Changing Antimicrobial Resistance Profiles among Neisseria gonorrhoeae Isolates in Italy, 2003 to 2012 (original) (raw)
Related papers
Update on antimicrobial susceptibility and genotype of Neisseria gonorrhoeae isolated in Italy
Diagnostic Microbiology and Infectious Disease, 2012
Antimicrobial susceptibilities and genotypes of Neisseria gonorrhoeae collected in 2006-2010 from 6 medical centers located in Italy were compared with those from a previous survey conducted in 2003-2005. Resistance to ciprofloxacin increased from 34.2% to 62% whereas penicillin resistance declined from 25.5% to 14%. Important change in antimicrobial resistance rates and a high genetic variability among N. gonorrhoeae from Italy were observed. Published by Elsevier Inc.
Sexually Transmitted Diseases, 2010
Objectives: To update surveillance data on antimicrobial susceptibility of Neisseria gonorrhoeae isolated in Greece with information for the years 2005 to 2008, and analyze changes occurred from the previous 4-year period. Methods: Annual antimicrobial susceptibility rates, susceptibility patterns, and serovars of 635 gonococci isolated in 2005 to 2008 were determined and compared to respective data concerning the gonococcal sample of 2001 to 2004. Genetic similarity of the isolates in phenotypic clusters was investigated by pulsed field gel electrophoresis. Epidemiologic information was also considered. Results: Despite a reduction in the isolation frequency of penicillinase-producing strains (3.9% vs. 11.6% in the previous period), the rates of resistance and intermediate susceptibility increased for penicillin, as well as for tetracycline, erythromycin, and chloramphenicol, leaving very small proportions of isolates sensitive to these agents (4.3%, 12.8%, 10.2%, and 3.6%, respectively). Resistance to fluoroquinolones increased from 11.3% in 2004 up to 63% in 2008, and strongly correlated with multidrug-resistant isolates of Bropyst serovar, accounting for 72.6% of the quinolone-resistant strains isolated during the last 4 years. All isolates were susceptible to spectinomycin and only 2 exceeded susceptibility breakpoints set for cefotaxime, exhibiting MICs 0.75 to 1g/mL. These latter isolates, however, belonged to a cluster of strains with decreased susceptibility to cephalosporins (CDS, cefotaxime MICs Ն0.25 g/mL) that emerged in late 2006 and increased in frequency up to 20.7% through 2008. Notably, CDS isolates were also quinolone-resistant and multiresistant, further contributing to the increasing rates of quinolone and multidrug resistance in the Greek gonococcal sample. Conclusions: Antimicrobial susceptibility figures of Neisseria gonorrhoeae in Greece are worsening due to changes in the synthesis of gonococcal population, resulting from high endemicity rates of multidrug-resistant strains. MATERIALS AND METHODS Neisseria gonorrhoeae Isolates A total of 635 gonococci submitted to the NRCNG from January 2005 through December 2008 were characterized by antibiotic susceptibility and serovar and the results were com-From the
African Journal of Microbiology Research, 2011
Present study was aimed to determine antibiotic susceptibility and penicillinase production by Neisseria gonorrhoeae strains isolated from gonorrheal patients in Zahedan (south-east Iran). In a descriptive study from 2007 to 2010, 400 suspected patients were studied by history review, medical examination, Gram staining and culture in Thayer-Martin medium. Antibiotic susceptibility test of isolated strains was done by disk diffusion method and penicillinase test in penicillin resistant isolates by aciodometric method. The culture of 77(19.2%) of gonorrheal patients were positive. The resistance rate against applied antibiotics was as follow: penicillin (79.2%), ciprofloxacin (53.2%), ceftriaxone (3.8%), spectinomycin (2.5%), cefixim (12.9%), co-trimoxazole (93.5%), tetracycline (88.3%) and gentamicin (29.8%). In the meantime, 83.1% of penicillin resistant isolates produced penicillinase enzyme. Ceftriaxone, spectinomycin and cefixime are the sole antibiotics that could be considered as selective drugs. Quinolones which were regarded as an effective group of antibiotics until recently, haven lost their efficacy. Resistance against other antibiotics is rapidly growing, thus, conducting experimental tests and determination of minimum inhibitory concentration and clinical trial studies at fixed intervals can contribute to diagnosis of resistance of gonococci and rapid and successful treatment of their infections.
BMC Infectious Diseases, 2014
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.
Objectives international spread has contributed substantially to the high prevalence of antimicrobial resistant (aMr) Neisseria gonorrhoeae infections worldwide. We compared the prevalence of aMr gonococcal isolates among native persons to foreignborn (reporting country different from country of birth) persons, and describe the epidemiological and clinical characteristics of foreign-born patients and their associations to aMr. Methods We analysed isolates and patient data reported to the european gonococcal antimicrobial Surveillance Programme (euro-gaSP) 2010-2014 (n=9529). results Forty-three per cent of isolates had known country of birth and 17.2% of these were from persons born abroad. almost 50% of foreign-born were from the WHO european region (13.1% from non-european Union [eU] and the european economic area [eea] countries). compared with isolates from natives, isolates from foreign-born had a similar level (p>0.05) of azithromycin resistance (7.5% vs 7.2%), ciprofloxacin resistance (50.0% vs 46.3%) and of decreased susceptibility to ceftriaxone (1.9% vs 2.8%); a lower rate of cefixime resistance (5.7% vs 3.6%, p=0.02), and a higher proportion of isolates producing penicillinase (8.4% vs 11.7%, p=0.02). among isolates from persons born outside eU/eea, the level of decreased susceptibility to ceftriaxone was higher (1.8% vs 3.5%, p=0.02), particularly in those from the WHO eastern Mediterranean region and non-eU/eea WHO european countries (1.9% vs 9.6% and 8.7%, respectively, p<0.01). in multivariable analysis, foreign-born patients with aMr isolates were more likely to be from non-eU/eea WHO european countries (adjusted Or [aOr]: 3.2, 95% ci 1.8 to 5.8), WHO eastern Mediterranean countries (aOr: 1.8, 95% ci 1.1 to 3.3) and heterosexual males (aOr: 1.8, 95% ci 1.2 to 2.7). Conclusions importation of aMr strains remains an important threat in the eU/eea. research to improve understanding of sexual networks within foreign born and sexual tourism populations could help to inform effective tailor-made interventions. the euro-gaSP demonstrates the public health value of quality-assured surveillance of gonococcal aMr and the need for strengthened aMr surveillance, particularly in the non-eU/eea WHO european region.
