and fungal pathogens of crucial importance in addressing AMR, including drug-resistant pathogens causing tuberculosis. These research priorities encompass the entire people-centred journey, covering prevention, diagnosis, and treatment of antimicrobial-resistant infections, in addition to addressing the overarching knowledge gaps in AMR epidemiology, burden and drivers, policies and regulations, and awareness and education. The research priorities were identified through a multistage process, starting with a comprehensive scoping review of knowledge gaps, with expert inputs gathered through a survey and open call. The priority setting involved a rigorous modified Child Health and Nutrition Research Initiative approach, ensuring global representation and applicability of the findings. The ultimate goal of this research agenda is to encourage research and investment in the generation of evidence to better understand AMR dynamics and facilitate policy translation for reducing the burden and consequences of AMR.

Published
2024

10. Vaccine value profile for Neisseria gonorrhoeae

Author

Lyu, Yiming, Choong, Annabelle, Chow, Eric P. F., Seib, Kate L., Marshall, Helen S., Unemo, Magnus, de Voux, Alex, Wang, Bing, Miranda, Angelica E., Gottlieb, Sami L., Mello, Maeve B., Wi, Teodora, Baggaley, Rachel, Marshall, Caroline, Abu-Raddad, Laith J., Abara, Winston E., Chen, Xiang-Sheng, Ong, Jason J., Lyu, Yiming, Choong, Annabelle, Chow, Eric P. F., Seib, Kate L., Marshall, Helen S., Unemo, Magnus, de Voux, Alex, Wang, Bing, Miranda, Angelica E., Gottlieb, Sami L., Mello, Maeve B., Wi, Teodora, Baggaley, Rachel, Marshall, Caroline, Abu-Raddad, Laith J., Abara, Winston E., Chen, Xiang-Sheng, and Ong, Jason J.

Abstract

Neisseria gonorrhoeae infection (gonorrhoea) is a global public health challenge, causing substantial sexual and reproductive health consequences, such as infertility, pregnancy complications and increased acquisition or transmission of HIV. There is an urgency to controlling gonorrhoea because of increasing antimicrobial resistance to ceftriaxone, the last remaining treatment option, and the potential for gonorrhoea to become untreatable. No licensed gonococcal vaccine is available. Mounting observational evidence suggests that N. meningitidis serogroup B outer membrane vesicle-based vaccines may induce cross-protection against N. gonorrhoeae (estimated 30%-40% effectiveness using the 4CMenB vaccine). Clinical trials to determine the efficacy of the 4CMenB vaccine against N. gonorrhoeae are underway, as are Phase 1/2 studies of a new gonococcal-specific vaccine candidate. Ultimately, a gonococcal vaccine must be accessible, affordable and equitably dispensed, given that those most affected by gonorrhoea are also those who may be most disadvantaged in our societies, and most cases are in less-resourced settings. This vaccine value profile (VVP) provides a high level, holistic assessment of the current data to inform the potential public health, economic and societal value of pipeline vaccines. This was developed by a working group of subject matter experts from academia, non-profit organizations, public private partnerships and multi-lateral organizations. All contributors have extensive expertise on various elements of the N. gonorrhoeae VVP and collectively aimed to identify current research and knowledge gaps. The VVP was developed using published data obtained from peer-reviewed journals or reports., Funding Agencies:World Health OrganizationBill & Melinda Gates Foundation, Seattle, WA

Published
2024
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11. The novel 2024 WHO Neisseria gonorrhoeae reference strains for global quality assurance of laboratory investigations and superseded WHO N. gonorrhoeae reference strains-phenotypic, genetic and reference genome characterization

Author

Unemo, Magnus, Sánchez-Busó, Leonor, Golparian, Daniel, Jacobsson, Susanne, Shimuta, Ken, Lan, Pham Thi, Eyre, David W., Cole, Michelle, Maatouk, Ismael, Wi, Teodora, Lahra, Monica M., Unemo, Magnus, Sánchez-Busó, Leonor, Golparian, Daniel, Jacobsson, Susanne, Shimuta, Ken, Lan, Pham Thi, Eyre, David W., Cole, Michelle, Maatouk, Ismael, Wi, Teodora, and Lahra, Monica M.

