scholarly journals Antimicrobial Resistance of Neisseria gonorrhoeae and Emerging Ciprofloxacin Resistance in The Netherlands, 1991 to 1998

2000 ◽  
Vol 44 (11) ◽  
pp. 3184-3185 ◽  
Author(s):  
Albert J. de Neeling ◽  
Marga van Santen-Verheuvel ◽  
Joke Spaargaren ◽  
Rob J. L. Willems
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
The Netherlands ◽  
Neisseria Gonorrhoeae ◽  
Far East ◽  
The Far East ◽  
Resistant Strains ◽  
Ciprofloxacin Resistance ◽  
High Level

ABSTRACT Surveillance of antibiotic resistance in Neisseria gonorrhoeae showed a decrease in the percentage of β-lactamase-producing isolates but an increase in intermediately penicillin-resistant strains and strains resistant to a high level of tetracycline. MICs for the ciprofloxacin-resistant isolates that emerged increased, and these isolates had mutations in gyrAand parC similar to those observed in the Far East.

scholarly journals A Novel Mechanism of High-Level, Broad-Spectrum Antibiotic Resistance Caused by a Single Base Pair Change in Neisseria gonorrhoeae

mBio ◽  
2011 ◽  
Vol 2 (5) ◽  
Author(s):  
Elizabeth A. Ohneck ◽  
Yaramah M. Zalucki ◽  
Paul J. T. Johnson ◽  
Vijaya Dhulipala ◽  
Daniel Golparian ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Base Pair ◽  
Health Concern ◽  
Content Type ◽  
Single Base ◽  
Single Base Pair ◽  
Resistant Strains ◽  
High Level

ABSTRACTThe MtrC-MtrD-MtrE multidrug efflux pump ofNeisseria gonorrhoeaeconfers resistance to a diverse array of antimicrobial agents by transporting these toxic compounds out of the gonococcus. Frequently in gonococcal strains, the expression of themtrCDEoperon is differentially regulated by both a repressor, MtrR, and an activator, MtrA. ThemtrRgene lies 250 bp upstream of and is transcribed divergently from themtrCDEoperon. Previous research has shown that mutations in themtrRcoding region and in themtrR-mtrCDEintergenic region increase levels of gonococcal antibiotic resistance andin vivofitness. Recently, a C-to-T transition mutation 120 bp upstream of themtrCstart codon, termedmtr120, was identified in strain MS11 and shown to be sufficient to confer high levels of antimicrobial resistance when introduced into strain FA19. Here we report that this mutation results in a consensus −10 element and that its presence generates a novel promoter formtrCDEtranscription. This newly generated promoter was found to be stronger than the wild-type promoter and does not appear to be subject to MtrR repression or MtrA activation. Although rare, themtr120mutation was identified in an additional clinical isolate during sequence analysis of antibiotic-resistant strains cultured from patients with gonococcal infections. We propose thatcis-acting mutations can develop in gonococci that significantly alter the regulation of themtrCDEoperon and result in increased resistance to antimicrobials.IMPORTANCEGonorrhea is the second most prevalent sexually transmitted bacterial infection and a worldwide public health concern. As there is currently no vaccine againstNeisseria gonorrhoeae, appropriate diagnostics and subsequent antibiotic therapy remain the primary means of infection control. However, the effectiveness of antibiotic treatment is constantly challenged by the emergence of resistant strains, mandating a thorough understanding of resistance mechanisms to aid in the development of new antimicrobial therapies and genetic methods for antimicrobial resistance testing. This study was undertaken to characterize a novel mechanism of antibiotic resistance regulation inN. gonorrhoeae. Here we show that a single base pair mutation generates a second, stronger promoter formtrCDEtranscription that acts independently of the known efflux system regulators and results in high-level antimicrobial resistance.

scholarly journals High Primary Antibiotic Resistance of Helicobacter pylori Strains Isolated from Pediatric and Adult Patients in Poland during 2016–2018

Antibiotics ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. 228
Author(s):  
Paweł Krzyżek ◽  
Dorota Pawełka ◽  
Barbara Iwańczak ◽  
Radosław Kempiński ◽  
Konrad Leśniakowski ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Effective Treatment ◽  
Adult Patients ◽  
Minimum Inhibitory Concentrations ◽  
Treatment Naïve ◽  
Resistant Strains ◽  
H Pylori ◽  
High Level

