ArticleSexually transmitted diseases2022
Gentamicin Susceptibility in Neisseria gonorrhoeae and Treatment Outcomes for Urogenital Gonorrhea After 25 Years of Sustained Gentamicin Use in Malawi.
Article in Sexually transmitted diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Temporal and geographic trends in extended-spectrum cephalosporins resistance among Neisseria gonorrhoeae isolates worldwide: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Molecular Characterization of Staphylococcus aureus and Coagulase-Negative Staphylococci Isolates at a Rural Hospital in Southern Malawi.BioMed research international · 2026Article
- Gentamicin induction of the gonococcalmBio · 2025Article
- Prevalence of Antibiotic Resistance Bacteria in Manure, Soil, and Vegetables in Urban Blantyre, Malawi, from a Farm-to-Fork Perspective.International journal of environmental research and public health · 2025Article
- In vitro susceptibility of Neisseria gonorrhoeae to netilmicin and etimicin in comparison to gentamicin and other aminoglycosides.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- Antibiotic use and resistance patterns at Rumphi District Hospital in Malawi: a cross-sectional study.BMC infectious diseases · 2024Article
- High-level in vitro resistance to gentamicin acquired in a stepwise manner in Neisseria gonorrhoeae.The Journal of antimicrobial chemotherapy · 2023Article
- In Vitro Study of the Interaction of Gentamicin with Ceftriaxone and Azithromycin againstAntibiotics (Basel, Switzerland) · 2022Article
- National surveillance ofJAC-antimicrobial resistance · 2022Article
- A Single Amino Acid Substitution in Elongation Factor G Can Confer Low-Level Gentamicin Resistance inAntimicrobial agents and chemotherapy · 2022Article
- Gentamicin Susceptibility in Neisseria gonorrhoeae and Treatment Outcomes for Urogenital Gonorrhea After 25 Years of Sustained Gentamicin Use in Malawi.Sexually transmitted diseases · 2022Article
- Structural and Functional Annotation and Molecular Docking Analysis of a Hypothetical Protein fromBioMed research international · 2022Article
- Etiological profile of male urethritis and genital ulcer disease and antimicrobial susceptibility of Neisseria gonorrhoeae in Southeastern Brazil.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesArticle
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15 authors at 3 institutions in 3 countries.
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Abstract
backgroundGentamicin has been used for the treatment of gonorrhea in Malawi since 1993. However, declining clinical cure rates have been suspected. We evaluated current Neisseria gonorrhoeae susceptibility to gentamicin in vitro and clinically.
methodsMen with acute urethritis were recruited at the Bwaila District Hospital STI Clinic in Lilongwe, Malawi, between January 2017 and August 2019. All men provided urethral swabs for etiological testing at enrollment and test of cure (TOC), 1 week later, using Gram-stained microscopy and culture. We used Etest to determine minimum inhibitory concentrations (MICs) of gentamicin, azithromycin, cefixime, ceftriaxone, ciprofloxacin, and spectinomycin; disc diffusion for tetracycline susceptibility; and whole-genome sequencing (WGS) to verify/refute treatment failure.
resultsAmong 183 N. gonorrhoeae culture-positive men enrolled, 151 (82.5%) had a swab taken for TOC. Of these 151 men, 16 (10.6%) had a positive culture at TOC. One hundred forty-one baseline isolates were tested for gentamicin susceptibility using Etest: 2 (1.4%), MIC = 2 μg/mL; 111 (78.7%), MIC = 4 μg/mL; and 28 (19.9%), MIC = 8 μg/mL. All isolates were susceptible to azithromycin, cefixime, ceftriaxone, and spectinomycin, whereas 63.1% had intermediate susceptibility or resistance to ciprofloxacin. Almost all (96.1%) isolates were resistant to tetracycline. All examined isolates cultured at TOC (n = 13) had gentamicin MICs ≤8 μg/mL. Ten men had pretreatment and posttreatment isolates examined by whole-genome sequencing; 2 (20%) were verified new infections (4119 and 1272 single-nucleotide polymorphisms), whereas 8 (80%) were confirmed treatment failures (0-1 single-nucleotide polymorphism).
conclusionsGentamicin MICs poorly predict gonorrhea treatment outcome with gentamicin, and treatment failures are verified with gonococcal strains with in vitro susceptibility to gentamicin. The first-line treatment of gonorrhea in Malawi should be reassessed.
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