scholarly journals Antimicrobial Resistance Profiles of Human Commensal Neisseria Species

2021 ◽  
Author(s):  
Maira Goytia ◽  
Symone T Thompson ◽  
Skylar VL Jordan ◽  
Kacey A King
Keyword(s):  
Antimicrobial Resistance ◽  
Antibiotic Resistance Gene ◽  
Dual Therapy ◽  
Gene Pools ◽  
Transmitted Infection ◽  
Closely Related Species ◽  
Phenotypic Resistance ◽  
Neisseria Species ◽  
Sexually Transmitted ◽  
Commensal Neisseria

Pathogenic Neisseria gonorrhoeae causes the sexually-transmitted infection gonorrhea. N. gonorrhoeae has evolved high levels of antimicrobial resistance (AR) leading to therapeutic failures even in dual-therapy treatment with azithromycin and ceftriaxone. AR mechanisms can be acquired by genetic transfer from closely related species, such as naturally-competent commensal Neisseria species. At present, little is known about the antimicrobial resistance profiles of commensal Neisseria. Here, we characterized the phenotypic resistance profile of four commensal Neisseria species (N. lactamica, N. cinerea, N. mucosa, and N. elongata) against 10 commonly used antibiotics, and compared their profiles to 4 N. gonorrhoeae strains, using disk diffusion and minimal inhibitory concentration assays. Overall, we observed that 3 of the 4 commensals were more resistant to several antibiotics than pathogenic N. gonorrhoeae strains. Next, we compared the penicillin-binding-protein 2 (PBP2) sequences between commensal and N. gonorrhoeae strains. We found mutations in PBP2 known to confer resistance in N. gonorrhoeae also present in commensal Neisseria sequences. Our results suggest that commensal Neisseria have unexplored antibiotic resistance gene pools that may be exchanged with pathogenic N. gonorrhoeae, possibly impairing drug development and clinical treatment.

scholarly journals Association between intensity of STI screening and development of antimicrobial resistance in N. gonorrhoeae in 12 cities in the USA: An ecological study

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1237
Author(s):  
Chris R. Kenyon
Keyword(s):  
United States ◽  
Antimicrobial Resistance ◽  
Ecological Study ◽  
Geometric Mean ◽  
The United States ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Antimicrobial Sensitivity ◽  
The Usa ◽  
Sex With Men

In this study, we assessed if there was a city-level association between sexually transmitted infection (STI) screening intensity in men who have sex with men and antimicrobial sensitivity in Neisseria gonorrhoeae in the United States, 2007 to 2013.  We found positive associations between STI screening intensity and increases in minimum inhibitory concentrations for cefixime and azithromycin, but not ceftriaxone when using change in city geometric mean N. gonorrhoeae MIC between 2005 and 2013.

scholarly journals Mosaic structure of the penA gene in the oropharynx of men who have sex with men negative for gonorrhoea

2020 ◽  
Vol 31 (3) ◽  
pp. 230-235 ◽  
Author(s):  
Antonella Marangoni ◽  
Giacomo Marziali ◽  
Melissa Salvo ◽  
Antonietta D’Antuono ◽  
Valeria Gaspari ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Dna Recombination ◽  
Genetic Material ◽  
Mosaic Structure ◽  
Multi Drug Resistance ◽  
Transmitted Infection ◽  
Neisseria Species ◽  
Sexually Transmitted ◽  
Pcr Products ◽  
Sex With Men