Abstract

OBJECTIVES: MDR and XDR Neisseria gonorrhoeae strains remain major public health concerns internationally, and quality-assured global gonococcal antimicrobial resistance (AMR) surveillance is imperative. The WHO global Gonococcal Antimicrobial Surveillance Programme (GASP) and WHO Enhanced GASP (EGASP), including metadata and WGS, are expanding internationally. We present the phenotypic, genetic and reference genome characteristics of the 2024 WHO gonococcal reference strains (n = 15) for quality assurance worldwide. All superseded WHO gonococcal reference strains (n = 14) were identically characterized. MATERIAL AND METHODS: The 2024 WHO reference strains include 11 of the 2016 WHO reference strains, which were further characterized, and four novel strains. The superseded WHO reference strains include 11 WHO reference strains previously unpublished. All strains were characterized phenotypically and genomically (single-molecule PacBio or Oxford Nanopore and Illumina sequencing). RESULTS: The 2024 WHO reference strains represent all available susceptible and resistant phenotypes and genotypes for antimicrobials currently and previously used (n = 22), or considered for future use (n = 3) in gonorrhoea treatment. The novel WHO strains include internationally spreading ceftriaxone resistance, ceftriaxone resistance due to new penA mutations, ceftriaxone plus high-level azithromycin resistance and azithromycin resistance due to mosaic MtrRCDE efflux pump. AMR, serogroup, prolyliminopeptidase, genetic AMR determinants, plasmid types, molecular epidemiological types and reference genome characteristics are presented for all strains. CONCLUSIONS: The 2024 WHO gonococcal reference strains are recommended for internal and external quality assurance in laboratory examinations, especially in the WHO GASP, EGASP and other GASPs, but also in phenotypic and molecular diagnostics, AMR prediction, pharmacodynamics, epidemiology, research and as complete reference genomes in WGS anal, This study was supported by grants from the Department of the Global HIV, Hepatitis and STI programmes, WHO, Geneva, Switzerland; Örebro County Council Research Committee, Örebro, Sweden and Foundation for Medical Research at Örebro University Hospital, Sweden.

Published
2024
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12. Prevention of sexual transmission of mpox: a systematic review and qualitative evidence synthesis of approaches.

Author

Paparini, Sara, Whelan, Isabelle, Mwendera, Chikondi, Hayes, Rosalie, Maatouk, Ismael, Lewis, Rosamund, Prochazka Nunez, Mateo, Mozalevskis, Antons, Wi, Teodora, and Orkin, Chloe

Subjects
MONKEYPOX, HUMAN sexuality, VACCINATION
Abstract

The ongoing multi-country mpox outbreak in previously unaffected countries is primarily affecting sexual networks of men who have sex with men. Evidence is needed on the effectiveness of recommended preventive interventions. To inform WHO guidelines, a systematic review and qualitative evidence synthesis were conducted on mpox preventive behavioural interventions to reduce: (i) sexual acquisition; (ii) onward sexual transmission from confirmed/probable cases; and (iii) utility of asymptomatic testing. Medline, EMBASE, PubMed, Cochrane and WHO trial databases, grey literature and conferences were searched for English-language primary research published since 1 January 2022. A reviewer team performed screening, data extraction and bias assessment. A qualitative thematic synthesis explored views and experiences of engagement in prevention in individuals at increased risk. There were 16 studies: 1 on contact-tracing, 2 on sexual behaviour, and 13 on asymptomatic testing. Although MPXV was detected in varying proportions of samples (0.17%–6.5%), the testing studies provide insufficient evidence to fully evaluate this strategy. For the qualitative evidence synthesis, four studies evaluated the experiences of most affected communities. Preferences about preventive interventions were shaped by: mpox information; the diversity of sexual practices; accessibility and quality of mpox testing and care; and perceived cost to wellbeing. Evidence on the effectiveness of interventions to prevent the sexual transmission of mpox remains scarce. Limited qualitative evidence on values and preferences provides insight into factors influencing intervention acceptability. Given global and local inequities in access to vaccines and treatment, further research is needed to establish the effectiveness of additional interventions. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Missed opportunities for sexually transmitted infections testing for HIV pre-exposure prophylaxis users: a systematic review

