scholarly journals Antimicrobal resistance ofNeisseria gonorrhoeaestrains in Hungary

2015 ◽  
Vol 156 (6) ◽  
pp. 226-229 ◽  
Author(s):  
Éva Nemes-Nikodém ◽  
Alexandra Brunner ◽  
Béla Tóth ◽  
Veronika Tóth ◽  
András Bánvölgyi ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Treatment Guideline ◽  
Typing Method ◽  
Sexually Transmitted ◽  
European Guidelines ◽  
Antimicrobial Surveillance ◽  
National Treatment Guideline ◽  
Molecular Typing Method ◽  
Sequence Types

Introduction: European guidelines on the treatment of Neisseria gonorrhoeae are based mostly on Western European data, although these recommendations may not be optimised for the circumstances in Hungary. Aim: The aim of the authors was to assess current antimicrobial resistance of Neisseria gonorrhoeae strains in order to enhance gonococcal antimicrobial surveillance in Hungary. Neisseria gonorrhoeae strains were isolated at the National Center of Sexually Transmitted Infections at the Department of Dermatology, Venerology and Dermatooncology of Semmelweis University in the period between January 2011 and June 2014. Method: Antimicrobial resistance was determined with minimum inhibitory concentration measurement. Neisseria gonorrhoeae Multiantigen Sequence typing was used as molecular typing method. Results: Resistance to the currently recommended extended spectrum cephalosporins is rare in Hungary, but there is an emerging azithromycin resistance among the Neisseria gonorrhoeae strains. Conclusions: Revision of the national treatment guideline must consider that the most frequent sequence types of Neisseria gonorrhoeae strains causing infections in Hungary are mainly resistant to azithromycin. Orv. Hetil., 2015, 156(6), 226–229.

Antimicrobial resistance mechanisms, MLST and NG-STAR sequence types of diverse Neisseria gonorrhoeae isolates in KwaZulu-Natal, South Africa

2021 ◽  
Author(s):  
Nireshni Mitchev ◽  
Ravesh Singh ◽  
Mushal Allam ◽  
Stanford Kwenda ◽  
Arshad Ismail ◽  
...  
Keyword(s):  
South Africa ◽  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Point Mutations ◽  
Resistance Mechanisms ◽  
Public Healthcare ◽  
Multiple Sequence ◽  
Genotypic Analysis ◽  
Kwazulu Natal ◽  
Sequence Types

Objective: Antimicrobial resistance (AMR) is a major challenge to managing infectious diseases. Africa has the highest incidence of gonorrhoea but there is a lack of comprehensive data from sparse surveillance programs. This study investigated the molecular epidemiology and AMR profiles of Neisseria gonorrhoeae isolates in KwaZulu-Natal province (KZN), South Africa. Methods: Repository isolates, from patients attending public healthcare clinics for STI care, were used for phenotypic and genotypic analysis. Etest® was performed to determine antimicrobial susceptibility. Whole-genome sequencing (WGS) was used to determine epidemiology and to predict susceptibility by detecting resistance-associated genes and mutations. Results: Among the 61 isolates, multiple sequence types were identified. Six isolates were novel as determined by multilocus sequence typing. N.gonorrhoeae Sequence Typing for Antimicrobial Resistance (NG-STAR) determined 48 sequence types, of which 35 isolates had novel antimicrobial profiles. Two novel penA alleles and eight novel mtrR alleles were identified. Point mutations were detected in gyrA , parC , mtrR , penA , ponA and porB1 . This study revealed a high prevalence of AMR (penicillin 67%, tetracycline 89% and ciprofloxacin 52%). However, spectinomycin, cefixime, ceftriaxone and azithromycin remained 100% effective. Conclusion: This study is one of the first to comprehensively describe the epidemiology and AMR of N. gonorrhoeae in KZN, South Africa and Africa, using WGS. KZN has a wide strain diversity and most of these sequence types have been detected in multiple countries, however more than half of our isolates have novel antimicrobial profiles. Continued surveillance is crucial to monitor the emergence of resistance to cefixime, ceftriaxone and azithromycin.

