scholarly journals Antimicrobial resistance of Neisseria gonorrhoeae isolates in south-west Germany, 2004 to 2015: increasing minimal inhibitory concentrations of tetracycline but no resistance to third-generation cephalosporins

2016 ◽  
Vol 21 (36) ◽  
Author(s):  
Thomas Regnath ◽  
Thomas Mertes ◽  
Ralf Ignatius
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Susceptibility Testing ◽  
West Germany ◽  
Third Generation ◽  
Minimal Inhibitory Concentrations ◽  
South West ◽  
Male Patients ◽  
High Level ◽  
Third Generation Cephalosporins

Increasing antimicrobial resistance of Neisseria gonorrhoeae, particularly to third-generation cephalosporins, has been reported in many countries. We examined the susceptibility (determined by Etest and evaluated using the breakpoints of the European Committee on Antimicrobial Susceptibility Testing) of 434 N. gonorrhoeae isolates collected from 107 female and 327 male patients in Stuttgart, south-west Germany, between 2004 and 2015. During the study period, high proportions of isolates were resistant to ciprofloxacin (70.3%), tetracycline (48.4%; increasing from 27.5% in 2004/2005 to 57.7% in 2014/2015; p = 0.0002) and penicillin (25.6%). The proportion of isolates resistant to azithromycin was low (5.5%) but tended to increase (p = 0.08). No resistance and stable minimum inhibitory concentrations were found for cefixime, ceftriaxone, and spectinomycin. High-level resistance was found for ciprofloxacin (39.6%) and tetracycline (20.0%) but not for azithromycin; 16.3% of the isolates produced betalactamase. Thus, cephalosporins can still be used for the treatment of gonorrhoea in the study area. To avoid further increasing resistance to azithromycin, its usage should be limited to patients allergic to cephalosporins, or (in combination with cephalosporins) to patients for whom no susceptibility testing could be performed or those co-infected with chlamydiae.

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 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.

Emergence and dissemination of three mild outbreaks of Neisseria gonorrhoeae with high-level resistance to azithromycin in Barcelona, 2016–18

2020 ◽  
Author(s):  
P Salmerón ◽  
A Moreno-Mingorance ◽  
J Trejo ◽  
R Amado ◽  
B Viñado ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
23S Rrna ◽  
Phylogenomic Analysis ◽  
Rrna Gene ◽  
Snp Analysis ◽  
Enhanced Resolution ◽  
23S Rrna Gene ◽  
High Level ◽  
Level Resistance

Abstract Background Neisseria gonorrhoeae (NG) isolates with high-level azithromycin resistance (HL-AziR) have emerged worldwide in recent decades, threatening the sustainability of current dual-antimicrobial therapy. Objectives This study aimed to characterize the first 16 NG isolates with HL-AziR in Barcelona between 2016 and 2018. Methods WGS was used to identify the mechanisms of antimicrobial resistance, to establish the MLST ST, NG multiantigen sequence typing (NG-MAST) ST and NG sequence typing for antimicrobial resistance (NG-STAR) ST and to identify the clonal relatedness of the isolates with other closely related NG previously described in other countries based on a whole-genome SNP analysis approach. The sociodemographic characteristics of the patients included in the study were collected by comprehensive review of their medical records. Results Twelve out of 16 HL-AziR isolates belonged to the MLST ST7823/NG-MAST ST5309 genotype and 4 to MLST ST9363/NG-MAST ST3935. All presented the A2059G mutation in all four alleles of the 23S rRNA gene. MLST ST7823/NG-MAST ST5309 isolates were only identified in men who have sex with women and MLST ST9363/NG-MAST ST3935 were found in MSM. Phylogenomic analysis revealed the presence of three transmission clusters of three different NG strains independently associated with sexual behaviour. Conclusions Our findings support the first appearance of three mild outbreaks of NG with HL-AziR in Spain. These results highlight the continuous capacity of NG to develop antimicrobial resistance and spread among sexual networks. The enhanced resolution of WGS provides valuable information for outbreak investigation, complementing the implementation of public health measures focused on the prevention and dissemination of MDR NG.

scholarly journals Antimicrobial resistance in non-typhoidal salmonellas from humans in Northern Ireland, 2001–2003: standardization needed for better epidemiological monitoring