Author

Ong, Jason J., Fu, Hongyun, Baggaley, Rachel C., Wi, Teodora E., Tucker, Joseph D., Smith, M. Kumi, Rafael, Sabrina, Falconer, Jane, Terris-Prestholt, Fern, Mameletzis, Ioannis, and Mayaud, Phillipe

Subjects
Medical tests -- Statistics, Sexually transmitted diseases -- Diagnosis -- Risk factors -- Statistics, HIV infection -- Risk factors -- Diagnosis -- Statistics -- Prevention, Health
Abstract

Introduction: Given the synergistic relationship between HIV and sexually transmitted infections (STI), the integration of services has the potential to reduce the incidence of both HIV and STIs. We explored the extent to which STI testing has been offered within HIV pre-exposure prophylaxis (PrEP) programmes worldwide. Methods: We conducted a systematic review of PrEP programmes implementing STI testing services in nine databases. We approached PrEP implementers for additional unpublished data and implementation details. Descriptive statistics were used to present the characteristics of STI testing within PrEP programmes. Content analysis of the input from PrEP implementers was conducted to summarize the barriers to and facilitators of STI testing. Results: Of 9,161 citations, 91 studies conducted in 32 countries were included: 69% from high-income countries (HICs) and 64% from programmes targeting men who have sex with men (MSM) and transgender women (TGW) only. The majority of programmes (70%, 64/91) conducted STI testing before the initiation of PrEP. The most common STIs tested were gonorrhoea (86%, 78/91), chlamydia (84%, 76/91) and syphilis (84%, 76/91).The majority provided STI testing at three-month intervals (70%, 53/76, for syphilis; 70% 53/78, for chlamydia; 68%, 53/78, for gonorrhoea). Relative to low- and middle-income countries (LMICs), a higher proportion of PrEP programmes in HICs offered testing for gonorrhoea (92% vs. 71%, p < 0.05), chlamydia (92% vs. 64%, p < 0.01), syphilis (87% vs. 75%, p < 0.05), hepatitis A (18% vs. 4%, p < 0.05) and hepatitis C (43% vs. 21%, p < 0.05); offered testing for a higher number of STIs (mean 3.75 vs. 3.04, p < 0.05); and offered triple (throat, genital/urine and anorectal) anatomical site screening (54% vs. 18%, p < 0.001). Common implementation challenges included costs, access to STI diagnostics, programme logistics of integrating STI testing into PrEP delivery models and lack of capacity building for staff involved in PrEP provision. Conclusions: Significant gaps and challenges remain in the provision of STI testing services within HIV PrEP programmes. We recommend more active integration of STI testing and management into PrEP programmes, supported by standardized practice guidelines, staff capacity building training and adequate funding. This could lead to improved sexual health and HIV outcomes in key populations. Keywords: sexually transmitted infections; HIV; pre-exposure prophylaxis; sexual health; STI testing; systematic review, 1 | INTRODUCTION Pre-exposure prophylaxis (PrEP) is a safe and effective approach to prevent HIV infection when adherence is high [1-4]. PrEP was first approved for use as an HIV [...]

Published
2021
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15. Strengthening a collaborative approach to implementing surveillance systems: Lessons from the Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) in Malawi and Zimbabwe

Author

Vumbugwa, Phiona, primary, Maatouk, Ismael, additional, Machiha, Anna, additional, Matoga, Mitch, additional, Mitambo, Collins, additional, Nyirenda, Rose, additional, Nyasulu, Ishmael, additional, Mugabe, Muchaneta, additional, Ngwenya, Mkhokheli, additional, Mundade, Yamuna, additional, Wi, Teodora, additional, Unemo, Magnus, additional, and Soge, Olusegun O., additional

Published
2024
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16. A community-driven resource for genomic epidemiology and antimicrobial resistance prediction of Neisseria gonorrhoeae at Pathogenwatch

Author

Sánchez-Busó, Leonor, Yeats, Corin A., Taylor, Benjamin, Goater, Richard J., Underwood, Anthony, Abudahab, Khalil, Argimón, Silvia, Ma, Kevin C., Mortimer, Tatum D., Golparian, Daniel, Cole, Michelle J., Grad, Yonatan H., Martin, Irene, Raphael, Brian H., Shafer, William M., Town, Katy, Wi, Teodora, Harris, Simon R., Unemo, Magnus, and Aanensen, David M.

