Clinical<i>Neisseria gonorrhoeae</i>Isolates in the United States with Resistance to Azithromycin Possess Mutations in All 23S rRNA Alleles and the<i>mtrR</i>Coding Region

Wu, Abel; Buono, Sean; Katz, Kenneth A.; Pandori, Mark

doi:10.1089/mdr.2010.0199

Cited by 10 publications

(8 citation statements)

References 19 publications

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“…In the current study, only seven AZM-R isolates contained mutation C2611T, whereas the remaining large number of AZM-R isolates contained four wild-type alleles. These findings contrast, however, with other reports from Canada [ 9 ], the United States [ 11 , 20 ] and the United Kingdom [ 10 ], which most of the AZM-MLR isolates contained this mutation was more than 80 %. Notably, all the above-mentioned seven AZM-R isolates that contained the mutation C2611T showed reduced susceptibility to ceftriaxone.…”

Section: Discussioncontrasting

confidence: 98%

“…Mutations at various genes such as 23S rRNA, mtrR and penA (encoding penicillin-binding protein 2, PBP2), have been identified associating with chromosomally mediated resistance to AZM [ 10 , 11 ] and ESCs [ 12 ] in N. gonorrhoeae . Globally, AZM-R together decreased susceptibility to ESCs in N. gonorrhoeae has only rarely been reported [ 9 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Azithromycin-resistant Neisseria gonorrhoeae isolates in Guangzhou, China (2009–2013): coevolution with decreased susceptibilities to ceftriaxone and genetic characteristics

Liang

Cao

et al. 2016

BMC Infect Dis

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BackgroundThe recent emergence of azithromycin-resistant (AZM-R) N. gonorrhoeae isolates that have coevolved decreased susceptibility to extended-spectrum cephalosporins has caused great concern. Here we investigated the prevalence of decreased susceptibility to ceftriaxone (CROD) in AZM-R isolates and genetically characterized AZM-R isolates in Guangzhou, China from 2009 to 2013.MethodsThe minimum inhibitory concentration (MIC) of AZM and ceftriaxone was determined using an agar-dilution method. All AZM-R isolates were screened for mutations in 23S rRNA, mtrR and penA genes and genotyped using N. gonorrhoeae multi-antigen sequence typing (NG-MAST).ResultsOf the 485 identified N. gonorrhoeae isolates, 445 (91.8 %) were isolated from male urethritis subjects, and 77 (15.9 %) were AZM-R (MIC ≥ 1 mg/L), including 33 (6.8 %) with AZM low-level resistant (AZM-LLR, MIC = 1 mg/L) and 44 (9.1 %) with AZM middle-level resistant (AZM-MLR, MIC ≥ 2 mg/L). Significantly more CROD (MIC ≥ 0.125 mg/L) showed in AZM-MLR isolates (43.2 %, 19/44) as compared with that in AZM-LLR isolates (18.2 %, 6/33) (p < 0.05). For the 23S rRNA, mtrR, penA or combined 23S rRNA/MtrR/penA mutations, no significant difference was found between AZM-LLR isolates and AZM-MLR isolates (P > 0.05); similar results were detected between combined AZM-LLR/CROD isolates and combined AZM-MLR/CROD isolates (P > 0.05). No mutation A2059G or AZM high-level resistant (AZM-HLR, MIC ≥ 256 mg/L) isolate was detected. Among 77 AZM-R isolates, 67 sequence types (STs) were identified by NG-MAST, of which 30 were novel. Most STs were represented by a single isolate.ConclusionsThe AZM-R together CROD isolates are now present in Guangzhou, China, which deserve continuous surveillance and the mechanism of concurrent resistance needs further study.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1469-3) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Azithromycin-resistant Neisseria gonorrhoeae isolates in Guangzhou, China (2009–2013): coevolution with decreased susceptibilities to ceftriaxone and genetic characteristics

Liang

Cao

et al. 2016

BMC Infect Dis

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“…For the past 8 decades, gonorrhea has been treated successfully with antibiotics, despite patterns of resistance, but over the last several years, multidrug-resistant and untreatable strains have begun to emerge worldwide. Resistant strains include isolates from both Eastern and Western Europe ( 3 , 4 ), Asia ( 5 – 7 ), and recently the United States ( 8 – 10 ). This rise in antibiotic-resistant strains may be linked, in part, to an increase in availability of over-the-counter antibiotics, particularly in many parts of Asia.…”

Section: Introductionmentioning

confidence: 99%

Transcriptome Analysis of Neisseria gonorrhoeae during Natural Infection Reveals Differential Expression of Antibiotic Resistance Determinants between Men and Women

Nudel

McClure

Moreau

et al. 2018

mSphere

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Recent emergence of antimicrobial resistance of Neisseria gonorrhoeae worldwide has resulted in limited therapeutic choices for treatment of infections caused by this organism. We performed global transcriptomic analysis of N. gonorrhoeae in subjects with gonorrhea who attended a Nanjing, China, sexually transmitted infection (STI) clinic, where antimicrobial resistance of N. gonorrhoeae is high and increasing. We found that N. gonorrhoeae transcriptional responses to infection differed in genital specimens taken from men and women, particularly antibiotic resistance gene expression, which was increased in men. These sex-specific findings may provide a new approach to guide therapeutic interventions and preventive measures that are also sex specific while providing additional insight to address antimicrobial resistance of N. gonorrhoeae.

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“…A previous study investigating isolates from San Diego County with unusually a high MIC for azithromycin (MIC of 8.0-16.0) showed that those isolates were found to have the NG-MAST type ST2992. 20 In this study, ST2992 isolates were found to have azithromycin MIC ranging from 0.03 to 1.0 (nonalert value). Possibly, the loci …”

Section: Discussionmentioning

confidence: 69%

Using the Neisseria gonorrhoeae Multiantigen Sequence-Typing Method to Assess Strain Diversity and Antibiotic Resistance in San Francisco, California

Buono

Hess

et al. 2012

Microbial Drug Resistance

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Urogenital Neisseria gonorrhoeae isolates (266) collected in San Francisco, CA, in 2009 were analyzed for antimicrobial susceptibility and were subsequently genotyped by N. gonorrhoeae multiantigen sequence typing (NG-MAST). Isolates of identical or closely related sequence types were found to possess highly similar phenotypes with regard to drug susceptibility. Isolates containing decreased susceptibility to oral cephalosporins were detected in 2009 and were found to contain the mosaic penA allele (XXXIV) found previously to be associated with decreased susceptibility to cephalosporins. A better understanding of the relationships between phenotypic and genotypic markers for antimicrobial resistance may be helpful to the development of effective surveillance systems for drug-resistant N. gonorrhoeae.

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ClinicalNeisseria gonorrhoeaeIsolates in the United States with Resistance to Azithromycin Possess Mutations in All 23S rRNA Alleles and themtrRCoding Region

Cited by 10 publications

References 19 publications

Azithromycin-resistant Neisseria gonorrhoeae isolates in Guangzhou, China (2009–2013): coevolution with decreased susceptibilities to ceftriaxone and genetic characteristics

Azithromycin-resistant Neisseria gonorrhoeae isolates in Guangzhou, China (2009–2013): coevolution with decreased susceptibilities to ceftriaxone and genetic characteristics

Transcriptome Analysis of Neisseria gonorrhoeae during Natural Infection Reveals Differential Expression of Antibiotic Resistance Determinants between Men and Women

Using the Neisseria gonorrhoeae Multiantigen Sequence-Typing Method to Assess Strain Diversity and Antibiotic Resistance in San Francisco, California

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