2006 ◽  
Vol 135 (4) ◽  
pp. 675-680 ◽  
Author(s):  
G. ONG ◽  
I. WILSON ◽  
B. SMYTH ◽  
P. ROONEY
Keyword(s):  
Northern Ireland ◽  
Antimicrobial Resistance ◽  
Susceptibility Testing ◽  
Treatment Options ◽  
Resistance Pattern ◽  
Sensitivity Testing ◽  
Antimicrobial Sensitivity ◽  
Epidemiological Monitoring ◽  
Testing Practices ◽  
Third Generation Cephalosporins

SUMMARYThis study investigated the identification and antimicrobial susceptibility testing of Salmonella isolates in Northern Ireland during 2001–2003. All six participating hospital laboratories used similar methods. Identification and antimicrobial resistance of human enteric (n=897) Salmonella isolates were analysed by retrospective collation of laboratory records. Resistance of human Salmonella isolates to nalidixic acid was 16% but resistance to ciprofloxacin or cefotaxime was rare (<1%). Minor inter-laboratory variations in sensitivity testing practices make it difficult to compare antimicrobial sensitivity results reliably and also to monitor for epidemic clones such as S. Typhimurium DT104 with the ACSSuT resistance pattern. The outcome of this study was the adoption of a standardized regional approach to the isolation of salmonella antimicrobial resistance. This should improve epidemiological monitoring of epidemic clones and assure optimum treatment options are available. In cases of treatment failure, MICs to third-generation cephalosporins and ciprofloxacin should be determined.

Comparison of deferred and bedside culture of Neisseria gonorrhoeae: a study to improve the isolation of gonococci for antimicrobial susceptibility testing

2020 ◽  
Author(s):  
Iryna Boiko ◽  
Yuliia Stepas ◽  
Inna Krynytska
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Susceptibility Testing ◽  
Agar Gel ◽  
Successful Isolation ◽  
Antimicrobial Resistance Profile ◽  
Specimen Processing ◽  
Culture Performance ◽  
Guide Lines ◽  
Higher Sensitivity

Background and Objectives: Antimicrobial resistance of Neisseria gonorrhoeae is globally spread and threatening. Cultur- ing of N. gonorrhoeae is the only method to collect live isolates for investigation antimicrobial resistance profile. Therefore, quality assessment of N. gonorrhoeae culture is essential for successful isolation of gonococci. This study was conducted to evaluate deferred and bedside culture of N. gonorrhoeae depending on the year season and temperature condition of transport media temporary storage. Materials and Methods: Urogenital swabs from 46 symptomatic heterosexual patients with gonorrhoea and subculture of N. gonorrhoeae in 46 suspensions in concentrations 1.5 × 108 CFU/ml were subjected to the study. Non-nutritive transporting medium Amies Agar Gel Medium with charcoal (Copan Diagnostics Inc., Brescia, Italy) was used for deferred culture and selective Chocolate agar TM+PolyViteX VCAT3 (BioMérieux, Marcy-l'Étoile, France) for both tested methods of culture. Results: The specificity of both bedside and deferred methods of culture was 100%. The sensitivity of deferred culture was higher than of bedside culture (82.6% vs 47.8%, p<0.0005). Deferred culture showed significantly higher sensitivity com- paring to bedside culture in summer (100% vs 50%, p=0.003), and comparably the same as for bedside culture in autumn, winter and spring. Conclusion: The viability of N. gonorrhoeae subcultures was significantly higher in refrigerated samples from transport media than from ambient one after exposition from 48 to 96 hours. Optimal viability of N. gonorrhoeae was observed when transport swabs were kept refrigerated up to 48 h (73.9-93.5%) or ambiently – up to 24 h (87%). Updating laboratory guide- lines regarding sampling and timely specimen processing might improve gonococcal culture performance.

scholarly journals Subacute Bacterial Endocarditis Caused byCardiobacterium hominis: A Case Report

