Gamaleya Research Institute of Epidemiology and Microbiology, Moscow, Russia
Gonorrhea in spite of its fully elucidated etiopathogenesis and available drugs for etiotropic therapy belongs to infections which are not controlled by vaccination due to absence of immunity formation. Analysis of scientific publication, statistical materials and WHO’s data showed that epidemic process of gonorrhea infection depends mainly from people’s behaviour, first of all, sexual. Modern epidemic process of gonorrhea infection consists from irregular increases and decreases of incidence due to various reasons. Reasons for increases of incidence appear to be simultaneous action of a range of biologic and anthropogenic factors. First reason — rapid increase of resistance of gonococci to widely used antibacterial preparations as well as synergy of pathogenic effects between HIV and gonococci; anthropogenic — wars, increase of high-risk groups due to urbanization, use of oral contraceptives, rise of prostitution, migration, inadequate access to medical care, poverty, intensification of intercourses (including hetero- and homosexual) between people, as well as demographic changes — increase of proportion of young people in population structure. Same but reciprocal factors lead to decrease of morbidity. Of them, the following were considered as most important: mass implementation of new effective antimicrobial drug as well as intensification of sanitary education, availability of early diagnostics and treatment, increase of material and cultural standards of life, decrease in number of persons belonging to high risk groups. Yet, capabilities of modern science expressed only in continuous development of new antibacterial drugs active against circulating population of gonococci, which is resistant to previously used drug.
Zh. Mikrobiol. (Moscow), 2009, No. 1, P. 87—93