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Purpose of Review <p>Antimicrobial resistance in sexually transmitted infections (STIs) has become an urgent global public health threat, raising the specter of untreatable infections. This review summarizes the determinants of resistance among the five most common curable STIs <i>Neisseria gonorrhoeae</i>,<i> Chlamydia trachomatis</i>,<i> Mycoplasma genitalium</i>, <i>Treponema pallidum</i>,<i> and Trichomonas vaginalis</i>, as well as strategies to mitigate the spread of resistance.</p> Recent Findings <p>Genetic mutations are key drivers of resistance for <i>N. gonorrhoeae</i> and <i>M. genitalium.</i> Resistance in <i>T. vaginalis</i> can also occur because of genetic mutations, yet differential regulation of genes critical in antibiotic metabolism as well as co-infection with organisms that inactivate therapy play important roles. While resistance in <i>C. trachomatis</i> and <i>T. pallidum</i> has not been a substantial clinical concern, resistance selection via the continued widespread use of antimicrobials remains possible.</p> Summary <p>While resistance determinants are diverse and differ by pathogen, the strategies required to mitigate the continued emergence of resistance are similar: prevention of infection and treatment diversification. Underpinning those strategies, surveillance remains essential for monitoring and responding to the threat of drug-resistant infections.</p>

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Antimicrobial Resistance in Curable Sexually Transmitted Infections

  • 期刊论文

  • 发表日期：

    2025年1月25日

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  • Lorenzo Giacani,
  • Catriona S. Bradshaw,
  • Christina A. Muzny,
  • Keonte J. Graves,
  • Shivani Pasricha,
  • Stephen J. Jordan,
  • Lao-Tzu Allan-Blitz

摘要

Purpose of Review

Antimicrobial resistance in sexually transmitted infections (STIs) has become an urgent global public health threat, raising the specter of untreatable infections. This review summarizes the determinants of resistance among the five most common curable STIs Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, Treponema pallidum, and Trichomonas vaginalis, as well as strategies to mitigate the spread of resistance.

Recent Findings

Genetic mutations are key drivers of resistance for N. gonorrhoeae and M. genitalium. Resistance in T. vaginalis can also occur because of genetic mutations, yet differential regulation of genes critical in antibiotic metabolism as well as co-infection with organisms that inactivate therapy play important roles. While resistance in C. trachomatis and T. pallidum has not been a substantial clinical concern, resistance selection via the continued widespread use of antimicrobials remains possible.

Summary

While resistance determinants are diverse and differ by pathogen, the strategies required to mitigate the continued emergence of resistance are similar: prevention of infection and treatment diversification. Underpinning those strategies, surveillance remains essential for monitoring and responding to the threat of drug-resistant infections.