2015 ◽  
Vol 26 (1) ◽  
pp. 41-43 ◽  
Author(s):  
Davie Wong ◽  
Julie Carson ◽  
Andrew Johnson
Keyword(s):  
Susceptibility Testing ◽  
Medical Literature ◽  
Generation Cephalosporin ◽  
Bacterial Endocarditis ◽  
Clinical Microbiology Laboratory ◽  
Third Generation ◽  
First Line ◽  
Subacute Bacterial Endocarditis ◽  
First Line Therapy ◽  
Third Generation Cephalosporins

Cardiobacterium hominis, a member of the HACEK group of organisms, is an uncommon but important cause of subacute bacterial endocarditis. First-line therapy is a third-generation cephalosporin due to rare beta-lactamase production. The authors report a case involving endovascular infection due toC hoministhat initially tested resistant to third-generation cephalosporins using an antibiotic gradient strip susceptibility method (nitrocephin negative), but later proved to be susceptible using broth microdilution reference methods (a ‘major’ error). There are limited studies to guide susceptibility testing and interpretive breakpoints forC hominisin the medical literature, and the present case illustrates some of the issues that may arise when performing susceptibility testing for fastidious organisms in the clinical microbiology laboratory.

scholarly journals Survey ofNeisseria gonorrhoeaeAntimicrobial Susceptibility in Ontario

1990 ◽  
Vol 1 (4) ◽  
pp. 136-138
Author(s):  
Vivian G Loo ◽  
Andrew E Simor ◽  
Ruth Jaeger ◽  
Donald E Low
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Tetracycline Resistance ◽  
Beta Lactamase ◽  
Minimal Inhibitory Concentrations ◽  
High Level ◽  
L 13

The minimal inhibitory concentrations (MICs) of penicillin, tetracycline, erythromycin, cefoxitin, ceftriaxone and spectinomycin were determined for 300 consecutive strains ofNeisseria gonorrhoeaecollected from physicians’ offices in Ontario. Only four isolates were found to produce beta-lactamase. Of the remaining 296 isolates, five (1.7%) had penicillin MICs greater than or equal to 1 mg/L, 78 (26.3%) had tetracycline MICs greater than or equal to 1 mg/L, 13 (4.4%) had cefoxitin MICs greater than or equal to 1 mg/L and 43 (14.5%) had erythromycin MICs greater than or equal to 1 mg/L. Two isolates (0.7%) had high level tetracycline resistance with MICs greater than or equal to 16 mg/L. AllN gonorrhoeaeisolates were susceptible to ceftriaxone and to spectinomycin.

Prevalence and Antimicrobial Resistance of Salmonella Isolated from Broiler Farms, Chicken Carcasses, and Street-Vended Restaurants in Casamance, Senegal

2009 ◽  
Vol 72 (11) ◽  
pp. 2423-2427 ◽  
Author(s):  
MICHEL M. DIONE ◽  
MARGARETA IEVEN ◽  
BENOÎT GARIN ◽  
TANGUY MARCOTTY ◽  
STANNY GEERTS
Keyword(s):  
Antimicrobial Resistance ◽  
Chicken Meat ◽  
Third Generation ◽  
Production Chain ◽  
Broiler Production ◽  
Chicken Feces ◽  
Salmonella Serovars ◽  
Third Generation Cephalosporins

This study was undertaken to determine the prevalence and distribution of Salmonella on 57 randomly selected broiler farms at the end of the rearing period and in chicken products in urban and periurban areas in Casamance, Senegal, and to evaluate the antimicrobial resistance profiles of the Salmonella serovars. Salmonella was detected in chicken feces, on carcass skin, and in muscle on 35.1, 38.6, and 29.8% of farms, respectively. Salmonella was found in chicken meat servings from 14.3% of the 42 street restaurants and in 40.4% of the 285 chicken carcasses examined. The prevalence on skin and in muscle was significantly associated with the detection of Salmonella in feces (P ≤ 0.001). Eighteen Salmonella serovars were identified; the most common were Brancaster (57.9%), Goelzau (10.7%), Kentucky (8.4%), and Hadar (7.3%). High levels of resistance were found to trimethoprim-sulfamethoxazole, tetracycline, trimethoprim, streptomycin, and sulfonamides. All Salmonella serovars were susceptible to fluoroquinolones and third-generation cephalosporins. A large proportion of the isolates belonging to 11 serovars were resistant to two or more antibiotics. Salmonella continues to be of serious concern in the broiler production chain in Senegal.

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