scholarly journals Antimicrobial Resistance of Neisseria gonorrhoeae Isolated from Out Patients Presenting with Urethral and Vaginal Discharges at Mbarara Regional Referral Hospital

2019 ◽  
pp. 1-7
Author(s):  
Judith Owokuhaisa ◽  
Joel Bazira
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Test Organism ◽  
Referral Hospital ◽  
Cross Sectional ◽  
Regional Referral Hospital ◽  
Sexually Transmitted ◽  
Peptone Water ◽  
Phenotypic Methods ◽  
Micro Organisms

Background: Gonococcus is one of the most common sexually transmitted diseases in developing countries and it has become a global health burden, hence a need for effective treatment. However, there is growing trend of antimicrobial resistant strains, in many parts of the world, to the previously effective antimicrobials thus creating serious health concerns. Setting: Mbarara Regional Referral Hospital -South-Western Uganda. Objectives: 1) To determine the prevalence of gonococcus among out patients presenting with urethral and vaginal discharges at MRRH. 2) To determine the level of antimicrobial resistance of gonococcus based on phenotypic methods at MRRH. Design: The study was cross sectional and enrolled 189 participants presenting with urethral and vaginal discharges. The urethral and endo cervical swab samples collected were cultured on Chocolate media supplemented with 5%-10% carbondioxide in candle jar (inoculated plates were placed in a jar and a burning candle placed in the same jar, then closed, by the time the candle went off, that 5%-10% carbondioxide atmosphere would have been created). Isolates obtained were identified according to the laboratory standard operating procedures. Drug Sensitivity Test (DST) on confirmed Neisseria gonorrheae isolates was performed using the Kirby Bauer technique. The colonies of the test organism were emulsified in peptone water and then inoculated on prepared sterile chocolate agar and the following discs were applied to it (Ceftriaxone discs (30µg), Erythromycin (15ug), Ciprofloxacin (10ug) and Penicillin (10IU). The plates were incubated at 37°C for 24- 48 hours under 5% carbon dioxide atmospheres. The Zone of inhibition was seen around an antibiotic disc to which the organism was sensitive. Results: Out of the 189 participants whose urethral swabs and Endo cervical swabs were cultured, 89 were positive cultures (47%), out of which 25 (28%) were found to have gonococcal infection, 64 (72%) patients had other micro-organisms. The prevalence of Neisseria Gonorrhoeae was 13%. In total, 4% of the isolates were resistant to Ceftriaxone, 28% to Ciprofloxacin, 68% to Erythromycin and 80% to Penicillin. A high percentage of resistance was observed against Penicillin (80%) and Erythromycin (68%). Conclusion: Adults aged 18 years and above who present at Mbarara Regional Referral Hospital with urethral or vaginal discharges are more likely to have a Neisseria gonorrhoeae which is resistant to Penicillin and Erythromycin.

scholarly journals Differences in Neisseria gonorrhoeae population structure and antimicrobial resistance pattern between men who have sex with men and heterosexuals

2016 ◽  
Vol 145 (2) ◽  
pp. 379-385 ◽  
Author(s):  
J. SERRA-PLADEVALL ◽  
M. J. BARBERÁ ◽  
A. E. CALLARISA ◽  
R. BARTOLOMÉ-COMAS ◽  
A. ANDREU
Keyword(s):  
Population Structure ◽  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Antimicrobial Susceptibility ◽  
Sexual Practices ◽  
Resistance Pattern ◽  
High Prevalence ◽  
Sex With Men ◽  
Resistance Rates ◽  
Sequence Types

SUMMARYThis study compared the antimicrobial susceptibility and genotypes of strains of Neisseria gonorrhoeae isolated from men who have sex with men (MSM) and from heterosexuals. One hundred and eleven strains were characterized from 107 patients, comprising 57 strains from 54 heterosexuals and 54 strains from 53 MSM. Antimicrobial resistance rates were higher in strains from heterosexual patients, with resistance to cefixime (P = 0·0159) and ciprofloxacin (P = 0·002) being significantly higher. Typing by N. gonorrhoeae multi-antigen sequence typing (NG-MAST) showed that the most prevalent sequence types (ST) and genogroups (G) respectively were ST2400, ST2992, and ST5793, and G1407, G2992, and G2400. A statistically significant association was observed for MSM and genogroups G2400 (P = 0·0005) and G2992 (P = 0·0488), and G1407 with heterosexuals (P = 0·0002). We conclude that in our region distinct populations of gonococci are circulating among subjects with different sexual practices, with their corresponding transmission patterns. Furthermore, the high prevalence of genotype G2400 in MSM, has not to our knowledge been previously described.

