Antimicrobial resistance in Neisseria gonorrhoeae and Treponema pallidum: evolution, therapeutic challenges and the need to strengthen global surveillance

INTRODUCTION The emergence of drug resistance among bacterial, viral and protozoan sexually transmitted infections (STI) in recent years threatens to undermine global STI control programmes. While this review will focus on microbiological resistance determinants for two important bacterial STI pathogens, namely Neisseria gonorrhoeae and Treponema pallidum, it is important to appreciate that a number of nonmicrobiological determinants may also directly influence both the emergence and transmission of antimicrobial resistant STI pathogens (table 1). This short paper describes the historical development of antibiotic resistance in N gonorrhoeae and T pallidum, outlines the challenges of identifying and treating these resistant infections, and highlights the requirement for the strengthening of global microbiological surveillance programmes for STI.