Antimicrobial susceptibility and typing of Neisseria gonorrhoeae strains from Southern Spain, 2012–2014

Cobo, Fernando; Cabezas-Fernández, Ma Teresa; Cabeza-Barrera, María Isabel

doi:10.1016/j.eimc.2015.01.017

Cited by 18 publications

(13 citation statements)

References 25 publications

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“…The overall azithromycin resistance rate in our study was 2.6% based on the EUCAST breakpoint (ECOFF is 1 mg/L). This percentage is lower than that reported by other Spanish groups such as Cobo et al [18], who showed a resistance percentage of 13.8% in Almería. On the other hand, Fuertes de Vega et al reported a resistance rate of 5.2% in Barcelona [19], which is more similar to our results.…”

Section: Discussioncontrasting

confidence: 69%

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Antimicrobial susceptibility of Neisseria gonorrhoeae in Barcelona during a five-year period, 2013 to 2017

et al. 2020

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Increasing rates of antimicrobial resistance in Neisseria gonorrhoeae cause problems for treating gonorrhoea. Aim: This observational study aimed to describe isolates from all patients found infected with N. gonorrhoeae, in Barcelona, Spain, between 2013 and 2017, and with available antimicrobial susceptibility data. Methods: Minimum inhibitory concentrations (MICs) of penicillin (PEN), cefixime (CFM), ceftriaxone (CRO), azithromycin (AZM), ciprofloxacin (CIP), spectinomycin (SPT), fosfomycin (FOF) and gentamicin (GEN) were determined by E-test. Susceptibility was assessed using clinical breakpoints from the European Committee on Antimicrobial Susceptibility Testing. Time trends for PEN, CFM, AZM and CIP were investigated using logistic regression. Results: Of 1,979 patients with infection (2,036 isolates), 1,888 (95.4%) were men. Patient median age was 32 years. The proportions of isolates resistant to extended-spectrum cephalosporins were low, with 0.3% (5/1,982) resistant to CRO and 4.9% (98/1,985) to CFM. AZM resistance prevalence was 2.7% (52/1,981), including 16 isolates detected in 2016 and 2017, with high-level resistance. For CIP, 51.3% (1,018/1,986) of isolates were resistant, and for PEN, 20.1% (399/1,985). All isolates were susceptible to SPT. MIC 50 and MIC90 values of GEN were 4 and 6 mg/L and of FOF 12 and 24 mg/L, respectively. Between 2013 and 2017, PEN and CFM resistance rates each decreased from 28.1% (92/327) to 12.2% (70/572) and from 8.3% (27/327) to 4.4% (25/572) (p ≤ 0.0073). In contrast, AZM resistance prevalence appeared to increase from 1.5% in 2014 (5/340) to 3.0% (17/572) in 2017. No trend was identified for CIP. Conclusion: Antimicrobial susceptibility surveillance is important to timely detect new phenotypes and trends.

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Section: Discussioncontrasting

confidence: 69%

“…Other studies have been published previously [18,19], but the amount of strains included was much lower. Our findings show that the rate of ceftriaxone resistance remains low and stable.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial susceptibility of Neisseria gonorrhoeae in Barcelona during a five-year period, 2013 to 2017

et al. 2020

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“…Although three-quarters of our isolates were recovered from MSM, we found a statistically significant relationship between G2400 and heterosexual patients, while G2992 seemed arbitrarily distributed between MSM and heterosexual subjects. It is also noteworthy that G1407, the most prevalent genogroup seen in the previous studies [20, 22, 24], was one of the less prevalent genogroups found here and represented only by three strains. G1407, which is widely disseminated, has been associated with cefixime and ceftriaxone resistance [3, 20, 36], and specifically with cephalosporin treatment failures internationally [3].…”

Section: Discussionsupporting

confidence: 60%

Epidemiology, molecular characterisation and antimicrobial susceptibility ofNeisseria gonorrhoeaeisolates in Madrid, Spain, in 2016

et al. 2019

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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.

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“…Resistance to azithromycin was 28.6%, higher than had been reported from certain other countries, such as Japan [25] and Spain [26] during this period. We found that 10.3% (13/126) of isolates were highly resistant to azithromycin (MIC > 2048 mg/L).…”

Section: Discussionmentioning

confidence: 55%

Antimicrobial susceptibility of Neisseria gonorrhoeae isolates from Hefei (2014–2015): genetic characteristics of antimicrobial resistance

Jiang

Lei

et al. 2017

BMC Infect Dis

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BackgroundAntimicrobial resistance (AMR) and genetic determinants of resistance of N. gonorrhoeae isolates from Hefei, China, were characterized adding a breadth of information to the molecular epidemiology of gonococcal resistance in China.Methods126 N. gonorrhoeae isolates from a hospital clinic in Hefei, were collected between January, 2014, and November, 2015. The minimum inhibitory concentration (MIC) of N. gonorrhoeae isolates for seven antimicrobials were determined by the agar dilution method. Isolates were tested for mutations in penA and mtrR genes and 23S rRNA, and also genotyped using N. gonorrhoeae multi-antigen sequence typing (NG-MAST).ResultsAll N. gonorrhoeae isolates were resistant to ciprofloxacin; 81.7% (103/126) to tetracycline and 73.8% (93/126) to penicillin. 39.7% (50/126) of isolates were penicillinase producing N. gonorrhoeae (PPNG), 31.7% (40/126) were tetracycline resistant N. gonorrhoeae (TRNG) and 28.6% (36/126) were resistant to azithromycin. While not fully resistant to extended spectrum cephalosporins (ESCs), a total of 14 isolates (11.1%) displayed decreased susceptibility to ceftriaxone (MIC ≥ 0.125 mg/L, n = 10), cefixime (MIC ≥ 0. 25 mg/L, n = 1) or to both ESCs (n = 3). penA mosaic alleles XXXV were found in all isolates that harbored decreased susceptibility to cefixime, except for one. Four mutations were found in mtrR genes and mutations A2143G and C2599T were identified in 23S rRNA. No isolates were resistant to spectinomycin. Gonococcal isolates were distributed into diverse NG-MAST sequence types (STs); 86 separate STs were identified.Conclusions N. gonorrhoeae isolates from Hefei during 2014–2015, displayed high levels of resistance to antimicrobials that had been recommended previously for treatment of gonorrhea, e.g., penicillin, tetracycline and ciprofloxacin. The prevalence of resistance to azithromycin was also high (28.6%). No isolates were found to be fully resistant to spectinomycin, ceftriaxone or cefixime; however, 11.1% isolates, overall, had decreased susceptibility to ESCs.

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Antimicrobial susceptibility and typing of Neisseria gonorrhoeae strains from Southern Spain, 2012–2014

Cited by 18 publications

References 25 publications

Antimicrobial susceptibility of Neisseria gonorrhoeae in Barcelona during a five-year period, 2013 to 2017

Antimicrobial susceptibility of Neisseria gonorrhoeae in Barcelona during a five-year period, 2013 to 2017

Epidemiology, molecular characterisation and antimicrobial susceptibility ofNeisseria gonorrhoeaeisolates in Madrid, Spain, in 2016

Antimicrobial susceptibility of Neisseria gonorrhoeae isolates from Hefei (2014–2015): genetic characteristics of antimicrobial resistance

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