Sexually transmitted infections (STI/SOA)
5 important questions on Sexually transmitted infections (STI/SOA)
What is the infection way of N. Gonorrhoea?
- Adherence to urogenital epithelium, OPA protein and type 4 pilli
- Competition with resident microbiota, nutrient acquisition and microcolony formation → Colonisation and invasion of epithelium
- Release of peptidoglycan, LOS and OMVs
- Cytokine, chemokine and inflammatory transcription factor activation
- Influx of neutrophils; adherence and phagocytosis of N. gonorrhoeae
- A neutrophil-rich purulent exudate facilitates transmission
Why is it difficult to treat N. Gonorrhoea?
- Plasmid-mediated resistance
- Mutations in antibiotic binding site
- Mutations in topo-isomerases
Overexpression of efflux pumps
Explain Mutations in antibiotic binding site
- Mutation in penicillin-binding protein A (penA) and proin B (porB) lead to inhibited uptake of beta-lactams and cephalosporins
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Explain overexpression of efflux pumps
- Mutation in promoter of multi-drug resistance (mtr) gene involved in resistance to multiple antibiotics
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Multi-locus sequence typing (MLST) surveillance technique
- Sequence of 7 housekeeping genes that are genetically stable
- Widely spear over the chromosome
- Not under selective pressure
- Not adjacent to outer membrane proteins and secreted or hypothetical proteins
- Not on mobile elements
MLST types and antimicrobial resistance
- Certain MLST types were found to be associated to antimicrobial resistance
- Surveillance: MLST typing of circulating bacteria to get insight in resistance prevalence
- Higher resolution: whole-genome sequencing
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