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Article ; Online: Antimicrobial treatment and resistance in sexually transmitted bacterial infections.

Jensen, Jorgen S / Unemo, Magnus

2024

Abstract: Sexually transmitted infections (STIs) have been part of human life since ancient times, and their symptoms affect quality of life, and sequelae are common. Socioeconomic and behavioural trends affect the prevalence of STIs, but the discovery of ... ...

Abstract	Sexually transmitted infections (STIs) have been part of human life since ancient times, and their symptoms affect quality of life, and sequelae are common. Socioeconomic and behavioural trends affect the prevalence of STIs, but the discovery of antimicrobials gave hope for treatment, control of the spread of infection and lower rates of sequelae. This has to some extent been achieved, but increasing antimicrobial resistance and increasing transmission in high-risk sexual networks threaten this progress. For Neisseria gonorrhoeae, the only remaining first-line treatment (with ceftriaxone) is at risk of becoming ineffective, and for Mycoplasma genitalium, for which fewer alternative antimicrobial classes are available, incurable infections have already been reported. For Chlamydia trachomatis, in vitro resistance to first-line tetracyclines and macrolides has never been confirmed despite decades of treatment of this highly prevalent STI. Similarly, Treponema pallidum, the cause of syphilis, has remained susceptible to first-line penicillin.
Language	English
Publishing date	2024-03-20
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2139054-X
ISSN	1740-1534 ; 1740-1526
ISSN (online)	1740-1534
ISSN	1740-1526
DOI	10.1038/s41579-024-01023-3
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Article ; Online: Quinolone Resistance-Associated Mutations in Mycoplasma genitalium: Not Ready for Prime Time.

Manhart, Lisa E / Jensen, Jørgen S

Sexually transmitted diseases

2020 Volume 47, Issue 3, Page(s) 199–201

MeSH term(s)	Drug Resistance, Bacterial ; Humans ; Moxifloxacin ; Mutation ; Mycoplasma Infections ; Mycoplasma genitalium ; Quinolones
Chemical Substances	Quinolones ; Moxifloxacin (U188XYD42P)
Language	English
Publishing date	2020-02-07
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	435191-5
ISSN	1537-4521 ; 0148-5717
ISSN (online)	1537-4521
ISSN	0148-5717
DOI	10.1097/OLQ.0000000000001132
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Article ; Online: Chlamydia treatment failure after repeat courses of azithromycin and doxycycline.

Sherrard, Jackie / Jensen, Jorgen S

International journal of STD & AIDS

2019 Volume 30, Issue 10, Page(s) 1025–1027

MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Azithromycin/administration & dosage ; Azithromycin/therapeutic use ; Chlamydia Infections/diagnosis ; Chlamydia Infections/drug therapy ; Chlamydia trachomatis/drug effects ; Chlamydia trachomatis/isolation & purification ; Doxycycline/administration & dosage ; Doxycycline/therapeutic use ; Drug Administration Schedule ; Female ; Humans ; Treatment Failure ; Young Adult
Chemical Substances	Anti-Bacterial Agents ; Azithromycin (83905-01-5) ; Doxycycline (N12000U13O)
Language	English
Publishing date	2019-07-23
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1018089-8
ISSN	1758-1052 ; 0956-4624
ISSN (online)	1758-1052
ISSN	0956-4624
DOI	10.1177/0956462419857303
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Article ; Online: Weighing Potential Benefits and Harms of Mycoplasma genitalium Testing and Treatment Approaches.

Manhart, Lisa E / Geisler, William M / Bradshaw, Catriona S / Jensen, Jørgen S / Martin, David H

Emerging infectious diseases

2022 Volume 28, Issue 8

MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Drug Resistance, Bacterial ; Humans ; Macrolides ; Mycoplasma Infections/diagnosis ; Mycoplasma Infections/drug therapy ; Mycoplasma genitalium/genetics ; Prevalence
Chemical Substances	Anti-Bacterial Agents ; Macrolides
Language	English
Publishing date	2022-07-25
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid2808.220094
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Article ; Online: Antimicrobial-resistant sexually transmitted infections: gonorrhoea and Mycoplasma genitalium.

