Sexually transmitted infections · 2025
Could tolerance explain an individual's eight episodes of gonococcal treatment failure with ceftriaxone? A case report.
СтатьяНазвание и аннотация: Перевод в очереди
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Kanesaka Izumo, Vanbaelen Thibaut, De Baetselier Irith, Van den Bossche Dorien, Abdellati Said, de Block Tessa, Manoharan-Basil Sheeba Santhini, Kenyon Chris
Аннотация
OBJECTIVES: Describe the clinical evolution of a person with recurrent gonococcal cervicitis despite appropriate treatment and lack of reinfection.
METHODS: We used the tolerance detection test to confirm that all three culture-positive gonococcal isolates were tolerant to ceftriaxone.
RESULTS: Over a period of 6 months, a transgender man with gonococcal cervicitis experienced eight episodes of treatment failure despite receiving ceftriaxone 1 g intramuscularly on each occasion. The isolate remained susceptible to ceftriaxone throughout this period. His Neisseria gonorrhoeae infection was then successfully eradicated with a prolonged course of ceftriaxone.
CONCLUSIONS: We propose that bacterial tolerance be considered a possible cause of treatment failure in N. gonorrhoeae. A tolerance detection test can be used to diagnose tolerance.
METHODS: We used the tolerance detection test to confirm that all three culture-positive gonococcal isolates were tolerant to ceftriaxone.
RESULTS: Over a period of 6 months, a transgender man with gonococcal cervicitis experienced eight episodes of treatment failure despite receiving ceftriaxone 1 g intramuscularly on each occasion. The isolate remained susceptible to ceftriaxone throughout this period. His Neisseria gonorrhoeae infection was then successfully eradicated with a prolonged course of ceftriaxone.
CONCLUSIONS: We propose that bacterial tolerance be considered a possible cause of treatment failure in N. gonorrhoeae. A tolerance detection test can be used to diagnose tolerance.