TABLE OF CONTENTS
Title Page i
Certification ii
Acknowledgement iii
Abstract IV
CHAPTER
ONE
Introduction
CHAPTER
TWO
Characteristic of
Neisseria Gonorrhea
CHAPTER
THREE
Epidemiology
Mechanism of Drug
Resistance
CHAPTER
FOUR
Conclusion
Recommendation
Reference
ABSTRACT
Among
the aetiological agents of treatable sexually transmitted diseases (STDs),
Neisseria Gonorrhea is considered to be most important, because of emerging
antibiotic resistance strains that compromise the effectiveness of treatment of
the disease. Gonococci infections are usually treated with single – dose
therapy with an agent found to cure above 95 percent of each case, but unfortunately
Neisseria gonorrhea has developed resistance to most of the antibiotic used
against it, which can be categorized into pre-quinolone, quinolone and post –
quinolone era.
Among the anti-biotic available so far,
the third generation “cephalosporin has also be safely recommended as first
line therapy for gonorrhea globally;
CHAPTER ONE
INTRODUCTION
Despite the recent advances in diagnosis,
surveillance and treatment, sexual transmitted disease (STDs) remain one of the
leading diseases throughout the world. Increased promiscuity and onset of
sexual activity at an early age are two important contributing factors to the
spread of sexual transmitted disease.
Neisseria gonorrheae (also known as the gonococcus) colonizes primarily
in the human genital urinary tract, giving rise to the sexually transmitted
infection gonorrhea. It cause both
symptomatic and asymptomatic genital and extra genital tract infections. Disease caused by this organism is a
significant public health problem despite continual advances in treatment
(Tanaka and Reyn et al, 2004).
World
wide, there is an estimated 62million new cases a year, with an average of 22miilion
cases at any given time (WHO, 1992). N.
gonorrhea inhabits mainly mucosal surface of the urethra in males and the
cervix in females. As the signs and
symptoms of infection are often absent or obscure complication such as pelvic
inflammatory disease (PID), infertility, entopic pregnant woman may lead to
crucial perforation and blindness in the newborn. Gonococci infection have also
been documented to facilitate acquisition and transmission of HIV and HPV
infection (Hunter et al. 1990).
Asymptomatic infections by N. gonorrhoeae largely contribute to the
persistence and transmission of disease in a community. (Hunter et, al.1990).
Therefore,
to eliminate N. gonorrhea infection and in turn to control HIV and HPV
infection it is important not only to screen high – risk population but also to
treat them immediately with most effective drugs. Control of gonococci infection has relied on
effective single – dose antibiotic therapy given at the initial clinical visit,
prior to any knowledge of the organism’s susceptibility pattern. In the recent past, there has been an
alarming increase in the number of isolate of N. gonorrhea resistance to
commonly used drugs. (Chaudhry et al,
2002). Surveillance is therefore,
necessary to understand on going resistance trends and to ensure the success of
any therapy.
The
irrational and injudicious use of antibacterial agents especially in the
developing countries is encouraging this trend and the situation is expected to
worsen unless appropriate steps are initiated. This resistance of the
gonococcus to antibiotics has been the cause of much concern in recent years
and has been the subject of extensive investigation. The present review summarizes and trends to
drug resistance in N. gonorrhoeae, mechanism of drug resistance and discusses
the treatment regime. In addition, the
need to look for new and alternative antibacterial agent is also emphasized.
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