New microbes and new infections, 2014
Gonorrhoea is a sexually transmitted infection with major public health implications and Neisseria gonorrhoeae has developed resistance to all antimicrobials introduced for treatment. Enhanced surveillance of antimicrobial resistance in N. gonorrhoeae is crucial globally. This is the first internationally reported antimicrobial resistance data for N. gonorrhoeae from Estonia (44 isolates cultured in 2009-2013). A high prevalence of resistance was observed for azithromycin, ciprofloxacin and tetracycline. One and two isolates with resistance and decreased susceptibility to the last remaining first-line treatment option ceftriaxone, respectively, were identified. It is crucial to implement surveillance of gonococcal antimicrobial resistance (ideally also treatment failures) in Estonia.
Antimicrobial susceptibility of Neisseria gonorrhoeae in Pune from 1996 to 2007
Indian Journal of Sexually Transmitted Diseases and AIDS, 2011
Background: Antimicrobial resistance (AMR) and genetic determinants of resistance of N. gonorrhoeae isolates from Hefei, China, were characterized adding a breadth of information to the molecular epidemiology of gonococcal resistance in China. Methods: 126 N. gonorrhoeae isolates from a hospital clinic in Hefei, were collected between January, 2014, and November, 2015. The minimum inhibitory concentration (MIC) of N. gonorrhoeae isolates for seven antimicrobials were determined by the agar dilution method. Isolates were tested for mutations in penA and mtrR genes and 23S rRNA, and also genotyped using N. gonorrhoeae multi-antigen sequence typing (NG-MAST). Results: All N. gonorrhoeae isolates were resistant to ciprofloxacin; 81.7% (103/126) to tetracycline and 73.8% (93/126) to penicillin. 39.7% (50/126) of isolates were penicillinase producing N. gonorrhoeae (PPNG), 31.7% (40/126) were tetracycline resistant N. gonorrhoeae (TRNG) and 28.6% (36/126) were resistant to azithromycin. While not fully resistant to extended spectrum cephalosporins (ESCs), a total of 14 isolates (11.1%) displayed decreased susceptibility to ceftriaxone (MIC ≥ 0.125 mg/L, n = 10), cefixime (MIC ≥ 0. 25 mg/L, n = 1) or to both ESCs (n = 3). penA mosaic alleles XXXV were found in all isolates that harbored decreased susceptibility to cefixime, except for one. Four mutations were found in mtrR genes and mutations A2143G and C2599T were identified in 23S rRNA. No isolates were resistant to spectinomycin. Gonococcal isolates were distributed into diverse NG-MAST sequence types (STs); 86 separate STs were identified. Conclusions: N. gonorrhoeae isolates from Hefei during 2014-2015, displayed high levels of resistance to antimicrobials that had been recommended previously for treatment of gonorrhea, e.g., penicillin, tetracycline and ciprofloxacin. The prevalence of resistance to azithromycin was also high (28.6%). No isolates were found to be fully resistant to spectinomycin, ceftriaxone or cefixime; however, 11.1% isolates, overall, had decreased susceptibility to ESCs.
2020
Background It is unclear how important bystander selection is in the genesis of antimicrobial resistance (AMR) in Neisseria gonorrhoeae . Methods We assessed bystander selection in a novel way. Mixed-effects linear regression was used to assess if country-level prevalence of gonococcal AMR in 30 European countries predicts homologous AMR in other bacteria. The data used was from the European Antimicrobial Resistance Surveillance Network. Results The prevalence of gonococcal ciprofloxacin resistance was found to be positively associated with AMR prevalence in E. coli (coef. 0.52; P=0.007), Acinetobacter spp . (coef. 0.13; P=0.044) and P. aeruginosa (coef. 0.36; P=0.020) but not K. pneumoniae . Azithromycin resistance in N. gonorrhoeae was positively associated with macrolide resistance in S. pneumoniae (coef. 0.01; P=0.018). No association was found for cephalosporins. Conclusions Gonococcal AMR is linked to that in other bacteria. This finding is likely explained by high antimicrobi...
PloS one, 2017
Neisseria gonorrhoeae (NG) antimicrobial susceptibility trends to azithromycin, cefixime and ceftriaxone were analyzed, from 2009 to 2016, to monitor changing antimicrobial susceptibility concomitant with the change in prescribing practice in 2012 from cefixime, or ceftriaxone, to ceftriaxone plus azithromycin. Patient characteristics predictive to be infected by antibiotic resistant N. gonorrhoeae were estimated. Finally, the protocol for the treatment of gonorrhoea, in comparison with the international guidelines, was also evaluated. Data on NG antimicrobial resistance were obtained from a network of sexually transmitted diseases clinics and other laboratories in 12 cities in Italy. We tested the 1,433 gonococci for antimicrobial susceptibility to azithromycin, cefixime and ceftriaxone using a gradient diffusion method. Logistic-regression methods with cluster robust standard errors were used to investigate the association of resistance categories with demographic and clinical pat...