Neisseria gonorrhoeae Sequence Typing for Antimicrobial Resistance, a Novel Antimicrobial Resistance Multilocus Typing Scheme for Tracking Global Dissemination of N-gonorrhoeae Strains

被引:6
作者
Demczuk, W. [1 ]
Sidhu, S. [1 ]
Unemo, M. [2 ]
Whiley, D. M. [3 ]
Allen, V. G. [4 ]
Dillon, J. R. [5 ]
Cole, M. [6 ]
Seah, C. [4 ]
Trembizki, E.
Trees, D. L. [7 ]
Kersh, E. N. [7 ]
Abrams, A. J. [7 ]
de Vries, H. J. C. [8 ,9 ,10 ]
van Dam, A. P. [11 ,12 ]
Medina, I. [1 ]
Bharat, A. [1 ]
Mulvey, M. R. [1 ]
Van Domselaar, G. [1 ]
Martin, I. [1 ]
机构
[1] Publ Hlth Agcy Canada, Natl Microbiol Lab, Winnipeg, MB, Canada
[2] Orebro Univ Hosp, WHO Collaborating Ctr Gonorrhoea & Other STIs, Orebro, Sweden
[3] Univ Queensland, Ctr Clin Res, Brisbane, Qld, Australia
[4] Publ Hlth Ontario Labs, Toronto, ON, Canada
[5] Univ Saskatchewan, Dept Microbiol & Immunol, Saskatoon, SK, Canada
[6] Publ Hlth England, London, England
[7] Ctr Dis Control & Prevent, Div STD Prevent, Atlanta, GA USA
[8] Publ Hlth Serv Amsterdam, Dept Infect Dis, STI Outpatient Clin, Amsterdam, Netherlands
[9] Univ Amsterdam, Acad Med Ctr, Dept Dermatol, Amsterdam, Netherlands
[10] Univ Amsterdam, Acad Med Ctr, Ctr Infect & Immun Amsterdam, Amsterdam, Netherlands
[11] Publ Hlth Serv Amsterdam, Publ Hlth Lab, Amsterdam, Netherlands
[12] OLVG Gen Hosp, Dept Med Microbiol, Amsterdam, Netherlands
关键词
Neisseria gonorrhoeae; antimicrobial resistance; molecular epidemiology; sequence typing; REDUCED SUSCEPTIBILITY; TREATMENT FAILURE; AZITHROMYCIN RESISTANCE; ANTIBIOTIC-RESISTANCE; GENOMIC EPIDEMIOLOGY; MACROLIDE RESISTANCE; LEVEL RESISTANCE; MUTATIONS; CANADA; CEFTRIAXONE;
D O I
10.1128/JCM.00100-17
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
A curated Web-based user-friendly sequence typing tool based on antimicrobial resistance determinants in Neisseria gonorrhoeae was developed and is publicly accessible (https://ngstar.canada.ca). The N. gonorrhoeae Sequence Typing for Antimicrobial Resistance (NG-STAR) molecular typing scheme uses the DNA sequences of 7 genes (penA, mtrR, porB, ponA, gyrA, parC, and 23S rRNA) associated with resistance to beta-lactam antimicrobials, macrolides, or fluoroquinolones. NG-STAR uses the entire penA sequence, combining the historical nomenclature for penA types I to XXXVIII with novel nucleotide sequence designations; the full mtrR sequence and a portion of its promoter region; portions of ponA, porB, gyrA, and parC; and 23S rRNA sequences. NG-STAR grouped 768 isolates into 139 sequence types (STs) (n = 660) consisting of 29 clonal complexes (CCs) having a maximum of a single-locus variation, and 76 NG-STAR STs (n = 109) were identified as unrelated singletons. NG-STAR had a high Simpson's diversity index value of 96.5% (95% confidence interval [CI] = 0.959 to 0.969). The most common STs were NG-STAR ST-90 (n = 100; 13.0%), ST-42 and ST-91 (n = 45; 5.9%), ST-64 (n = 44; 5.72%), and ST-139 (n = 42; 5.5%). Decreased susceptibility to azithromycin was associated with NG-STAR ST-58, ST-61, ST-64, ST-79, ST-91, and ST-139 (n = 156; 92.3%); decreased susceptibility to cephalosporins was associated with NG-STAR ST-90, ST-91, and ST-97 (n = 162; 94.2%); and ciprofloxacin resistance was associated with NG-STAR ST-26, ST-90, ST-91, ST-97, ST-150, and ST-158 (n = 196; 98.0%). All isolates of NG-STAR ST42, ST-43, ST-63, ST-81, and ST-160 (n = 106) were susceptible to all four antimicrobials. The standardization of nomenclature associated with antimicrobial resistance determinants through an internationally available database will facilitate the monitoring of the global dissemination of antimicrobial-resistant N. gonorrhoeae strains.
引用
收藏
页码:1454 / 1468
页数:15
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