UMMS Affiliation

Department of Medicine, Division of Infectious Diseases and Immunology

Publication Date

2018-04-26

Document Type

Article

Disciplines

Bacteria | Bacterial Infections and Mycoses | Epidemiology | Immunology of Infectious Disease | Microbiology

Abstract

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.

Keywords

Neisseria gonorrhoeae, antimicrobial resistance, azithromycin, eastern Chinese cities, molecular epidemiology

Rights and Permissions

Copyright © 2018 Wan et al. This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International license.

DOI of Published Version

10.1128/AAC.02499-17

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

Journal/Book/Conference Title

Antimicrobial agents and chemotherapy

Related Resources

Link to Article in PubMed

PubMed ID

29530847

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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