OBJECTIVES: The aim of this study was to characterize the first two extended-spectrum cephalosporin-resistant and multidrug-resistant (MDR) Neisseria gonorrhoeae isolates collected from two sexually related patients (men who have sex with men) in Spain. METHODS: Antimicrobial susceptibility was studied by Etest. Genes involved in quinolone, ceftriaxone and multidrug resistance were amplified by PCR and sequenced in both directions. The isolates were typed by N. gonorrhoeae multi-antigen sequence typing (NG-MAST). RESULTS: The two isolates had the same MDR profile, showing resistance to penicillin (MIC 0.094 mg/L; β-lactamase negative), ceftriaxone (MIC 1.5 mg/L), cefixime (MIC 1.5 mg/L), cefotaxime (MIC 1 mg/L), ciprofloxacin (MIC >32 mg/L) and tetracycline (MIC 1.5 mg/L). NG-MAST showed that both isolates belonged to sequence type (ST) 1407 (porB-908 and tbpB-110). Ciprofloxacin resistance was due to amino acid substitutions in GyrA (S91F and D95G) and ParC (S87R). An A deletion in the promoter of the MtrCDE efflux pump (mtrR) was detected. No changes were detected in the pilQ gene. The outer membrane protein PorB showed two substitutions at G120K and A121N. An L421P substitution was observed in the PBP1A (ponA) sequence. The sequence of PBP2 (penA) showed a mosaic structure related to genotype XXXIV with a single additional amino acid substitution (A501P). This genotype was identical to a recently described French isolate (F89). CONCLUSIONS: This is the first reported case of high-level extended-spectrum cephalosporin-resistant N. gonorrhoeae transmission. The molecular typing and MDR genotype suggest possible European spread of this strain, highlighting the need for surveillance and the importance of testing the susceptibility of N. gonorrhoeae to extended-spectrum cephalosporins.
OBJECTIVES: The aim of this study was to characterize the first two extended-spectrum cephalosporin-resistant and multidrug-resistant (MDR) Neisseria gonorrhoeae isolates collected from two sexually related patients (men who have sex with men) in Spain. METHODS: Antimicrobial susceptibility was studied by Etest. Genes involved in quinolone, ceftriaxone and multidrug resistance were amplified by PCR and sequenced in both directions. The isolates were typed by N. gonorrhoeae multi-antigen sequence typing (NG-MAST). RESULTS: The two isolates had the same MDR profile, showing resistance to penicillin (MIC 0.094 mg/L; β-lactamase negative), ceftriaxone (MIC 1.5 mg/L), cefixime (MIC 1.5 mg/L), cefotaxime (MIC 1 mg/L), ciprofloxacin (MIC >32 mg/L) and tetracycline (MIC 1.5 mg/L). NG-MAST showed that both isolates belonged to sequence type (ST) 1407 (porB-908 and tbpB-110). Ciprofloxacin resistance was due to amino acid substitutions in GyrA (S91F and D95G) and ParC (S87R). An A deletion in the promoter of the MtrCDE efflux pump (mtrR) was detected. No changes were detected in the pilQ gene. The outer membrane protein PorB showed two substitutions at G120K and A121N. An L421P substitution was observed in the PBP1A (ponA) sequence. The sequence of PBP2 (penA) showed a mosaic structure related to genotype XXXIV with a single additional amino acid substitution (A501P). This genotype was identical to a recently described French isolate (F89). CONCLUSIONS: This is the first reported case of high-level extended-spectrum cephalosporin-resistant N. gonorrhoeae transmission. The molecular typing and MDR genotype suggest possible European spread of this strain, highlighting the need for surveillance and the importance of testing the susceptibility of N. gonorrhoeae to extended-spectrum cephalosporins.
Authors: Magnus Unemo; Daniel Golparian; Leonor Sánchez-Busó; Yonatan Grad; Susanne Jacobsson; Makoto Ohnishi; Monica M Lahra; Athena Limnios; Aleksandra E Sikora; Teodora Wi; Simon R Harris Journal: J Antimicrob Chemother Date: 2016-07-17 Impact factor: 5.790
Authors: S W Peterson; I Martin; W Demczuk; A Bharat; L Hoang; J Wylie; V Allen; B Lefebvre; G Tyrrell; G Horsman; D Haldane; R Garceau; T Wong; M R Mulvey Journal: J Clin Microbiol Date: 2015-04-15 Impact factor: 5.948
Authors: Joshua Tomberg; Alena Fedarovich; Leah R Vincent; Ann E Jerse; Magnus Unemo; Christopher Davies; Robert A Nicholas Journal: Biochemistry Date: 2017-02-16 Impact factor: 3.162
Authors: L Ryan; D Golparian; N Fennelly; L Rose; P Walsh; B Lawlor; M Mac Aogáin; M Unemo; B Crowley Journal: Eur J Clin Microbiol Infect Dis Date: 2018-06-07 Impact factor: 3.267
Authors: Jonathan D Lenz; Kristina A Shirk; Adrienne Jolicoeur; Joseph P Dillard Journal: Antimicrob Agents Chemother Date: 2018-11-26 Impact factor: 5.191
Authors: Joshua Tomberg; Magnus Unemo; Makoto Ohnishi; Christopher Davies; Robert A Nicholas Journal: Antimicrob Agents Chemother Date: 2013-04-15 Impact factor: 5.191