The oropharynx represents a crucial site for the emergence of multi-drug resistance in Neisseria gonorrhoeae. The mosaic penA alleles, associated with decreased susceptibility to cephalosporins, have emerged by DNA recombination with partial penA genes, particularly those from commensal pharyngeal Neisseria species. Here, we investigated the prevalence of the mosaic structure of the penA gene in the oropharynx of men who have sex with men testing negative for pharyngeal gonorrhoea. From January 2016 to June 2018, 351 gonorrhoea-negative men who have sex with men attending a sexually transmitted infection clinic in Italy were enrolled. Pharyngeal swabs underwent a real-time polymerase chain reaction (PCR) for the detection of the mosaic penA gene. In case of positivity, PCR products were sequenced and searched against several sequences of Neisseria strains. Overall, 31 patients (8.8%) were found positive for the presence of the mosaic penA gene. The positivity was significantly associated with previous cases of pharyngeal gonorrhoea (relative risk [RR]: 3.56, 95% confidence interval 1.44–8.80) and with recent exposure to beta-lactams (RR: 4.29, 95% confidence interval 2.20–8.38). All penA-positive samples showed a high relatedness (90–99%) with mosaic-positive Neisseria strains. Our data underline that commensal Neisseria species of the oropharynx may be a significant reservoir for genetic material conferring antimicrobial resistance in N. gonorrhoeae.

Empiric antimicrobial treatment for asymptomatic sexual contacts of sexually transmitted infection in the era of antimicrobial resistance: time to rethink?

2018 ◽  
Vol 30 (2) ◽  
pp. 137-139 ◽  
Author(s):  
Elizabeth Pearce ◽  
Derek J Chan ◽  
Don E Smith
Keyword(s):  
Antimicrobial Resistance ◽  
Sexually Transmitted Infection ◽  
Public Health Problem ◽  
Antimicrobial Treatment ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
The Public ◽  
Retrospective Audit ◽  
Laboratory Confirmation ◽  
Sexual Contacts

Prudent prescribing of antimicrobials is essential in ameliorating the public health problem of antimicrobial resistance. This retrospective audit assesses whether empiric antimicrobial treatment for asymptomatic sexual contacts of sexually transmitted infection is appropriate based on laboratory confirmation.

scholarly journals Genomic epidemiology of syphilis reveals independent emergence of macrolide resistance across multiple circulating lineages

2018 ◽  
Author(s):  
Mathew A. Beale ◽  
Michael Marks ◽  
Sharon K. Sahi ◽  
Lauren C. Tantalo ◽  
Achyuta V. Nori ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Sexually Transmitted Infection ◽  
Direct Sequencing ◽  
Treponema Pallidum ◽  
Macrolide Resistance ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Genomic Epidemiology ◽  
Phylogenomic Analyses

AbstractSyphilis is a sexually transmitted infection caused byTreponema pallidumsubspeciespallidumand may lead to severe complications. Recent years have seen striking increases in syphilis in many countries. Previous analyses have suggested one lineage of syphilis, SS14, may have expanded recently, indicating emergence of a single pandemic azithromycin-resistant cluster. We used direct sequencing ofT. pallidumcombined with phylogenomic analyses to show that both SS14- and Nichols-lineages are simultaneously circulating in clinically relevant populations in multiple countries. We correlate the appearance of genotypic macrolide resistance with multiple independently evolved SS14 sub-lineages and show that genotypically resistant and sensitive sub-lineages are spreading contemporaneously, incompatible with the notion that SS14-lineage expansion is driven purely by macrolide resistance. These findings inform our understanding of the current syphilis epidemic by demonstrating how macrolide resistance evolves inTreponemasubspecies and provide a warning on broader issues of antimicrobial resistance.

scholarly journals Association between intensity of STI screening and development of antimicrobial resistance in N. gonorrhoeae in 12 cities in the USA: An ecological study

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1237 ◽  
Author(s):  
Chris R. Kenyon
Keyword(s):  
United States ◽  
Antimicrobial Resistance ◽  
Sexually Transmitted Infection ◽  
Ecological Study ◽  
The United States ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Antimicrobial Sensitivity ◽  
The Usa ◽  
Sex With Men

In this study, we assessed if there was a city-level association between sexually transmitted infection (STI) screening intensity in men who have sex with men and antimicrobial sensitivity in Neisseria gonorrhoeae in the United States, 2007 to 2013.  We found positive associations between STI screening intensity and increases in minimum inhibitory concentrations for cefixime and azithromycin, but not ceftriaxone.

