Antibiotic-resistant Neisseria gonorrhoeae spread faster with more treatment, not more sexual partners

Institute of Integrative Biology, Swiss Federal Institute of Technology, Zurich, Zurich, Switzerland
Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
DOI
10.7287/peerj.preprints.1449v1
Subject Areas
Computational Biology, Evolutionary Studies, Mathematical Biology, Epidemiology, Infectious Diseases
Keywords
Neisseria gonorrhoeae, bacterial drug resistance, antimicrobial resistance, mathematical model, sexually transmitted infection, epidemiology
Copyright
© 2015 Fingerhuth et al.
Licence
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ PrePrints) and either DOI or URL of the article must be cited.
Cite this article
Fingerhuth SM, Bonhoeffer S, Low N, Althaus CL. 2015. Antibiotic-resistant Neisseria gonorrhoeae spread faster with more treatment, not more sexual partners. PeerJ PrePrints 3:e1449v1

Abstract

The sexually transmitted bacterium Neisseria gonorrhoeae has developed resistance to all antibiotic classes that have been used for treatment and strains resistant to multiple antibiotic classes have evolved. In many countries, there is only one antibiotic remaining for empirical N. gonorrhoeae treatment and antibiotic management to counteract resistance spread is urgently needed. Understanding dynamics and drivers of resistance spread can provide rationales for antibiotic management. In our study, we first used antibiotic resistance surveillance data to estimate the rates at which antibiotic-resistant N. gonorrhoeae spread in two host populations, heterosexual men (HetM) and men who have sex with men (MSM). We found higher rates of spread for MSM (0.86 to 2.38 y−1, mean doubling time: 6 months) compared to HetM (0.24 to 0.86 y−1, mean doubling time: 16 months). We then developed a dynamic transmission model to reproduce the observed dynamics of N. gonorrhoeae transmission in populations of heterosexual men and women (HMW) and MSM. We parameterized the model using sexual behavior data and calibrated it to N. gonorrhoeae prevalence and incidence data. In the model, antibiotic-resistant N. gonorrhoeae spread with a median rate of 0.88 y−1 in HMW and 3.12 y−1 in MSM. These rates correspond to median doubling times of 9 (HMW) and 3 (MSM) months. The model shows the difference in the host population’s treatment rate rather than the difference in the number of sexual partners explains the differential spread of resistance. As higher treatment rates result in faster spread of antibiotic resistance, treatment recommendations for N. gonorrhoeae should carefully balance prevention of infection and avoidance of resistance spread.

Author Comment

This is a preprint submission to PeerJ.

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