Antimicrobial susceptibility/resistance and genetic characteristics of Neisseria gonorrhoeae isolates from Poland, 2010-2012

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• 作者：Beata Mlynarczyk-Bonikowska (41)
  Agnieszka Beata Serwin (42)
  Daniel Golparian (43)
  Szymon Walter de Walthoffen (44)
  Slawomir Majewski (41)
  Marta Koper (42)
  Magdalena Malejczyk (41)
  Marius Domeika (45)
  Magnus Unemo (43)
  
• 关键词：Neisseria gonorrhoeae ; Gonorrhoea ; Poland ; Antimicrobial resistance (AMR) ; Extended ; spectrum cephalosporins (ESCs) ; Ceftriaxone ; Cefixime ; penA ; NG ; MAST
• 刊名：BMC Infectious Diseases
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：206 KB
• 作者单位：Beata Mlynarczyk-Bonikowska (41)
  Agnieszka Beata Serwin (42)
  Daniel Golparian (43)
  Szymon Walter de Walthoffen (44)
  Slawomir Majewski (41)
  Marta Koper (42)
  Magdalena Malejczyk (41)
  Marius Domeika (45)
  Magnus Unemo (43)
  
  41. Department of Dermatology and Venereology, Medical University of Warsaw, Warsaw, Poland
  42. Department of Dermatology and Venereology, Medical University of Bialystok, Bialystok, Poland
  43. WHO Collaborating Centre for Gonorrhoea and other STIs, National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Microbiology, ?rebro University Hospital, ?rebro, Sweden
  44. Department of Medical Microbiology, Medical University of Warsaw, Warsaw, Poland
  45. Department of Prevention and Control of Communicable Diseases, Uppsala County Council, Uppsala, Sweden
  
• ISSN：1471-2334

文摘

Background In Poland, gonorrhoea has been a mandatorily reported infection since 1948, however, the reported incidences are likely underestimated. No antimicrobial resistance (AMR) data for Neisseria gonorrhoeae has been internationally reported in nearly four decades, and data concerning genetic characteristics of N. gonorrhoeae are totally lacking. The aims of this study were to investigate the AMR to previously and currently recommended gonorrhoea treatment options, the main genetic resistance determinant (penA) for extended-spectrum cephalosporins (ESCs), and genotypic distribution of N. gonorrhoeae isolates in Poland in 2010-2012. Methods N. gonorrhoeae isolates cultured in 2010 (n--8), 2011 (n--2) and 2012 (n--08) in Warsaw and Bialystok, Poland, were examined using antimicrobial susceptibility testing (Etest), pyrosequencing of penA and N. gonorrhoeae multi-antigen sequence typing (NG-MAST). Results The proportions of N. gonorrhoeae isolates showing resistance were as follows: ciprofloxacin 61%, tetracycline 43%, penicillin G 22%, and azithromycin 8.8%. No isolates resistant to ceftriaxone, cefixime or spectinomycin were found. However, the proportion of isolates with an ESC MIC--.125?mg/L, i.e. at the resistance breakpoint, increased significantly from none in 2010 to 9.3% and 19% in 2012 for ceftriaxone and cefixime, respectively. Furthermore, 3.1% of the isolates showed multidrug resistance, i.e., resistance to ciprofloxacin, penicillin G, azithromycin, and decreased susceptibility to cefixime (MIC--.125?mg/L). Seventy-six isolates (33%) possessed a penA mosaic allele and 14 isolates (6.1%) contained an A501V/T alteration in penicillin-binding protein 2. NG-MAST ST1407 (n--8, 25% of isolates) was the most prevalent ST, which significantly increased from 2010 (n--) to 2012 (n--6; 43%). Conclusions In Poland, the diversified gonococcal population displayed a high resistance to most antimicrobials internationally previously recommended for gonorrhoea treatment and decreasing susceptibility to the currently recommended ESCs. The decreasing susceptibility to ESCs was mostly due to the introduction of the internationally spread multidrug-resistant NG-MAST ST1407 in 2011. It is essential to promptly revise the gonorrhoea treatment guidelines, improve the gonorrhoea laboratory diagnostics, and implement quality assured surveillance of gonococcal AMR (ideally also treatment failures) in Poland.