scholarly journals Epidemiology, molecular characterisation and antimicrobial susceptibility of Neisseria gonorrhoeae isolates in Madrid, Spain, in 2016

2019 ◽  
Vol 147 ◽  
Author(s):  
M. D. Guerrero-Torres ◽  
M. B. Menéndez ◽  
C. S. Guerras ◽  
E. Tello ◽  
J. Ballesteros ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Antimicrobial Susceptibility ◽  
Strong Association ◽  
Clinical Samples ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
High Incidence ◽  
Ciprofloxacin Resistance ◽  
Sequence Types ◽  
Infection Clinic

Abstract With the aim to elucidate gonococcal antimicrobial resistance (AMR)–risk factors, we undertook a retrospective analysis of the molecular epidemiology and AMR of 104 Neisseria gonorrhoeae isolates from clinical samples (urethra, rectum, pharynx and cervix) of 94 individuals attending a sexually transmitted infection clinic in Madrid (Spain) from July to October 2016, and explored potential links with socio-demographic, behavioural and clinical factors of patients. Antimicrobial susceptibility was determined by E-tests, and isolates were characterised by N. gonorrhoeae multi-antigen sequence typing. Penicillin resistance was recorded for 15.4% of isolates, and most were susceptible to tetracycline, cefixime and azithromycin; a high incidence of ciprofloxacin resistance (~40%) was found. Isolates were grouped into 51 different sequence types (STs) and 10 genogroups (G), with G2400, ST5441, ST2318, ST12547 and G2992 being the most prevalent. A significant association (P = 0.015) was evident between HIV-positive MSM individuals and having a ciprofloxacin-resistant strain. Likewise, a strong association (P = 0.047) was found between patient age of MSM and carriage of isolates expressing decreased susceptibility to azithromycin. A decrease in the incidence of AMR gonococcal strains and a change in the strain populations previously reported from other parts of Spain were observed. Of note, the prevalent multi-drug resistant genogroup G1407 was represented by only three strains in our study, while the pan-susceptible clones such as ST5441, and ST2318, associated with extragenital body sites were the most prevalent.

scholarly journals Typing of Neisseria gonorrhoeae Isolates in Shenzhen, China, from 2014 to 2018 Reveals the Shift of Genotypes Significantly Associated with Antimicrobial Resistance

2021 ◽  
Vol 65 (5) ◽  
Author(s):  
Yizhun Li ◽  
Yamei Li ◽  
Leshan Xiu ◽  
Yaling Zeng ◽  
Chi Zhang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Molecular Epidemiology ◽  
Important Data ◽  
Content Type ◽  
Future Studies ◽  
Ideal Tool ◽  
Global Threat ◽  
Sequence Types

ABSTRACT The growing antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a serious global threat to gonococcal therapy. Molecular typing is an ideal tool to reveal the association between specific genotypes and resistance phenotypes that provide effective data for tracking the transmission of resistant clones of N. gonorrhoeae. In our study, we aimed to describe the molecular epidemiology of AMR and the distribution of resistance-associated genotypes in Shenzhen, China, during 2014 to 2018. In total, 909 isolates were collected from Shenzhen from 2014 to 2018. Two typing schemes, multilocus sequence typing (MLST) and N. gonorrhoeae sequence typing for antimicrobial resistance (NG-STAR), were performed for all isolates. The distribution of resistance-associated genotypes was described using goeBURST analysis combined with logistic regression data. Among 909 isolates, sequence type 8123 (ST8123), ST7363, ST1901, ST7365, and ST7360 were the most common MLST sequence types, and ST348, ST2473, ST497, and ST199 were the most prevalent NG-STAR STs. Logistic regression analysis showed that NG-STARST497, MLSTST7365, and MLSTST7360 were typically associated with decreased susceptibility to ceftriaxone. Furthermore, the internationally spreading extended-spectrum cephalosporin (ESC)-resistant clone MLSTST1901 has been prevalent since at least 2014 in Shenzhen and showed a significant increase during 2014 to 2018. Additionally, MLSTST7363 owns the potential to become the next internationally spreading ceftriaxone-resistant ST. In conclusion, we performed a comprehensive epidemiological study to explore the correlation between AMR and specific STs, which provided important data for future studies of the molecular epidemiology of AMR in N. gonorrhoeae. Besides, these findings provide insight for adjusting surveillance strategies and therapy management in Shenzhen.

