Stewardship / Resistance Scan for Feb 05, 2018

Drug-resistant gonorrhea in Americas
MDR-TB treatment

PAHO: cephalosporin-resistant gonorrhea present in 4 Americas countries

The United States, Brazil, Argentina, and now Canada, have all reported cases of cephalosporin-resistant gonorrhea, according to the latest situation report published by the Pan American Health organization (PAHO).

Gonorrhea has the ability to develop resistance to nearly all major antibiotics used for first-line empiric treatment of sexually transmitted infection, and extended-spectrum cephalosporins are the last available monotherapy used to treat infections caused by Neisseria gonorrhoeae.

In 2017, an asymptomatic Canadian woman was found to be infected with cephalosporin-resistant gonorrhea that was also resistant to ceftriaxone, cefixime, ciprofloxacin, and tetracycline. Her infection was susceptible to azithromycin.

 PAHO said clinicians should be aware of any local resistance patterns when choosing an antibiotic to treat gonorrhea. So far, the bacterium is still susceptible to dual treatment with ceftriaxone and azithromycin.
Feb 2 PAHO report


Chinese study finds 45% cure rate for second-line MDR-TB treatment

A large Chinese study determined that less than half of patients with multidrug-resistant tuberculosis (MDR-TB) were cured with second-line treatment, according to a report in the Journal of Infection.

Of 2,322 MDR-TB patients identified in 2008 through 2010, 1,542 received standardized second-line TB drugs. Of those patients, 688 (44.6%) were cured. The researchers also reported that the percentage of patients who had a favorable outcome was 57.6% in previously untreated patients and 46.1% in patients who had received previous TB therapy. And women had a higher rate of favorable outcome (52.0%) than did men (45.8%). Favorable outcomes were also significantly decreased in elderly patients.

The authors concluded, "More attention should be paid to the MDR-TB population at high-risk of poor clinical outcome, including male, elderly age, and those who have received prior treatment."
Feb 2 J Infect study

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