Unemo, Magnus / Jensen, Jorgen S

Nature reviews. Urology

2017 Volume 14, Issue 3, Page(s) 139–152

Abstract: The emergence of antimicrobial resistance (AMR) is a major concern worldwide and already compromises treatment effectiveness and control of several bacterial sexually transmitted infections (STIs). Neisseria gonorrhoeae and Mycoplasma genitalium are ... ...

Abstract	The emergence of antimicrobial resistance (AMR) is a major concern worldwide and already compromises treatment effectiveness and control of several bacterial sexually transmitted infections (STIs). Neisseria gonorrhoeae and Mycoplasma genitalium are evolving into so-called superbugs that can become resistant, both in vitro and clinically, to essentially all antimicrobials available for treatment, causing exceedingly difficult-to-treat or untreatable STIs and threatening global public health. Widespread AMR in these bacteria is likely to persist and even worsen in the future, owing to the high number of infections, widespread and uncontrolled use of antimicrobials, limited surveillance of AMR and clinical failures, as well as the extraordinary capacity of these bacteria to develop AMR. This development would not only result in an increased prevalence of N. gonorrhoeae and M. genitalium infections but also in a considerably increasing number of severe complications affecting reproductive health. To combat this threat, clinicians need to be aware of the current guidelines on diagnostic procedures, recommended treatment regimens, as well as therapeutic options for multidrug-resistant bacteria. AMR testing needs to be more frequently performed, inform treatment decisions and elucidate how AMRs compromise treatment effectiveness, guiding research for effective future therapies.
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Anti-Infective Agents/pharmacology ; Anti-Infective Agents/therapeutic use ; Drug Resistance, Multiple, Bacterial/drug effects ; Drug Resistance, Multiple, Bacterial/physiology ; Gonorrhea/diagnosis ; Gonorrhea/drug therapy ; Gonorrhea/genetics ; Humans ; Mycoplasma Infections/diagnosis ; Mycoplasma Infections/drug therapy ; Mycoplasma Infections/genetics ; Mycoplasma genitalium/drug effects ; Mycoplasma genitalium/physiology ; Sexually Transmitted Diseases, Bacterial/diagnosis ; Sexually Transmitted Diseases, Bacterial/drug therapy ; Sexually Transmitted Diseases, Bacterial/genetics
Chemical Substances	Anti-Bacterial Agents ; Anti-Infective Agents
Language	English
Publishing date	2017-01-10
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2493737-X
ISSN	1759-4820 ; 1759-4812
ISSN (online)	1759-4820
ISSN	1759-4812
DOI	10.1038/nrurol.2016.268
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Article: Understanding the spread of de novo and transmitted macrolide-resistance in

Cadosch, Dominique / Garcia, Victor / Jensen, Jørgen S / Low, Nicola / Althaus, Christian L

PeerJ

2020 Volume 8, Page(s) e8913

Abstract: Background: The rapid spread of azithromycin resistance in sexually transmitted : Methods: We developed a compartmental transmission model to investigate the contribution of de novo macrolide resistance mutations to the spread of antimicrobial- ... ...

Abstract	Background: The rapid spread of azithromycin resistance in sexually transmitted Methods: We developed a compartmental transmission model to investigate the contribution of de novo macrolide resistance mutations to the spread of antimicrobial-resistant Results: The high probability of de novo resistance in Conclusions: Blind treatment of urethritis with single-dose azithromycin continues to select for the spread of macrolide resistant
Language	English
Publishing date	2020-04-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2703241-3
ISSN	2167-8359
ISSN	2167-8359
DOI	10.7717/peerj.8913
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Article ; Online: New Horizons in Mycoplasma genitalium Treatment.

Bradshaw, Catriona S / Jensen, Jorgen S / Waites, Ken B

The Journal of infectious diseases

2017 Volume 216, Issue suppl_2, Page(s) S412–S419

Abstract: Mycoplasmagenitalium is an important sexually transmitted pathogen responsible for both male and female genital tract disease. Appreciation of its significance in human disease has been hampered by its slow growth in culture, difficulty in isolating it, ... ...