Published
2021
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19. Securing the supply of benzathine penicillin: a global perspective on risks and mitigation strategies to prevent future shortages.

Author

Seghers, Frederic, Taylor, Melanie M, Storey, Andrew, Dong, Jicui, Wi, Teodora C, Wyber, Rosemary, Ralston, Kate, and Nguimfack, Boniface Dongmo

Subjects
RHEUMATIC heart disease, RHEUMATIC fever, PENICILLIN, STREPTOCOCCAL diseases, SCARCITY
Abstract

Benzathine benzylpenicillin is a globally indispensable medicine. As a long-lasting injectable penicillin, it serves as the primary treatment for syphilis, group A streptococcal infections, rheumatic fever and rheumatic heart disease. A competitive market and low profit margins, compounded by limited visibility of demand, have resulted in a decreased number of active pharmaceutical ingredient (API) manufacturers. By 2016, only three Chinese API manufacturers remained, continuing to supply to the global market today. Recurring global shortages, a consequence of supply and demand imbalances, indicate underlying market risks. Therefore, the need for mitigation strategies is imperative. [ABSTRACT FROM AUTHOR]

Published
2024
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20. Vaccine value profile for Neisseria gonorrhoeae

Author

Lyu, Yiming, primary, Choong, Annabelle, additional, Chow, Eric P.F., additional, Seib, Kate L., additional, Marshall, Helen S., additional, Unemo, Magnus, additional, de Voux, Alex, additional, Wang, Bing, additional, Miranda, Angelica E., additional, Gottlieb, Sami L., additional, Mello, Maeve B., additional, Wi, Teodora, additional, Baggaley, Rachel, additional, Marshall, Caroline, additional, Abu-Raddad, Laith J., additional, Abara, Winston E., additional, Chen, Xiang-Sheng, additional, and Ong, Jason J., additional

Published
2023
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22. The WHO Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) identifies high levels of ceftriaxone resistance across Vietnam, 2023

Author

Doanh, Le Huu, Lan, Pham Thi, Hoa, Pham Quynh, Hoa, Pham Dieu, Minh Phuong, Pham Thi, Trang, Trinh Minh, Dieu Van, Thai Thi, Nam, Pham Trieu, Ha Vinh, Nguyen Thi, Ha Giang, Quach Thi, Tung, Vu Thanh, Tuan, Nguyen Doan, Nguyen, Hao Trong, Phan Nguyen, Thuy Thi, Phuong Vu, Thao Thi, Thanh Nguyen, Phuong Thi, Duong, Bao Hac, Van Loi Doan, Em, Thuy Nguyen, Dung Thi, Le, Khanh Tuan, Bui, Tan Minh, Pham, Nguyen Nhat, Kieu Nguyen, Trang Thi, Thanh Phan, Trang Thi, Quynh Dang, Anh Duy, Thuy Van, Nguyen Thi, Khoa, Nguyen Trong, Lahra, Monica, McDonald, Robert, Kreisel, Kristen, Maatouk, Ismael, Wi, Teodora, Golparian, Daniel, Schröder, Daniel, Jacobsson, Susanne, and Unemo, Magnus

Published
2024
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27. Neisseria gonorrhoeae antimicrobial susceptibility trends in Bangkok, Thailand, 2015-21 : Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP)