scholarly journals Emergence and evolution of antimicrobial resistance genes and mutations in Neisseria gonorrhoeae

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Koji Yahara ◽  
Kevin C. Ma ◽  
Tatum D. Mortimer ◽  
Ken Shimuta ◽  
Shu-ichi Nakayama ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Acquired Resistance ◽  
Antibiotic Use ◽  
Health Concern ◽  
Fluoroquinolone Resistance ◽  
Resistance Mutations ◽  
Treatment Regimens ◽  
Antimicrobial Resistance Genes ◽  
Sequence Types

Abstract Background Antimicrobial resistance in Neisseria gonorrhoeae is a global health concern. Strains from two internationally circulating sequence types, ST-7363 and ST-1901, have acquired resistance to third-generation cephalosporins, mainly due to mosaic penA alleles. These two STs were first detected in Japan; however, the timeline, mechanism, and process of emergence and spread of these mosaic penA alleles to other countries remain unknown. Methods We studied the evolution of penA alleles by obtaining the complete genomes from three Japanese ST-1901 clinical isolates harboring mosaic penA allele 34 (penA-34) dating from 2005 and generating a phylogenetic representation of 1075 strains sampled from 35 countries. We also sequenced the genomes of 103 Japanese ST-7363 N. gonorrhoeae isolates from 1996 to 2005 and reconstructed a phylogeny including 88 previously sequenced genomes. Results Based on an estimate of the time-of-emergence of ST-1901 (harboring mosaic penA-34) and ST-7363 (harboring mosaic penA-10), and > 300 additional genome sequences of Japanese strains representing multiple STs isolated in 1996–2015, we suggest that penA-34 in ST-1901 was generated from penA-10 via recombination with another Neisseria species, followed by recombination with a gonococcal strain harboring wildtype penA-1. Following the acquisition of penA-10 in ST-7363, a dominant sub-lineage rapidly acquired fluoroquinolone resistance mutations at GyrA 95 and ParC 87-88, by independent mutations rather than horizontal gene transfer. Data in the literature suggest that the emergence of these resistance determinants may reflect selection from the standard treatment regimens in Japan at that time. Conclusions Our findings highlight how antibiotic use and recombination across and within Neisseria species intersect in driving the emergence and spread of drug-resistant gonorrhea.

scholarly journals Trends in Neisseria gonorrhoeae Antimicrobial Resistance over a Ten-Year Surveillance Period, Johannesburg, South Africa, 2008–2017

Antibiotics ◽  
2018 ◽  
Vol 7 (3) ◽  
pp. 58 ◽  
Author(s):  
Ranmini Kularatne ◽  
Venessa Maseko ◽  
Lindy Gumede ◽  
Tendesayi Kufa
Keyword(s):  
South Africa ◽  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Health Centre ◽  
P Value ◽  
Surveillance Period ◽  
Sexually Transmitted ◽  
Resistance Patterns ◽  
High Level ◽  
Level Resistance

