Gonorrheal Disease Case Study

Chapter 8
Summary and Conclusion
Study 5
From the present study, we conclude that gonorrheal infection predominantly occurred in (67.2%) women. Most of the patients were under 30 years of age and gave history of unprotected, multiple, heterosexual exposure.

Prevalence of gonorrheal infection is majorly affected by a variety of demographic and medical factors. Various factors influencing the incidence and spreading of gonorrheal diseases are such as lifestyle and the susceptibility of the individual to gonorrheal infection, pathogenicity, prevailing therapy and different measures to control disease. A multiple set of behavioral factors also determines the threat of acquiring an STD in developing countries like India, the risk of acquiring

In the absence of proper vaccine, one of the major requirements for control of gonorrheal disease is appropriate and effective treatment. However, options for the treatment of gonorrhea are decreasing as the organism has developed resistance to several antibiotics. Efficacy of standard treatment regimens is established and maintained with the help of antimicrobial resistance (AMR) surveillance of N. gonorrhoeae. AMR surveillance should be done continuously to know the occurrence of new resistant strains, monitor the changes in the patterns of resistance, and to update treatment recommendations so as to assist in disease control. Recent guidelines for treatment of gonorrhea recommends the use of single dose injectable or oral cephalosporins. Monitoring and investigation of gonorrhea have become essential due to the emergence and spread of multi drug resistant and cephalosporin resistant strains of N. gonorrhoeae. Routine clinical laboratories need to be alert for the detection of such strain, so that plans for control and prevention could be reviewed and revised from time to time. It is essential to know the genetic mechanisms responsible for decreased susceptibility and future resistance. There is

The co-infection of gonorrhea with HIV positive cases was 23.6%. The antibiotic resistance of Neisseria gonorrhea was high in HIV positive cases but was not statistically significant. Resistance to Ciprofloxacin in HIV negative and positive cases was 50% and 53.8% respectively. Among the Cephalosporin group, highest resistance was seen with Cefotaxime and Cefoxitin in both gonorrhea with HIV positive and negative patients. HIV negative patients showed no resistance to Ceftriaxone and Cefixime but HIV positive patients showed 7% and 15% resistance to Ceftriaxone and Cefixime respectively. Periodic monitoring of antimicrobial sensitivity profile will help in knowing the changes in susceptibility pattern and emergence of drug-resistant strains, which can help clinicians in choosing an appropriate antibiotic. This in turn helps the institution in evolving an effective hospital antimicrobial policy to promote rationale use of antibiotics and prevent the emergence of resistance. Research and identification of alternate treatment regimens play a vital role to prevent the development of resistance. The results of the present study support the current recommendations of NACO for use of third generation cephalosporins as the first choice of drugs for the empirical treatment of gonorrheal disease in