Author

Kittiyaowamarn, Rossaphorn, Girdthep, Natnaree, Cherdtrakulkiat, Thitima, Sangprasert, Pongsathorn, Tongtoyai, Jaray, Weston, Emily, Borisov, Andrey, Dunne, Eileen F., Chinhiran, Kittipoom, Woodring, Joseph, Ngarmjiratam, Nattapon, Masciotra, Silvina, Frankson, Rebekah, Sirivongrangson, Pachara, Unemo, Magnus, Wi, Teodora, Kittiyaowamarn, Rossaphorn, Girdthep, Natnaree, Cherdtrakulkiat, Thitima, Sangprasert, Pongsathorn, Tongtoyai, Jaray, Weston, Emily, Borisov, Andrey, Dunne, Eileen F., Chinhiran, Kittipoom, Woodring, Joseph, Ngarmjiratam, Nattapon, Masciotra, Silvina, Frankson, Rebekah, Sirivongrangson, Pachara, Unemo, Magnus, and Wi, Teodora

Abstract

OBJECTIVES: Rising antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a global public health concern. Many ceftriaxone-resistant cases have been linked to Asia. In the WHO/CDC global Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP), we conducted AMR surveillance at two clinical sites in Bangkok, Thailand, 2015-21. METHODS: Urethral discharge samples, from males with urethral discharge and/or dysuria, were Gram-stained and cultured. ETEST was performed to determine AMR. EGASP MIC alert values, CLSI and EUCAST breakpoints were used. RESULTS: In 2015-21, gonococcal isolates were cultured from 1928 cases; most (64.1%) were males reporting having sex with females. The sensitivity and specificity of Gram-stained microscopy compared with culture for detection of gonococci were 97.5% and 96.6%, respectively. From 2015 to 2021, the azithromycin MIC90 increased from 0.125 to 1 mg/L, and the MIC90 of ceftriaxone and cefixime increased from 0.008 and ≤0.016 mg/L to 0.032 and 0.064 mg/L, respectively. Eight EGASP MIC alert values (in seven isolates) were identified. Five alert values were for cefixime (all resistant according to EUCAST breakpoints) and three for azithromycin (all resistant according to EUCAST breakpoints). The average annual resistance to ciprofloxacin during 2015-21 was 92%. CONCLUSIONS: A continuous high susceptibility to ceftriaxone, Thailand's first-line gonorrhoea treatment, was found. However, the increasing MICs of ceftriaxone, cefixime and azithromycin are a substantial threat, especially considering these are the last remaining options for the treatment of gonorrhoea. To monitor AMR, continuous and quality-assured gonococcal AMR surveillance such as the Thai WHO/CDC EGASP, ideally including WGS, is imperative globally., Funding Agencies:World Health OrganizationU.S. Centers for Disease Control and Prevention

Published
2023
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28. Genomic surveillance and antimicrobial resistance determinants in Neisseria gonorrhoeae isolates from Uganda, Malawi and South Africa, 2015-20

Author

Kakooza, Francis, Golparian, Daniel, Matoga, Mitch, Maseko, Venessa, Lamorde, Mohammed, Krysiak, Robert, Manabe, Yuka C., Chen, Jane S., Kularatne, Ranmini, Jacobsson, Susanne, Godreuil, Sylvain, Hoffman, Irving, Bercot, Beatrice, Wi, Teodora, Unemo, Magnus, Kakooza, Francis, Golparian, Daniel, Matoga, Mitch, Maseko, Venessa, Lamorde, Mohammed, Krysiak, Robert, Manabe, Yuka C., Chen, Jane S., Kularatne, Ranmini, Jacobsson, Susanne, Godreuil, Sylvain, Hoffman, Irving, Bercot, Beatrice, Wi, Teodora, and Unemo, Magnus