scholarly journals 670. Precision Metagenomic (PM) Sequencing Outperforms Conventional Urine Culture in Detecting Clinically Relevant Microorganisms

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S437-S438
Author(s):  
Rita C Stinnett ◽  
Bethany Kent ◽  
Marta Mangifesta ◽  
Anagha Kadam ◽  
Heng Xie ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Pathogen Detection ◽  
Urine Culture ◽  
Diagnostic Yield ◽  
Panel Member ◽  
Reference Method ◽  
Antibiotic Use ◽  
Transmitted Infection ◽  
Phenotypic Resistance ◽  
The Impact

Abstract Background Morbidity from urinary tract infection (UTI) is high. Urine culture is the reference method for UTI diagnosis. Its diagnostic yield is limited as prior antibiotic use prevents growth of established uropathogens, many emerging uropathogens do not grow under routine culture conditions, and results interpretation can be subjective. Faster, more comprehensive diagnostics could help manage recurrent and/or drug-resistant infections. We evaluated the diagnostic yield of a precision metagenomic (PM) workflow for pathogen detection & antimicrobial resistance (AMR) characterization directly from urine. Methods Residual urine samples from symptomatic adults evaluated by culture & susceptibility were identified by a combination of consecutive & stratified random sampling (n=480; 79% culture positive). DNA was extracted with modifications to the Quick-DNA Urine Kit (Zymo). Libraries were generated with Illumina DNA Prep with Enrichment for clinically relevant targets (191 pathogens, 1976 AMR markers) with the Explify Urinary ID/AMR Panel (UPIP, IDbyDNA). Enriched libraries were sequenced on the NextSeq550 (Illumina) and data analyzed with the Explify UPIP Data Analysis Solution (IDbyDNA). Results For bacterial uropathogens, 94% positive agreement was observed between this PM workflow and culture. PM detected fastidious and/or anaerobic potential uropathogens in 30% and 7% of samples reported as culture-negative or positive for other bacteria, respectively. Total agreement between AMR marker detection and phenotypic resistance was 78%. Notably, PM predicted phenotypes of ESBL E. coli and K. pneumoniae (10/10), MRSA (9/9), and vancomycin-resistant E. faecium (4/5). PM also detected pathogens associated with sexually-transmitted infection (C. trachomatis, HSV) and bacterial vaginosis (G. vaginalis). PM produced complete results within 24-36 hours of sample receipt (vs culture & susceptibility: 42-72 hrs). Conclusion The sensitivity of PM for uropathogen detection was noninferior to culture (Δ = 0.05; Nam RMLE; p < 0.0005). PM predicted antimicrobial resistance phenotypes for common uropathogens and identified potential pathogens not detected by conventional culture. Future studies should assess the impact of PM-guided management on clinical outcomes. Disclosures Rita C. Stinnett, PhD, MHS, IDbyDNA (Employee) Marta Mangifesta, PhD, IDbyDNA (Employee) Anagha Kadam, PhD, IDbyDNA (Employee) Heng Xie, PhD, IDbyDNA (Employee) Stacie Stauffer, BS, IDbyDNA (Employee) Jamie Lemon, PhD, D(ABMM), IDbyDNA (Employee) Benjamin Briggs, MD, PhD, IDbyDNA (Employee) Lauge Farnaes, MD, PhD, Cardea Bio (Advisor or Review Panel member)IDbyDNA (Employee) Robert Schlaberg, MD, MPH, IDbyDNA (Consultant, Shareholder, Co-founder)

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.

scholarly journals Emergence of ceftriaxone-resistant Neisseria gonorrhoeae strains harbouring a novel mosaic penA gene in China

2020 ◽  
Vol 75 (4) ◽  
pp. 907-910 ◽  
Author(s):  
Leshan Xiu ◽  
Qianqin Yuan ◽  
Yamei Li ◽  
Chi Zhang ◽  
Lingli Tang ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Current Treatment ◽  
Neisseria Species ◽  
Treatment Regimens ◽  
Gonorrhoeae Strain ◽  
Neisseria Perflava ◽  
Interspecies Recombination ◽  
Commensal Neisseria

