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Gonococcie rectale: mise au point à l’heure de la résistance aux antibiotiques

Rectal gonorrhoea: treatment guidelines in the antibiotic resistance era

  • Dossier Thématique / Thematic File
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Côlon & Rectum

Résumé

Le gonocoque est responsable d’infections sexuellement transmissibles comportant des risques de complications graves en l’absence de traitement approprié. Les résistances aux fluoroquinolones augmentent progressivement et atteignaient 43 % des souches isolées en 2006 en France. Ces résistances sont la source de traitements inefficaces qui peuvent favoriser la pérennisation des contaminations. Le traitement de première intention est actuellement la ceftriaxone intramusculaire ou intraveineuse en monodose. Vingt à 40 % des infections sont asymptomatiques. Les populations à risque doivent être dépistées, particulièrement les homosexuels masculins, les patients séropositifs pour le VIH et de plus en plus les femmes jeunes.

Abstract

Neisseria gonorrhoeae is a sexually transmitted infection with potential serious complications if not treated properly. Ciprofloxacin resistances raised 43% of the isolates in 2006 in France. These resistances are responsible of inefficient treatment and widespread of contaminations. The treatment recommended is a single intramuscular or intravenous dose of ceftriaxone. Twenty to 40% of patients are not symptomatic. High-risk patients must be identified and tested, especially men who have sex with men, HIV-positive patients and the young women.

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Références

  1. Wexner SD (1990) Sexually transmitted diseases of the colon, rectum, and anus. The challenge of the nineties. Dis Colon Rectum 33:1048–1062

    Article  PubMed  CAS  Google Scholar 

  2. Stansfield VA (1980) Diagnosis and management of anorectal gonorrhoea in women. Br J Vener Dis 56:319–321

    PubMed  CAS  Google Scholar 

  3. Benn PD, Rooney G, Carder C, et al (2007) Chlamydia trachomatis and Neisseria gonorrhoeae infection and the sexual behaviour of men who have sex with men. Sex Transm Infect 83:106–112

    Article  PubMed  CAS  Google Scholar 

  4. Rieg G, Lewis RJ, Miller LG, et al (2008) Asymptomatic sexually transmitted infections in HIV-infected men who have sex with men: prevalence, incidence, predictors, and screening strategies. AIDS Patient Care STDS 22:947–954

    Article  PubMed  Google Scholar 

  5. Olshen E, Shrier LA (2005) Diagnostic tests for chlamydial and gonorrheal infections. Semin Pediatr Infect Dis 16:192–198

    Article  PubMed  Google Scholar 

  6. Afssaps (2006) Traitement antibiotique des uréthrites et cervicites non compliquées. Med Mal Infect 36:27–35

    Article  Google Scholar 

  7. Moncada J, Schachter J, Liska S, et al (2009) Evaluation of self-collected glans and rectal swabs from men who have sex with men for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae by nucleic acid amplification tests. J Clin Microbiol 47(6):1657–1662 [Epub 2009 Apr 15]

    Article  PubMed  CAS  Google Scholar 

  8. Schachter J, Moncada J, Liska S, et al (2008) Nucleic acid amplification tests in the diagnosis of chlamydial and gonococcal infections of the oropharynx and rectum in men who have sex with men. Sex Transm Dis 35:637–642

    Article  PubMed  CAS  Google Scholar 

  9. Ison CA, Martin IM, London Gonococcal Working Group (1999) Susceptibility of gonococci isolated in London to therapeutic antibiotics: establishment of a London surveillance programme. Sex Transm Infect 75:107–111

    Article  PubMed  CAS  Google Scholar 

  10. Røtingen JA, Cameron DW, Garnett GP (2001) A systematic review of the epidemiologic interactions between classic sexually transmitted diseases and HIV: how much really is known? Sex Transm Dis 28:579–597

    Article  Google Scholar 

  11. Centers for Disease Control and Prevention (CDC) (2007) Update to CDC’s sexually transmitted diseases treatment guidelines, 2006: fluoroquinolones no longer recommended for treatment of gonococcal infections. MMWR Morb Mortal Wkly Rep 56:332–326

    Google Scholar 

  12. Papp JR, Ahrens K, Phillips C, et al (2007) The use and performance of oral-throat rinses to detect pharyngeal Neisseria gonorrhoeae and Chlamydia trachomatis infections. Diagn Microbiol Infect Dis 59:259–264

    Article  PubMed  CAS  Google Scholar 

  13. Farhi D, Gerhardt P, Falissard B, et al (2007) Increasing rates of quinolone-resistant Neisseria gonorrhoeae in Paris, France. J Eur Acad Dermatol Venereol 21:818–821

    Article  PubMed  CAS  Google Scholar 

  14. Hjelmevoll SO, Olsen ME, Sollid JU, et al (2008) Clinical validation of a real-time polymerase chain reaction detection of Neisseria gonorrheae porA pseudogene vs culture techniques. Sex Transm Dis 35:517–520

    Article  PubMed  CAS  Google Scholar 

  15. Alexander S, Ison C, Parry J, et al (2008) Self-taken pharyngeal and rectal swabs are appropriate for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in asymptomatic men who have sex with men. Sex Transm Infect 84:488–492

    Article  PubMed  CAS  Google Scholar 

  16. Martin IM, Hoffmann S, Ison CA, ESSTI Network (2006) European Surveillance of Sexually Transmitted Infections (ESSTI): the first combined antimicrobial susceptibility data for Neisseria gonorrhoeae in Western Europe. J Antimicrob Chemother 58:587–593

    Article  PubMed  CAS  Google Scholar 

  17. Heffernan H, Brokenshire M, Woodhouse R, et al. (2004) Antimicrobial susceptibility among Neisseria gonorrhoeae in New Zealand in 2002. N Z Med J 117:U817

    PubMed  Google Scholar 

  18. Sosa J, Ramirez-Arcos S, Ruben M, et al. (2003) High percentages of resistance to tetracycline and penicillin and reduced susceptibility to azithromycin characterize the majority of strain types of Neisseria gonorrhoeae isolates in Cuba, 1995–1998. Sex Transm Dis 30:443–448

    Article  PubMed  Google Scholar 

  19. Tanaka M, Nakayama H, Huruya K, et al. (2006) Analysis of mutations within multiple genes associated with resistance in a clinical isolate of Neisseria gonorrhoeae with reduced ceftriaxone susceptibility that shows a multidrug-resistant phenotype. Int J Antimicrob Agents 27:20–26

    Article  PubMed  CAS  Google Scholar 

  20. Lindberg R, Fredlund H, Nicholas R, Unemo M (2007) Neisseria gonorrhoeae isolates with reduced susceptibility to cefixime and ceftriaxone: associationwith genetic polymorphisms in penA, mtrR, porB1b, and ponA. Antimicrob Agents Chemother 51:2117–2122

    Article  PubMed  CAS  Google Scholar 

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  1. Hôpital Léopold-Bellan, 19, rue Vercingétorix, F-75014, Paris, France

    C. Bord

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  1. C. Bord
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Correspondence to C. Bord.

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Bord, C. Gonococcie rectale: mise au point à l’heure de la résistance aux antibiotiques. Colon Rectum 3, 151–155 (2009). https://doi.org/10.1007/s11725-009-0167-3

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  • DOI: https://doi.org/10.1007/s11725-009-0167-3

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