Molecular Epidemiological Identification of Neisseria gonorrhoeae Clonal Clusters with Distinct Susceptibility Profiles Associated with Specific Groups at High Risk of Contracting Human Immunodeficiency Virus and Syphilis

Abstract

a total of 146 Neisseria gonorrhoeae isolates collected from 139 male patients in Taipei, Taiwan, were analyzed by N. gonorrhoeae multiantigen sequence typing (NG-MAST) and antibiotic susceptibility testing. The resistance rates of all isolates to ciprofloxacin, cefpodoxime, and cefixime were 76.7 (112/146), 21.2 (31/146), and 16.4% (24/146), respectively. NG-MAST identified 71 sequence types (STs), of which 21 STs contained 2 to 21 isolates. The isolates that belonged to the three major ST clusters typically were from patients who had specific epidemiological characteristics (such as sexual orientation and human immunodeficiency virus status). The major ST clones exhibited distinct resistance profiles and are associated with specific groups at high risk of human immunodeficiency virus and syphilis infections.

Antimicrobial susceptibility of Neisseria gonorrhoeae isolates determined by the agar dilution, disk diffusion and Etest methods: comparison of results using GC agar and chocolate agar

“…Although the clinical impact of the lower susceptibility of N. gonorrhoeae to ceftriaxone remains to be demonstrated [20,21], the trend of ceftriaxone MICs should be monitored closely. In addition, pulse-field gel electrophoresis (PFGE) studies of isolates with elevated MICs are needed to clarify whether clonal spread of resistant strains has occurred, as in a recent study from Taiwan [22].…”

Multidrug-resistant Neisseria gonorrhoeae

“…13 Smaller recent studies show an even wider distribution of the Hong Kong genotype, which has genetic markers for decreased susceptibility to oral cephalosporins. 4,14 So far, no treatment failures with the injectable ceftriaxone have been reported. The Japanese recommendation for ceftriaxone use is a 1-g dose given intravenously.…”

“…As a result, gonococcal populations are made up of multiple, constantly evolving subtypes. Molecular-based studies [2][3][4] have shown that only small numbers of "successful" subtypes (usually specific to particular sexual networks) predominate and persist. A spread of multidrug-resistant gonococci occurs when these successful subtypes also acquire resistance genes.…”

Mosaic Penicillin-Binding Protein 2 in Neisseria gonorrhoeae Isolates Collected in 2008 in San Francisco, California

“…Isolates with decreased susceptibility to third-generation cephalosporins, particularly oral cephalosporins, have emerged in Asia, Australia, and elsewhere (1,2,4,5,7,11,12). Initial reports linked this decreased susceptibility to oral cephalosporins to an altered, mosaic penicillin-binding protein 2 (PBP2) encoded by the penA gene characterized by multiple genetic changes with segments that are nearly identical to the homologous regions of the penA genes of related commensal Neisseria species (2,3).…”