Abstract Objectives The continuous emergence of ceftriaxone-resistant Neisseria gonorrhoeae strains threatens the effectiveness of current treatment regimens for gonorrhoea. The objective of the present study was to characterize three ceftriaxone-resistant N. gonorrhoeae strains with a novel mosaic penA allele isolated in China. Methods Three ceftriaxone-resistant Neisseria gonorrhoeae strains (GC150, GC161 and GC208) isolated in 2017 were characterized by N. gonorrhoeae multiantigen sequence typing (NG-MAST), MLST and N. gonorrhoeae sequence typing for antimicrobial resistance (NG-STAR). Recombination analyses were performed using the SimPlot software. Results Three strains had the same antibiotic resistance profiles, with resistance to ceftriaxone (MIC 0.5 mg/L), ciprofloxacin (MIC 8.0 mg/L), penicillin (MIC 2.0 mg/L) and tetracycline (MIC 2.0–8.0 mg/L). STs were assigned as MLST7360, NG-MAST14292 and NG-STAR1611/NG-STAR1612. The penA gene of these three strains differed from previous ceftriaxone-resistant gonococcal strains and harboured a novel mosaic allele (penA-121.001). Like N. gonorrhoeae FC428, a widely disseminated ceftriaxone-resistant strain that was initially described in Japan in 2015, all strains also possessed substitutions A311V and T483S in PBP2, which are associated with resistance to ceftriaxone. Potential recombination events were detected in penA between N. gonorrhoeae strain FC428 and commensal Neisseria species. Our results provide further evidence that the commensal Neisseria species (Neisseria cinerea and Neisseria perflava) can serve as a reservoir of ceftriaxone resistance-mediating penA sequences in clinical gonococcal strains. Conclusions The emergence of such strains may be the result of the interspecies recombination of penA genes between N. gonorrhoeae strain FC428 and commensal Neisseria species.

scholarly journals A Retrospective Study: Characteristics and Management of Gonorrhea

2021 ◽  
Vol 33 (1) ◽  
pp. 1
Author(s):  
Indah Purnamasari ◽  
Dwi Murtiastutik ◽  
Muhammad Yulianto Listiawan ◽  
Evy Ervianti ◽  
Rahmadewi Rahmadewi ◽  
...  
Keyword(s):  
Public Health ◽  
Teaching Hospital ◽  
Public Health Problem ◽  
Dual Therapy ◽  
Health Impact ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Academic Teaching ◽  
Study Characteristics ◽  
Academic Teaching Hospital

Background: Gonorrhea (GO) is a sexually transmitted infection that remains an important clinical and public health problem worldwide. Its incidence tends to increase both in males and females. Given the scale of the public health impact of GO, the selection of appropriate therapy is essential. Purpose: This study aimed to evaluate the characteristics, management, and recovery of gonorrhea patients. Methods: The research material was obtained from the medical record of gonorrhea patients at the Sexually Transmitted Infections (STI) Outpatient Clinic, Dermatology and Venerelogy Department, Dr. Soetomo General Academic Teaching Hospital, Surabaya, from January 2016 to December 2018. Result: We found 84 new GO patients (0.02%) out of the total new outpatients at the Dermatology and Venereology Department, Dr. Soetomo General Academic Teaching Hospital, Surabaya. Most of them were males (92.9%), 17–25 years age group (52.4%), unmarried (67.9%), and heterosexual (90.5%). The majority of therapy is dual therapy, was combination of doxycycline and cefixime (78%). Only 34 patients (40.5%) attended the follow-up visits, and 94.1% of them recovered, and 5.9% presented with cystitis. Conclusion: The characteristics features of GO varies in each variable. One of important to control GO is provide effective and appropriate treatment and routinely clinical and laboratories were needed control.

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