Increasing Resistance to Azithromycin in Neisseria gonorrhoeae in Eastern Chinese Cities: Resistance Mechanisms and Genetic Diversity among Isolates from Nanjing
UMass Chan Affiliations
Department of Medicine, Division of Infectious Diseases and ImmunologyDocument Type
Journal ArticlePublication Date
2018-04-26Keywords
Neisseria gonorrhoeaeantimicrobial resistance
azithromycin
eastern Chinese cities
molecular epidemiology
Bacteria
Bacterial Infections and Mycoses
Epidemiology
Immunology of Infectious Disease
Microbiology
Metadata
Show full item recordAbstract
Azithromycin resistance (AZM-R) of Neisseria gonorrhoeae is emerging as a clinical and public health challenge. We determined molecular characteristics of recent AZM-R Nanjing gonococcal isolates and tracked the emergence of AZM-R isolates in eastern Chinese cities in recent years. A total of 384 N. gonorrhoeae isolates from Nanjing collected from 2013 to 2014 were tested for susceptibility to AZM and six additional antibiotics; all AZM-R strains were characterized genetically for resistance determinants by sequencing and were genotyped using N. gonorrhoeae multiantigen sequence typing (NG-MAST). Among the 384 isolates, 124 (32.3%) were AZM-R. High-level resistance (MIC, > /=256 mg/liter) was present in 10.4% (40/384) of isolates, all of which possessed the A2143G mutation in all four 23S rRNA alleles. Low- to mid-level resistance (MIC, 1 to 64 mg/liter) was present in 21.9% (84/384) of isolates, 59.5% of which possessed the C2599T mutation in all four 23S rRNA alleles. The 124 AZM-R isolates were distributed in 71 different NG-MAST sequence types (STs). ST1866 was the most prevalent type in high-level AZM-R (HL-AZM-R) isolates (45% [18/40]). This study, together with previous reports, revealed that the prevalence of AZM-R in N. gonorrhoeae isolates in certain eastern Chinese cities has risen > 4-fold (7% to 32%) from 2008 to 2014. The principal mechanisms of AZM resistance in recent Nanjing isolates were A2143G mutations (high-level resistance) and C2599T mutations (low- to mid-level resistance) in the 23S rRNA alleles. Characterization of NG-MAST STs and phylogenetic analysis indicated the genetic diversity of N. gonorrhoeae in Nanjing; however, ST1866 was the dominant genotype associated with HL-AZM-R isolates.Source
Antimicrob Agents Chemother. 2018 Apr 26;62(5). pii: e02499-17. doi: 10.1128/AAC.02499-17. Print 2018 May. Link to article on publisher's site
DOI
10.1128/AAC.02499-17Permanent Link to this Item
http://hdl.handle.net/20.500.14038/40628PubMed ID
29530847Related Resources
Rights
Copyright © 2018 Wan et al. This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International license.Distribution License
http://creativecommons.org/licenses/by/4.0/ae974a485f413a2113503eed53cd6c53
10.1128/AAC.02499-17
Scopus Count
Collections
Except where otherwise noted, this item's license is described as Copyright © 2018 Wan et al. This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International license.