Monitoring the antibiotic resistance of H. pylori is an important step in the effective treatment of this bacterium, thus the aim of the present study was to assess the prevalence of antimicrobial resistance of H. pylori strains isolated from pediatric and adult patients with primary infections in 2016–2018. Antral biopsies from 334 treatment-naïve patients (126 children and 208 adults) were obtained. A total of 71 clinical H. pylori strains (22 from children and 49 from adults) were isolated and examined for amoxicillin (AMX), clarithromycin (CLR), metronidazole (MTZ), tetracycline (TET), and levofloxacin (LEV) susceptibility. The activity of the antibiotics was measured by E-tests. Strains were considered as resistant to antibiotics with minimum inhibitory concentrations (MICs) equal to ≥0.125 μg/mL (AMX), ≥0.5 μg/mL (CLR), ≥8 μg/mL (MTZ), and ≥1 μg/mL (TET and LEV). The highest prevalence of antibiotic resistance in H. pylori strains was observed for CLR and MTZ, at frequencies of 54.5% and 31.8% vs. 30.6% and 46.9% for children and adults, respectively. A much lower frequency of isolation of resistant strains was demonstrated for LEV and TET, this being 9.1% and 4.5% vs. 18.4% and 4.1% for pediatric and adult patients, respectively. The presence of AMX-resistant strains was not observed. The H. pylori strains isolated from Polish patients with primary infections showed a high level of antibiotic resistance to CLR and MTZ (>30%).

scholarly journals Plasmid mediated penicillin and tetracycline resistance among Neisseria gonorrhoeae isolates from Kenya

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mary Wandia Kivata ◽  
Margaret Mbuchi ◽  
Fredrick Eyase ◽  
Wallace Dimbuson Bulimo ◽  
Cecilia Katunge Kyanya ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
De Novo ◽  
Antibiotic Resistance Genes ◽  
Tetracycline Resistance ◽  
Illumina Miseq ◽  
Miseq Platform ◽  
High Level

Abstract Background Treatment of gonorrhea is complicated by the development of antimicrobial resistance in Neisseria gonorrhoeae (GC) to the antibiotics recommended for treatment. Knowledge on types of plasmids and the antibiotic resistance genes they harbor is useful in monitoring the emergence and spread of bacterial antibiotic resistance. In Kenya, studies on gonococcal antimicrobial resistance are few and data on plasmid mediated drug resistance is limited. The present study characterizes plasmid mediated resistance in N. gonorrhoeae isolates recovered from Kenya between 2013 and 2018. Methods DNA was extracted from 36 sub-cultured GC isolates exhibiting varying drug resistance profiles. Whole genome sequencing was done on Illumina MiSeq platform and reads assembled de-novo using CLC Genomics Workbench. Genome annotation was performed using Rapid Annotation Subsystem Technology. Comparisons in identified antimicrobial resistance determinants were done using Bioedit sequence alignment editor. Results Twenty-four (66.7%) isolates had both β-lactamase (TEM) and TetM encoding plasmids. 8.3% of the isolates lacked both TEM and TetM plasmids and had intermediate to susceptible penicillin and tetracycline MICs. Twenty-six (72%) isolates harbored TEM encoding plasmids. 25 of the TEM plasmids were of African type while one was an Asian type. Of the 36 isolates, 31 (86.1%) had TetM encoding plasmids, 30 of which harbored American TetM, whereas 1 carried a Dutch TetM. All analyzed isolates had non-mosaic penA alleles. All the isolates expressing TetM were tetracycline resistant (MIC> 1 mg/L) and had increased doxycycline MICs (up to 96 mg/L). All the isolates had S10 ribosomal protein V57M amino acid substitution associated with tetracycline resistance. No relation was observed between PenB and MtrR alterations and penicillin and tetracycline MICs. Conclusion High-level gonococcal penicillin and tetracycline resistance in the sampled Kenyan regions was found to be mediated by plasmid borne blaTEM and tetM genes. While the African TEM plasmid, TEM1 and American TetM are the dominant genotypes, Asian TEM plasmid, a new TEM239 and Dutch TetM have emerged in the regions.

scholarly journals High Prevalence of High-Level Ciprofloxacin Resistance in Neisseria gonorrhoeae in Tel Aviv, Israel: Correlation with Response to Therapy

