New Ceftriaxone- and Multidrug-Resistant Neisseria gonorrhoeae Strain with a Novel Mosaic penA Gene Isolated in Japan

Abstract

We have characterized in detail a new ceftriaxone-and multidrug-resistant Neisseria gonorrhoeae strain (FC428) isolated in Japan in 2015. FC428 differed from previous ceftriaxone-resistant strains and contained a novel mosaic penA allele encoding a new mosaic penicillin-binding protein 2 (PBP 2). However, the resistance-determining 3=-terminal region of penA was almost identical to the regions of two previously reported ceftriaxone-resistant strains from Australia and Japan, indicating that both ceftriaxone-resistant strains and conserved ceftriaxone resistance-determining PBP 2 regions might spread.

Multidrug-resistant Neisseria gonorrhoeae failing treatment with ceftriaxone and doxycycline in France, November 2017

“…F90 differs from the French F89 isolate detected in 2010 [16], however, it is similar to a ceftriaxone-resistant clone initially described in Japan in 2016 (FC428 strain; similar antibiogram and an identical mosaic penA-60.001 allele, MLST 1903 , and NG-STAR 233 ) [14]. The FC428 strain appears to have spread internationally and has been subsequently detected in Australia, Canada and Denmark [20].…”

“…Regarding ceftriaxone resistance determinants, the isolate harboured a mosaic penA-60.001 allele, sharing a 100% homology with the penA FC428 of the Japanese ceftriaxone-resistant FC428 strain [14]. The penA FC428 gene encodes a mosaic penicillin-binding protein 2 (PBP2) including the amino acid alterations A311V, I312M, V316T, T483S, and G545S associated with resistance to extended-spectrum cephalosporins [15].…”

Resistance to β-Lactams in Neisseria ssp Due to Chromosomally Encoded Penicillin-Binding Proteins

“…The total current (15 July 2016) number of different penA alleles at the nucleotide level is 617, which translates into 137 different PBP2 proteins in meningococci. At the amino acid level in N. gonorrhoeae , over 50 different full sequences have been reported which are commonly ascribed a Roman numeral [21,22,23,24,25,26,27,28,29] (Figure 1). Although no global clonal expansion was detected, some clones can be highly successful locally.…”

Genotyping of the Resistance Determinant of Neisseria Gonorrhoeae with Reduced Susceptibility to Ceftriaxone in Manaus-AMBrazil

“…In last few decades, gonococci have developed resistance to all the antibiotics used as first line of treatment for gonococcal infections, leaving Extended-Spectrum Cephalosporins (ESCs) as the last remaining option for gonorrhea [1,2]. With reports of reduced susceptibility or resistance to ESCs from different regions, and due to therapeutic limitations, the infection has become a serious health problem to the point that disease complications can no longer be treated in the near future, besides the possibility of the gonococcus to evolve into "superbug" [3][4][5][6][7].…”