Abstract	Mycoplasmagenitalium is an important sexually transmitted pathogen responsible for both male and female genital tract disease. Appreciation of its significance in human disease has been hampered by its slow growth in culture, difficulty in isolating it, and lack of commercial molecular-based tests for rapid detection. Comparatively few in vitro data on antimicrobial susceptibility are available due to the scarcity of clinical isolates and difficulty in performing susceptibility tests to determine minimum inhibitory concentrations for M. genitalium. Antimicrobial agents that inhibit protein synthesis such as macrolides, along with fluoroquinolones that inhibit DNA replication, have been the treatments of choice for M. genitalium infections. Even though international guidelines recommend azithromycin as first-line treatment, rapid spread of macrolide resistance as well as emergence of quinolone resistance has occurred. Increasing rates of treatment failure have resulted in an urgent need for new therapies and renewed interest in other classes such as aminocyclitols, phenicols, and streptogramins as treatment alternatives. Limited data for new investigational antimicrobials such as the ketolide solithromycin suggest that this drug may eventually prove useful in management of some resistant M. genitalium infections, although it is not likely to achieve cure rates >80% in macrolide-resistant strains, in a similar range as recently reported for pristinamycin. However, agents with completely new targets and/or mechanisms that would be less likely to show cross-resistance with currently available drugs may hold the greatest promise. Lefamulin, a pleuromutilin, and new nonquinolone topoisomerase inhibitors are attractive possibilities that require further investigation.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Azithromycin/therapeutic use ; Drug Discovery/classification ; Drug Resistance, Bacterial ; Female ; Fluoroquinolones/therapeutic use ; Humans ; Male ; Microbial Sensitivity Tests ; Mycoplasma Infections/diagnosis ; Mycoplasma Infections/drug therapy ; Mycoplasma genitalium ; Quinolines/therapeutic use ; Spectinomycin/therapeutic use ; Streptogramins/therapeutic use ; Tetracyclines/therapeutic use ; Thiamphenicol/therapeutic use ; Treatment Failure
Chemical Substances	Anti-Bacterial Agents ; Fluoroquinolones ; Quinolines ; Streptogramins ; Tetracyclines ; Azithromycin (83905-01-5) ; Spectinomycin (93AKI1U6QF) ; quinoline (E66400VT9R) ; Thiamphenicol (FLQ7571NPM)
Language	English
Publishing date	2017-08-12
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	3019-3
ISSN	1537-6613 ; 0022-1899
ISSN (online)	1537-6613
ISSN	0022-1899
DOI	10.1093/infdis/jix132
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Article ; Online: The perinatal health challenges of emerging and re-emerging infectious diseases: A narrative review.

Malange, Veronica N E / Hedermann, Gitte / Lausten-Thomsen, Ulrik / Hoffmann, Steen / Voldstedlund, Marianne / Aabakke, Anna J M / Eltvedt, Anna K / Jensen, Jørgen S / Breindahl, Morten / Krebs, Lone / Christiansen, Michael / Hedley, Paula L

Frontiers in public health

2023 Volume 10, Page(s) 1039779

Abstract: The world has seen numerous infectious disease outbreaks in the past decade. In many cases these outbreaks have had considerable perinatal health consequences including increased risk of preterm delivery (e.g., influenza, measles, and COVID-19), and the ... ...