Abstract

OBJECTIVES: Global antimicrobial resistance (AMR) surveillance in Neisseria gonorrhoeae is essential. In 2017-18, only five (10.6%) countries in the WHO African Region reported to the WHO Global Gonococcal Antimicrobial Surveillance Programme (WHO GASP). Genomics enhances our understanding of gonococcal populations nationally and internationally, including AMR strain transmission; however, genomic studies from Africa are extremely scarce. We describe the gonococcal genomic lineages/sublineages, including AMR determinants, and baseline genomic diversity among strains in Uganda, Malawi and South Africa, 2015-20, and compare with sequences from Kenya and Burkina Faso. METHODS: Gonococcal isolates cultured in Uganda (n = 433), Malawi (n = 154) and South Africa (n = 99) in 2015-20 were genome-sequenced. MICs were determined using ETEST. Sequences of isolates from Kenya (n = 159), Burkina Faso (n = 52) and the 2016 WHO reference strains (n = 14) were included in the analysis. RESULTS: Resistance to ciprofloxacin was high in all countries (57.1%-100%). All isolates were susceptible to ceftriaxone, cefixime and spectinomycin, and 99.9% were susceptible to azithromycin. AMR determinants for ciprofloxacin, benzylpenicillin and tetracycline were common, but rare for cephalosporins and azithromycin. Most isolates belonged to the more antimicrobial-susceptible lineage B (n = 780) compared with the AMR lineage A (n = 141), and limited geographical phylogenomic signal was observed. CONCLUSIONS: We report the first multi-country gonococcal genomic comparison from Africa, which will support the WHO GASP and WHO enhanced GASP (EGASP). The high prevalence of resistance to ciprofloxacin (and empirical use continues), tetracycline and benzylpenicillin, and the emerging resistance determinants for azithromycin show it is imperative to strengthen the gonococcal AMR surveillance, ideally including genomics, in African countries.

Published
2023
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29. Antimicrobial Resistance in Neisseria gonorrhoeae: Proceedings of the STAR Sexually Transmitted Infection-Clinical Trial Group Programmatic Meeting

Author

Cristillo, Anthony D., Bristow, Claire C., Torrone, Elizabeth, Dillon, Jo-Anne, Kirkcaldy, Robert D., Dong, Huan, Grad, Yonatan H., Nicholas, Robert A., Rice, Peter A., Lawrence, Kenneth, Oldach, David, Shafer, William Maurice, Zhou, Pei, Wi, Teodora E., Morris, Sheldon R., and Klausner, Jeffrey D.

Published
2018
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33. Association Between the Level of Inflammation at Each Anatomical Sexual Activity from Gram Staining and Neisseria gonorrhoeae and Chlamydia trachomatis Infections

Author

Chinhiran, Kittipoom, primary, Kittiyaowamarn, Rossaphorn, additional, Bamrungsak, Busara, additional, Yuchui, Narissara, additional, Boonprathueng, Kornsiri, additional, Girdthep, Natnaree, additional, Karnpanich, Thanyaporn, additional, Phinyo, Phichayut, additional, Wongyikul, Pakpoom, additional, and Wi, Teodora Elvira, additional

Published
2023
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37. EGASP 1st year data

Author

Sirivongrangson, Pachara, Girdthep, Natnaree, Sukwicha, Wichuda, Buasakul, Prisana, Tongtoyai, Jaray, Weston, Emily, Papp, John, Wi, Teodora, Cherdtrakulkiat, Thitima, Dunne, Eileen, and Workgroup, EGASP

Subjects
Gonorrhea, Surveillance, virus diseases, Antimicrobial resistance, Thailand, geographic locations, Neisseria gonorrhoeae
Abstract

Data for first year publication--The First Year of the Global Enhanced Gonococcal Antimicrobial Surveillance Program (EGASP) in Bangkok, Thailand, 2015-2016

Published
2022
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38. Improved rapid diagnostic tests to detect syphilis and yaws: a systematic review and meta-analysis

Author

Zhang, Ying, primary, Goh, Su Mei, additional, Mello, Maeve B, additional, Baggaley, Rachel C, additional, Wi, Teodora, additional, Johnson, Cheryl C, additional, Asiedu, Kingsley B, additional, Marks, Michael, additional, Pham, Minh D, additional, Fairley, Christopher K, additional, Chow, Eric P F, additional, Mitjà, Oriol, additional, Toskin, Igor, additional, Ballard, Ronald C, additional, and Ong, Jason J, additional

Published
2022
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39. Cost-effectiveness of implementing HIV and HIV/syphilis dual testing among key populations in Viet Nam: a modelling analysis

Author

Coomes, David, primary, Green, Dylan, additional, Barnabas, Ruanne, additional, Sharma, Monisha, additional, Barr-DiChiara, Magdalena, additional, Jamil, Muhammad S, additional, Baggaley, R, additional, Owiredu, Morkor Newman, additional, Macdonald, Virginia, additional, Nguyen, Van Thi Thuy, additional, Vo, Son Hai, additional, Taylor, Melanie, additional, Wi, Teodora, additional, Johnson, Cheryl, additional, and Drake, Alison L, additional

