Abstract
Here, we review sexually transmitted diseases (STDs) caused by pathogenic bacteria and vaginal infections which result from an overgrowth of opportunistic bacterial microflora. First, we describe the STDs, the corresponding pathogens and the antimicrobials used for their treatment. In addition to the well-known diseases caused by single pathogens (i.e., syphilis, gonococcal infections, and chlamydiosis), we consider polymicrobial reproductive tract infections (especially those that are difficult to effectively clinically manage). Then, we summarize the biochemical mechanisms that lead to antimicrobial resistance and the most recent data on the emergence of drug resistance in STD pathogens and bacteria associated with vaginosis. A large amount of research performed in the last 10–15 years has shed light on the enormous diversity of mechanisms of resistance developed by bacteria. A detailed understanding of the mechanisms of antimicrobials action and the emergence of resistance is necessary to modify existing drugs and to develop new ones directed against new targets.
Highlights
The infections of human reproductive system include the sexually transmitted diseases (STDs) that are defined as infections that spread primarily through person-to-person sexual contact, and nonSTDs which are endogenous infections of the genital organs such as bacterial vaginosis (BV)
This review focuses on the characterization of the most common sexually transmitted bacterial pathogens and non-STD infections which result from an overgrowth of opportunistic bacterial microflora, and discusses the mechanisms and molecular determinants of their drug resistance
The emergence of resistance to antimicrobials is a natural consequence of the evolutionary process under increasing pressure from chemotherapy
Summary
The infections of human reproductive system include the sexually transmitted diseases (STDs) that are defined as infections that spread primarily through person-to-person sexual contact, and nonSTDs which are endogenous infections of the genital organs such as bacterial vaginosis (BV). There are strains of N. gonorrhoeae that are resistant to all major drugs used to treat gonorrhea, including β-lactams, fluoroquinolones, macrolides, tetracyclines, spectinomycin, cephalosporins, and azithromycin. The resistance of N. gonorrhoeae to macrolides (azithromycin) is caused by the presence of the erm (erythromycin ribosome methylation) and mef (associated with the active efflux of antibiotics) genes.
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