Abstract	The world has seen numerous infectious disease outbreaks in the past decade. In many cases these outbreaks have had considerable perinatal health consequences including increased risk of preterm delivery (e.g., influenza, measles, and COVID-19), and the delivery of low birth weight or small for gestational age babies (e.g., influenza, COVID-19). Furthermore, severe perinatal outcomes including perinatal and infant death are a known consequence of multiple infectious diseases (e.g., Ebola virus disease, Zika virus disease, pertussis, and measles). In addition to vaccination during pregnancy (where possible), pregnant women, are provided some level of protection from the adverse effects of infection through community-level application of evidence-based transmission-control methods. This review demonstrates that it takes almost 2 years for the perinatal impacts of an infectious disease outbreak to be reported. However, many infectious disease outbreaks between 2010 and 2020 have no associated pregnancy data reported in the scientific literature, or pregnancy data is reported in the form of case-studies only. This lack of systematic data collection and reporting has a negative impact on our understanding of these diseases and the implications they may have for pregnant women and their unborn infants. Monitoring perinatal health is an essential aspect of national and global healthcare strategies as perinatal life has a critical impact on early life mortality as well as possible effects on later life health. The unpredictable nature of emerging infections and the potential for adverse perinatal outcomes necessitate that we thoroughly assess pregnancy and perinatal health implications of disease outbreaks and their public health interventions in tandem with outbreak response efforts. Disease surveillance programs should incorporate perinatal health monitoring and health systems around the world should endeavor to continuously collect perinatal health data in order to quickly update pregnancy care protocols as needed.
MeSH term(s)	Infant, Newborn ; Infant ; Pregnancy ; Female ; Humans ; Communicable Diseases, Emerging/epidemiology ; Influenza, Human ; COVID-19/epidemiology ; Infant, Low Birth Weight ; Premature Birth/epidemiology ; Zika Virus ; Zika Virus Infection
Language	English
Publishing date	2023-01-05
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2022.1039779
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Article ; Online: Syndromic management of STIs and the threat of untreatable Mycoplasma genitalium.

Bradshaw, Catriona S / Horner, Patrick J / Jensen, Jørgen S / White, Peter J

The Lancet. Infectious diseases

2018 Volume 18, Issue 3, Page(s) 251–252

MeSH term(s)	Humans ; Mycoplasma Infections ; Mycoplasma genitalium ; Sexually Transmitted Diseases ; Urethritis
Language	English
Publishing date	2018-02-27
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2061641-7
ISSN	1474-4457 ; 1473-3099
ISSN (online)	1474-4457
ISSN	1473-3099
DOI	10.1016/S1473-3099(18)30080-X
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Article ; Online: A Nationwide Observational Study of Chlamydia trachomatis Infections in Denmark during the COVID-19 Pandemic.

Hedley, Paula L / Hoffmann, Steen / Lausten-Thomsen, Ulrik / Voldstedlund, Marianne / Bjerre, Karsten Dalsgaard / Hviid, Anders / Krebs, Lone / Jensen, Jørgen S / Christiansen, Michael

Acta dermato-venereologica

2022 Volume 102, Page(s) adv00704

Abstract: The aim of this study was to determine whether COVID-19 restrictions had an impact on Chlamydia trachomatis infections compared with 2018 and 2019. A retrospective nationwide observational study was performed using monthly incidences of laboratory- ... ...

Abstract	The aim of this study was to determine whether COVID-19 restrictions had an impact on Chlamydia trachomatis infections compared with 2018 and 2019. A retrospective nationwide observational study was performed using monthly incidences of laboratory-confirmed chlamydia cases and number of tests, obtained from Danish national surveillance data. Testing rates and positivity rates were compared using Poisson and logistic regression. The first Danish COVID-19 lockdown (12 March to 14 April 2020) resulted in a reduction in the number of chlamydia tests performed (rate ratio 0.72, 95% confidence interval 0.71-0.73) and a consequent reduction in the number of laboratory-identified cases (66.5 vs 88.3 per 100,000 population during the same period in 2018 to 2019). This period was followed by a return of testing and test positivity close to the level seen in 2018 to 2019. The second Danish COVID-19 lockdown (17 December to 31 March 2021) resulted in crude incidence rates of laboratory-confirmed chlamydia infection that were similar to the crude incidence rates seen during same period in 2018 to 2019. In conclusion, the Danish COVID-19 restrictions have had negligible effects on laboratory-confirmed C. trachomatis transmission.
MeSH term(s)	COVID-19/epidemiology ; Chlamydia Infections/diagnosis ; Chlamydia Infections/epidemiology ; Chlamydia trachomatis ; Communicable Disease Control ; Denmark/epidemiology ; Humans ; Pandemics/prevention & control ; Retrospective Studies ; SARS-CoV-2
Language	English
Publishing date	2022-05-04
Publishing country	Sweden
Document type	Journal Article ; Observational Study
ZDB-ID	80007-7
ISSN	1651-2057 ; 0001-5555
ISSN (online)	1651-2057
ISSN	0001-5555
DOI	10.2340/actadv.v102.2324
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