Published
2022
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41. Ebola RNA Persistence in Semen of Ebola Virus Disease Survivors — Final Report

Author

Deen, Gibrilla F., Broutet, Nathalie, Xu, Wenbo, Knust, Barbara, Sesay, Foday R., McDonald, Suzanna L.R., Ervin, Elizabeth, Marrinan, Jaclyn E., Gaillard, Philippe, Habib, Ndema, Liu, Hongtu, Liu, William, Thorson, Anna E., Yamba, Francis, Massaquoi, Thomas A., James, Faustin, Ariyarajah, Archchun, Ross, Christine, Bernstein, Kyle, Coursier, Antoine, Klena, John, Carino, Marylin, Wurie, Alie H., Zhang, Yong, Dumbuya, Marion S., Abad, Neetu, Idriss, Baimba, Wi, Teodora, Bennett, Sarah D., Davies, Tina, Ebrahim, Faiqa K., Meites, Elissa, Naidoo, Dhamari, Smith, Samuel J., Ongpin, Patricia, Malik, Tasneem, Banerjee, Anshu, Erickson, Bobbie R., Liu, Yongjian, Liu, Yang, Xu, Ke, Brault, Aaron, Durski, Kara N., Winter, Jörn, Sealy, Tara, Nichol, Stuart T., Lamunu, Margaret, Bangura, James, Landoulsi, Sihem, Jambai, Amara, Morgan, Oliver, Wu, Guizhen, Liang, Mifang, Su, Qiudong, Lan, Yu, Hao, Yanzhe, Formenty, Pierre, Ströher, Ute, and Sahr, Foday

Published
2017
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42. Transforming and integrating STI surveillance to enhance global advocacy and investment in STI control

Author

Taylor, Melanie M. and Wi, Teodora Ec

Subjects
Sexually transmitted diseases -- Prevention -- Risk factors -- Care and treatment, Sentinel health events -- Methods -- International aspects, Health planning -- International aspects, Health, World Health Organization -- Aims and objectives
Abstract

`Sexually transmitted infections (STI) exact an astounding yet preventable toll on the health and lives of men and women worldwide. The World Health Organization (WHO) estimated 376 million new curable [...]

Published
2019
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43. Diagnosing sexually transmitted infections in resource‐constrained settings: challenges and ways forward

Author

Wi, Teodora Ec, Ndowa, Francis J., Ferreyra, Cecilia, Kelly?Cirino, Cassandra, Taylor, Melanie M., Toskin, Igor, Kiarie, James, Santesso, Nancy, and Unemo, Magnus

Subjects
Sexually transmitted diseases -- Diagnosis -- Research, Medically underserved areas -- Research, Health
Abstract

: Introduction: Sexually transmitted infections (STIs) remain prevalent and are increasing in several populations. Appropriate STI diagnosis is crucial to prevent the transmission and sequelae of untreated infection. We reviewed the diagnostic accuracy of syndromic case management and existing point‐of‐care tests (POCTs), including those in the pipeline, to diagnose STIs in resource‐constrained settings. Methods: We prioritized updating the systematic review and meta‐analysis of the diagnostic accuracy of vaginal discharge from 2001 to 2015 to include studies until 2018. We calculated the absolute effects of different vaginal flowcharts and the diagnostic performance of POCTs on important outcomes. We searched the peer‐reviewed literature for previously conducted systematic reviews and articles from 1990 to 2018 on the diagnostic accuracy of syndromic management of vaginal and urethral discharge, genital ulcer and anorectal infections. We conducted literature reviews from 2000 to 2018 on the existing POCTs and those in the pipeline. Results and discussions: The diagnostic accuracy of urethral discharge and genital ulcer disease syndromes is relatively adequate. Asymptomatic Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections limit the use of vaginal discharge and anorectal syndromes. The pooled diagnostic accuracy of vaginal syndromic case management for CT/NG is low, resulting in high numbers of overtreatment and missed treatment. The absolute effect of POCTs was reduced overtreatment and missed treatment. Findings of the reviews on syndromic case management underscored the need for low‐cost and accurate POCTs for the identification, first, of CT/NG, and, second, of Mycoplasma genitalium (MG) and Trichomonas vaginalis (TV) and NG and MG resistance/susceptibility testing. Near‐patient POCT molecular assays for CT/NG/TV are commercially available. The prices of these POCTs remain the barrier for uptake in resource‐constrained settings. This is driving the development of lower cost solutions. Conclusions: The WHO syndromic case management guidelines should be updated to raise the quality of STI management through the integration of laboratory tests. STI screening strategies are needed to address asymptomatic STIs. POCTs that are accurate, rapid, simple and affordable are urgently needed in resource‐constrained settings to support the uptake of aetiological diagnosis and treatment., Abbreviations Introduction Sexually transmitted infections (STIs) remain prevalent and a major burden of morbidity and mortality globally, impacting on quality of life, reproductive and child health, and national and individual [...]