2002 ◽  
Vol 46 (6) ◽  
pp. 1671-1673 ◽  
Author(s):  
Michael Dan ◽  
Francesca Poch ◽  
Bracha Sheinberg
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Response To Therapy ◽  
High Rate ◽  
Sharp Rise ◽  
Tel Aviv ◽  
High Prevalence ◽  
Resistance To Penicillin ◽  
Resistant Strains ◽  
Ciprofloxacin Resistance ◽  
High Level

ABSTRACT A survey of the drug susceptibilities of gonococcal isolates from 100 consecutive patients attending clinics in the Tel Aviv area of Israel during the period from February to September 2000 has shown a 61% rate of ciprofloxacin resistance (MICs, ≥1 μg/ml); 51 isolates were highly resistant (MICs, ≥4 μg/ml). Ciprofloxacin-resistant strains were more prevalent among isolates with chromosomally mediated resistance to penicillin and tetracycline. Therapeutic failures with ciprofloxacin correlated with MICs of ≥1 mg/ml (P < 0.01). The high rate of ciprofloxacin resistance coinciding with a sharp rise in the incidence of gonorrhea precludes the use of fluoroquinolone drugs for the empirical treatment of gonococcal infections acquired in Israel.

scholarly journals Susceptibility to antibiotics in escherichiae isolated in a multidisciplinary medical centre

2016 ◽  
Vol 65 (4) ◽  
pp. 83-89
Author(s):  
Nadezda S. Kozlova ◽  
Natalia E. Barantsevich ◽  
Elena P. Barantsevich
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Multidrug Resistance ◽  
Antimicrobial Resistance ◽  
Antimicrobial Agents ◽  
E Coli ◽  
Microdilution Method ◽  
Carbapenem Resistant ◽  
Resistant Strains ◽  
High Level

Relevance. Antimicrobial resistance in nosocomial strains currently presents a very important problem.  Aim of the study: Study of antibiotic resistance in Escherichia coli, isolated in a multidisciplinary centre.  Materials and Methods. Susceptibility of 151 E. coli strains to 15 antibiotics was studied by microdilution method. Results. The majority of the studied strains were resistant to antibiotics, including: ampicillin (57.0%), ciprofloxacin and moxifloxacin (42.4% each), III and IV generation cephalosporins (37.1% and 34.4%, respectively) and gentamycin (29.1%). The highest activity against E. coliwas shown for carbapenems (resistance to erthapenem – 2.6%, meropenem – 0.7%), in particular, for imipenem – no strains resistant to this drug were isolated. Resistance to amikacin and phosphomycin was low: 3.3% and 1.3% respectively. Wide diversity of antibiotic resistance spectra was revealed in studied strains, with a high level of multidrug resistance (48.0%). Conclusion. Study of susceptibility to antimicrobial agents in E. coli, isolated in a multidisciplinary centre, showed predominance of resistant strains with a high level of multidrug resistance. The appearance of carbapenem-resistant strains in a multidisciplinary centre presents a rising problem.

scholarly journals Molecular Basis of High-Level Ciprofloxacin Resistance in Neisseria gonorrhoeae Strains Isolated in Denmark from 1995 to 1998

2001 ◽  
Vol 45 (1) ◽  
pp. 117-123 ◽  
Author(s):  
Xiaohong Su ◽  
Inga Lind
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Pulsed Field Gel Electrophoresis ◽  
Fluoroquinolone Resistance ◽  
Resistant Clone ◽  
In Vitro Susceptibility ◽  
Mutation Pattern ◽  
Resistant Strains ◽  
Ciprofloxacin Resistance ◽  
High Level

ABSTRACT In Denmark surveillance of the in vitro susceptibility to ciprofloxacin of Neisseria gonorrhoeae was established in 1990. The proportion of N. gonorrhoeae strains with decreased susceptibility or resistance to ciprofloxacin (MIC ≥ 0.06 μg/ml) was low (0.3 to 2.3%) up to 1995. Between 1995 and 1998 the rate of less-susceptible and resistant strains rose from 6.9 to 13.2%. Among ciprofloxacin-resistant strains (MIC ≥ 1 μg/ml), 81% were highly resistant (MIC ≥ 4 μg/ml). Thirty-fiveN. gonorrhoeae strains (40 isolates) for which ciprofloxacin MICs were 4 to 32 μg/ml were investigated for the frequency and patterns of mutations within the gyrA andparC genes. The quinolone resistance-determining regions of the gyrA and parC genes were amplified by PCR, and the amplicons were directly sequenced. Alterations at Ser-91 and Asp-95 in GyrA and a single or double alteration in ParC were identified in 32 strains (91%). Ser-91-to-Phe and Asp-95-to-Gly alterations in GyrA were detected in 28 strains (80%). The most common ParC alteration, Asp-86 to Asn, was found in 19 strains (54%). The strains were analyzed for genetic relationship by pulsed-field gel electrophoresis (PFGE). The analysis showed that nine strains with the same mutation pattern in the gyrA and parCgenes, originating from different geographical areas over 3 years, had the same PFGE patterns after SpeI as well asNheI digestion (only one strain with one band difference in the NheI pattern), suggesting that a resistant clone had spread worldwide. The results from this study strongly suggest that double gyrA mutations plus a parCmutation(s) play an important role in the development of high-level fluoroquinolone resistance in N. gonorrhoeae.