Background: In South Africa, sexually transmitted infections (STIs) are managed through a syndromic approach at primary healthcare centres (PHCs). Neisseria gonorrhoeae is the predominant cause of male urethritis syndrome. We describe antimicrobial resistance patterns and trends in Neisseria gonorrhoeae during a ten-year surveillance period at a large PHC in Johannesburg. Methods: Neisseria gonorrhoeae was cultured from genital discharge swab specimens obtained from consenting adult patients presenting at the Alexandra Health Centre in Johannesburg between 2008 and 2017. Isolates were tested for antimicrobial susceptibility by Etest™ (cefixime, ceftriaxone, ciprofloxacin) or agar dilution (penicillin, tetracycline, azithromycin). Results: During the period of surveillance, high-level resistance prevalence increased from 30% to 51% for penicillin (p-value for trend < 0.001), 75% to 83% for tetracycline (p-value for trend = 0.008), and 25% to 69% for ciprofloxacin (p-value for trend < 0.001). Analysis did not reveal high-level resistance to spectinomycin or a minimum inhibitory concentration (MIC) creep for extended-spectrum cephalosporins, and the prevalence of intermediate-resistance to azithromycin was less than 5%. Conclusions: High prevalence resistance to penicillin, tetracycline, and ciprofloxacin in N. gonorrhoeae obviates their use in future national treatment algorithms for genital discharge. It is essential to continue monitoring for emerging resistance to currently recommended antimicrobial therapy in this rapidly evolving pathogen.

scholarly journals Characteristics and Dissemination of Mosaic Penicillin-Binding Protein 2-Harboring Multidrug-Resistant Neisseria gonorrhoeae Isolates with Reduced Cephalosporin Susceptibility in Northern Taiwan

2010 ◽  
Vol 54 (11) ◽  
pp. 4893-4895 ◽  
Author(s):  
Chung-Ter Huang ◽  
Muh-Yong Yen ◽  
Wing-Wai Wong ◽  
Lan-Hui Li ◽  
Kun-Yen Lin ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Multidrug Resistant ◽  
Bisexual Men ◽  
Penicillin Binding Protein ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
Sequence Types ◽  
Northern Taiwan ◽  
Major Sequence

ABSTRACT Among 254 Neisseria gonorrhoeae isolates from a sexually transmitted infection (STI) clinic in northern Taiwan, 69 isolates were found to contain the mosaic penA (MA) gene and were associated with elevated cefixime and ceftriaxone MICs. Most of these MA gene-harboring isolates were also resistant to penicillin (71.4%) and ciprofloxacin (100%) and were from men who have sex with men (MSM) or from bisexual men (81.2%). Three major sequence types (ST835, ST2180, and ST2253) constituted 55.7% of these isolates. The major sequence types harboring the mosaic penA gene may represent major sexual networks responsible for the emergence/introduction and the spread of the multidrug-resistant clones in Taiwan.

Antimicrobial resistance patterns in Neisseria gonorrhoeae among male clients of a sexually transmitted infections clinic in Kisumu, Kenya

2019 ◽  
Vol 31 (1) ◽  
pp. 46-52
Author(s):  
Carrie Nacht ◽  
Walter Agingu ◽  
Fredrick Otieno ◽  
Finch Odhiambo ◽  
Supriya D Mehta
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Disk Diffusion ◽  
African Region ◽  
Surveillance Period ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Urethral Discharge ◽  
Male Clients ◽  
Resistance Patterns

Approximately 11.4 million cases of gonorrhea occur in the WHO African Region annually and global incidence has been increasing. We sought to determine the distribution and types of antimicrobial resistance in Neisseria gonorrhoeae (NG) in Kisumu, Kenya. Urethral swab specimens were obtained from men attending Universities of Nairobi, Illinois, and Manitoba sexually transmitted infection clinic with urethral discharge detected on clinical exam between 29 January and 2 July 2018. Gonorrhea was confirmed by culturing on Thayer–Martin GC Culture selective media. Disk diffusion was used to measure resistance to antimicrobials. Of the 138 males with history of urethral discharge or dysuria or urethral discharge on exam identified during the surveillance period, urethral swab samples were obtained from 60 men, and 35 (58%) were culture positive. Interpretation of the disk diffusion results showed high resistance (% of isolates) to: penicillin (97%), tetracycline (100%), ciprofloxacin (100%), and doxycycline (91%). All isolates were susceptible to ceftriaxone (100%) and azithromycin (100%). We observed high rates of resistance to several drug classes, likely driven by background selective pressure, as resistance was not observed among currently recommended Kenyan therapies for urethritis. Expanded surveillance for antimicrobial resistance in NG is warranted. Agar dilution or Etest reference testing is needed for accurate assessment of resistance.

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