Published
2019
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45. Assessment of country implementation of the WHO global health sector strategy on sexually transmitted infections (2016-2021)

Author

Taylor, Melanie M., primary, Wi, Teodora, additional, Gerbase, Antonio, additional, Thwin, Soe Soe, additional, Gottlieb, Sami, additional, Babovic, Maria Theresa, additional, Low-Beer, Daniel, additional, Alonso, Monica, additional, Mello, Maeve B., additional, Ishikawa, Naoko, additional, Brink, Anne, additional, Hermez, Joumana, additional, Sabry, Ahmed, additional, Sanni, Saliyou, additional, Ouedraogo, Leopold, additional, Rewari, Bharat, additional, Sharma, Mukta, additional, Seguy, Nicole, additional, Vovc, Elena, additional, Askew, Ian, additional, Doherty, Meg, additional, and Broutet, Nathalie, additional

Published
2022
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46. Cost-effectiveness of implementing HIV and HIV/syphilis dual testing among key populations in Viet Nam: a modeling analysis

Author

Coomes, David Michael, primary, Green, Dylan, additional, Barnabas, Ruanne, additional, Sharma, Monisha, additional, Barr-Dichiara, Magdalena, additional, Jamil, Muhammad S, additional, Baggaley, Rachel, additional, Owiredu, Morkor Newman, additional, Macdonald, Virginia, additional, Nguyen, Van, additional, Hai, Son Vo, additional, Taylor, Melanie M, additional, Wi, Teodora E, additional, Johnson, Cheryl, additional, and Drake, Alison, additional

Published
2022
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47. Prevalence of reproductive tract infections including sexually transmitted infections among married women in urban and peri-urban mid to low socioeconomic neighbourhoods of Delhi, North India: an observational study protocol

Author

Dhabhai, Neeta, primary, Chaudhary, Ritu, additional, Wi, Teodora, additional, Mburu, Gitau, additional, Chowdhury, Ranadip, additional, More, Deepak, additional, Chatterjee, Leena, additional, De, Devjani, additional, Kabra, Rita, additional, Kiarie, James, additional, Habib, Ndema, additional, Dang, Arjun, additional, Dang, Manvi, additional, and Mazumder, Sarmila, additional

Published
2022
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49. Transitioning to Digital Systems: The Role of World Health Organization’s Digital Adaptation Kits in Operationalizing Recommendations and Interoperability Standards

Author

Tamrat, Tigest, primary, Ratanaprayul, Natschja, additional, Barreix, Maria, additional, Tunçalp, Özge, additional, Lowrance, David, additional, Thompson, Jenny, additional, Rosenblum, Leona, additional, Kidula, Nancy, additional, Chahar, Ram, additional, Gaffield, Mary E., additional, Festin, Mario, additional, Kiarie, James, additional, Taliesin, Brian, additional, Leitner, Carl, additional, Wong, Sylvia, additional, Wi, Teodora, additional, Kipruto, Hillary, additional, Adegboyega, Ayotunde, additional, Muneene, Derrick, additional, Say, Lale, additional, and Mehl, Garrett, additional

Published
2022
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