scholarly journals Antimicrobial Resistance of Neisseria gonorrhoeae and High Prevalence of Ciprofloxacin-Resistant Isolates in Japan, 1993 to 1998

2000 ◽  
Vol 38 (2) ◽  
pp. 521-525 ◽  
Author(s):  
Masatoshi Tanaka ◽  
Hiroshi Nakayama ◽  
Masashi Haraoka ◽  
Takeshi Saika ◽  
Intetsu Kobayashi ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Susceptibility Testing ◽  
Tetracycline Resistance ◽  
Penicillin Resistance ◽  
Fluoroquinolone Resistance ◽  
Amino Acid Substitutions ◽  
High Prevalence ◽  
Ciprofloxacin Resistance ◽  
High Level

To assess the antimicrobial resistance of Neisseria gonorrhoeae isolated from 1993 through 1998 in Japan, susceptibility testing was conducted on 502 isolates. Selected isolates were characterized by auxotype and analysis for mutations within the quinolone resistance-determining region (QRDR) in the gyrAand parC genes, which confer fluoroquinolone resistance on the organism. Plasmid-mediated penicillin resistance (penicillinase-producing N. gonorrhoeae) decreased significantly from 1993–1994 (7.9%) to 1997–1998 (2.0%). Chromosomally mediated penicillin resistance decreased from 1993–1994 (12.6%) to 1995–1996 (1.9%) and then increased in 1997–1998 (10.7%). Chromosomally mediated tetracycline resistance decreased from 1993–1994 (3.3%) to 1997–1998 (2.0%), and no plasmid-mediated high-level tetracycline resistance was found. Isolates with ciprofloxacin resistance (MIC ≥ 1 μg/ml) increased significantly from 1993–1994 (6.6%) to 1997–1998 (24.4%). The proline-requiring isolates were less susceptible to ciprofloxacin than the prototrophic or arginine-requiring isolates. Ciprofloxacin-resistant isolates contained three or four amino acid substitutions within the QRDR in the GyrA and ParC proteins.

scholarly journals Genomic analysis and antimicrobial resistance of Neisseria gonorrhoeae isolates from Vietnam in 2011 and 2015–16

2020 ◽  
Vol 75 (6) ◽  
pp. 1432-1438 ◽  
Author(s):  
Pham Thi Lan ◽  
Daniel Golparian ◽  
Johan Ringlander ◽  
Le Van Hung ◽  
Nguyen Van Thuong ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Reproductive Health ◽  
Neisseria Gonorrhoeae ◽  
Molecular Epidemiology ◽  
Genomic Analysis ◽  
Illumina Miseq ◽  
Phylogenomic Analysis ◽  
Asian Countries ◽  
Resistant Strains ◽  
A Minor

