The prevalence of proline iminopeptidase negative Neisseria gonorrhoeae throughout England and Wales

Alexander, Sarah

doi:10.1136/sti.2005.018424

Cited by 14 publications

(11 citation statements)

References 8 publications

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“…9 Recently, the number of PIP-negative isolates has increased in Australia, 15 New Zealand 7 and Scotland (Helen Palmer, personal communication 2006), and continues to increase in England and Wales. 16 The aim of this study was to investigate the possibility of a widespread transmission of one or several N gonorrhoeae PIPnegative strains among several countries worldwide. PIPnegative N gonorrhoeae isolates from Australia, New Zealand and Scotland were comprehensively characterised and the data compared with those from previously documented clusters in England and Denmark.…”

mentioning

confidence: 99%

Global transmission of prolyliminopeptidase-negative Neisseria gonorrhoeae strains: implications for changes in diagnostic strategies

Unemo

Palmer

Blackmore

et al. 2006

Sexually Transmitted Infections

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Background: Species confirmation of Neisseria gonorrhoeae is commonly performed with biochemical kits, rely on the activity of the enzyme prolyliminopeptidase (PIP). This enzyme has previously been considered to be almost universally present in N gonorrhoeae. However, increasing numbers of N gonorrhoeae isolates lacking PIP activity have been identified. Objectives: To investigate the possibility of a widespread transmission of one or several N gonorrhoeae PIPnegative strains among several countries worldwide. Methods: PIP-negative N gonorrhoeae isolates cultured from 2001 to 2004 in Australia, New Zealand and Scotland were comprehensively characterised and compared with previous data from England and Denmark. All isolates were characterised by antibiotic susceptibility testing, serovar determination, pulsed-field gel electrophoresis (PFGE), opa-typing, sequencing of the entire porB gene and N gonorrhoeae multiantigen sequence typing (NG-MAST). Results: Most (83%) of the viable Australian isolates, and all the New Zealand and Scottish isolates were assigned serovar IB-4, with similar antibiograms, nearly identical porB1b gene sequences, identical (ST210) or highly related (ST292, ST1259) NG-MAST STs, and indistinguishable or related PFGE fingerprints as well as opa-types. The isolates showed characteristics indistinguishable or highly related to the previously described English and Danish outbreak strain. Conclusions: A comprehensive characterisation indicates a widespread dissemination, mainly among men who have sex with men (MSM), of indistinguishable and highly related genotypes that have evolved from a single N gonorrhoeae PIP-negative serovar IB-4 strain among several countries worldwide. An increased awareness of PIP-negative N gonorrhoeae strains is crucial and changes in the diagnostic strategies may need to be considered.

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mentioning

confidence: 99%

Global transmission of prolyliminopeptidase-negative Neisseria gonorrhoeae strains: implications for changes in diagnostic strategies

Unemo

Palmer

Blackmore

et al. 2006

Sexually Transmitted Infections

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“…It was most disquieting that during 2000–2003, increased numbers of PIP‐negative gonococci were identified in the United Kingdom and Denmark (8, 10). Subsequently, similar reports were published from Australia, New Zealand, Great Britain and Spain (7, 9, 12–14). Mutations, most commonly a single nucleotide deletion, in the encoding single‐copy pip gene have caused the lack of PIP expression, which may result in incorrect, doubtful or delayed species identification of the gonococci (7–11).…”

mentioning

confidence: 81%

“…For definitive diagnosis using culture, species confirmation is commonly performed using commercial biochemical test kits such as API NH, RapID NH, Gonochek II, Bacticard Neisseria and Neisseria Preformed Enzyme Test, which are globally used. These tests partly or almost entirely rely on the presence and activity of the enzyme prolyliminopeptidase (PIP; also referred to as hydroxyproline aminopeptidase, proline aminopeptidase or proline arylamidase), which is encoded by the pip gene (6–13). The preformed PIP enzyme was previously considered as mainly universally present in N. gonorrhoeae .…”

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confidence: 99%

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Prevalence, phenotypic and genetic characteristics of prolyliminopeptidase‐negative Neisseria gonorrhoeae isolates in Sweden during 2000–2007

Johansson

Fredlund

Unemo

2009

APMIS

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In Neisseria gonorrhoeae culture diagnostics, species confirmation is commonly performed using commercial biochemical tests relying on prolyliminopeptidase (PIP) activity. It was previously shown that one PIP-negative strain was mainly globally transmitted during 2000-2004. The aims were to investigate the prevalence and phenotypic and genetic characteristics of PIP-negative N. gonorrhoeae isolates in Sweden during 2000-2007. Gonococcal isolates (n = 1230) cultured in Sweden during 2000-2007 were characterized using PIP screening, antibiogram, serovar determination, pip and porB gene sequencing, and N. gonorrhoeae multiantigen sequence typing (NG-MAST). Fifteen (1.2%) of the isolates were PIP-negative. Of those, 13 (87%) were indistinguishable to the previously described globally transmitted strain, i.e. displayed serovar IB-4 (Bpyvut), similar antibiograms, ST210 (n = 10)/ST292 (n = 3) and contained an identical single nucleotide pip gene deletion. Wherever high reliance is placed on PIP activity for N. gonorrhoeae species confirmation, changes in the diagnostic strategies may need to be considered and/or monitoring of the PIP activity is crucial.

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“…Organised training additionally provides a network for microbiologists to use and exploit when advice is needed. In the absence of training courses, freely available on-line resources can be used5 and staff should be kept up-to-date with respect to emerging antimicrobial resistance and changes in enzyme expression6 and genetic target sequences7 8 used for identification. Harmonisation of the different susceptibility testing methodologies and interpretative criteria is a long-term aim so that data are comparable across regions and globally, but in the meantime appropriate quality management5 in the laboratory is essential to validate both the susceptibility and the identification processes.…”

Section: The Anticipated Challenges At Country Levelmentioning

confidence: 99%

Gonococcal antimicrobial resistance: challenges for public health control

et al. 2013

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The prevalence of proline iminopeptidase negative Neisseria gonorrhoeae throughout England and Wales

Cited by 14 publications

References 8 publications

Global transmission of prolyliminopeptidase-negative Neisseria gonorrhoeae strains: implications for changes in diagnostic strategies

Global transmission of prolyliminopeptidase-negative Neisseria gonorrhoeae strains: implications for changes in diagnostic strategies

Prevalence, phenotypic and genetic characteristics of prolyliminopeptidase‐negative Neisseria gonorrhoeae isolates in Sweden during 2000–2007

Gonococcal antimicrobial resistance: challenges for public health control

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