Abstract Objectives Antimicrobial resistance (AMR) in Neisseria gonorrhoeae, compromising gonorrhoea treatment, is a threat to reproductive health globally. South-East and East Asia have been major sources of emergence and subsequent international spread of AMR gonococcal strains during recent decades. We investigated gonococcal isolates from 2011 and 2015–16 in Vietnam using AMR testing, WGS and detection of AMR determinants. Methods Two hundred and twenty-nine gonococcal isolates cultured in 2015–16 (n = 121) and 2011 (n = 108) in Vietnam were examined. AMR testing was performed using Etest and WGS with Illumina MiSeq. Results Resistance among the 2015–16 isolates was as follows: ciprofloxacin, 100%; tetracycline, 79%; benzylpenicillin, 50%; cefixime, 15%; ceftriaxone, 1%; spectinomycin, 0%; and 5% were non-WT to azithromycin. Eighteen (15%) isolates were MDR. The MIC range for gentamicin was 2–8 mg/L. Among the 2015–16 isolates, 27% (n = 33) contained a mosaic penA allele, while no isolates had a mosaic penA allele in 2011. Phylogenomic analysis revealed introduction after 2011 of two mosaic penA-containing clones (penA-10.001 and penA-34.001), which were related to cefixime-resistant strains spreading in Japan and Europe, and a minor clade (eight isolates) relatively similar to the XDR strain WHO Q. Conclusions From 2011 to 2015–16, resistance in gonococci from Vietnam increased to all currently and previously used antimicrobials except ceftriaxone, spectinomycin and tetracycline. Two mosaic penA-containing clones were introduced after 2011, explaining the increased cefixime resistance. Significantly increased AMR surveillance, antimicrobial stewardship and use of WGS for molecular epidemiology and AMR prediction for gonococcal isolates in Vietnam and other Asian countries are crucial.

scholarly journals Genotypic and Phenotypic Characterization of Antimicrobial Resistance in Neisseria gonorrhoeae: a Cross-Sectional Study of Isolates Recovered from Routine Urine Cultures in a High-Incidence Setting

mSphere ◽  
2019 ◽  
Vol 4 (4) ◽  
Author(s):  
Adam L. Bailey ◽  
Robert F. Potter ◽  
Meghan A. Wallace ◽  
Caitlin Johnson ◽  
Gautam Dantas ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Susceptibility Testing ◽  
Clinical Laboratory ◽  
Phenotypic Characterization ◽  
First Line ◽  
Content Type ◽  
Gradient Diffusion

ABSTRACT The objectives of this study were to perform genomic and phenotypic characterization of antimicrobial resistance in Neisseria gonorrhoeae isolates recovered from urine samples from patients in St. Louis, MO, USA. Sixty-four clinical isolates were banked over a 2-year period and subjected to antimicrobial susceptibility testing (AST) by Kirby-Bauer disk diffusion (penicillin, tetracycline, cefuroxime, and ciprofloxacin) and gradient diffusion (tetracycline, doxycycline, azithromycin, ceftriaxone, cefixime, ciprofloxacin, gemifloxacin, and delafloxacin). The medical records for the patients were evaluated to determine the demographics, location, and prescribed treatment regimen. Isolate draft genomes were assembled from Illumina shotgun sequencing data, and resistance determinants were identified by ResFinder and PointFinder. Of the 64 isolates, 97% were nonsusceptible to penicillin, with resistant isolates all containing the blaTEM-1b gene; 78 and 81% of isolates were nonsusceptible to tetracycline and doxycycline, respectively, with resistant isolates all containing the tet(M) gene. One isolate was classified as non-wild-type to azithromycin, and all isolates were susceptible to ceftriaxone; 89% of patients received this combination of drugs as first-line therapy. Six percent of isolates were resistant to ciprofloxacin, with most resistant isolates containing multiple gyrA and parC mutations. Correlation between disk and gradient diffusion AST devices was high for tetracycline and ciprofloxacin (R2 > 99% for both). The rates of N. gonorrhoeae antibiotic resistance in St. Louis are comparable to current rates reported nationally, except ciprofloxacin resistance was less common in our cohort. Strong associations between specific genetic markers and phenotypic susceptibility testing hold promise for the utility of genotype-based diagnostic assays to guide directed antibiotic therapy. IMPORTANCE Neisseria gonorrhoeae causes the sexually transmitted infection gonorrhea, which is most commonly diagnosed using a DNA-based detection method that does not require growth and isolation of N. gonorrhoeae in the laboratory. This is problematic because the rates of antibiotic resistance in N. gonorrhoeae are increasing, but without isolating the organism in the clinical laboratory, antibiotic susceptibility testing cannot be performed on strains recovered from clinical specimens. We observed an increase in the frequency of urine cultures growing N. gonorrhoeae after we implemented a total laboratory automation system for culture in our clinical laboratory. Here, we report on the rates of resistance to multiple historically used, first-line, and potential future-use antibiotics for 64 N. gonorrhoeae isolates. We found that the rates of antibiotic resistance in our isolates were comparable to national rates. Additionally, resistance to specific antibiotics correlated closely with the presence of genetic resistance genes, suggesting that DNA-based tests could also be designed to guide antibiotic therapy for treating gonorrhea.

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