The prevalence and epidemiology of plasmid-mediated penicillin and tetracycline resistance among Neisseria gonorrhoeae isolates in Guangzhou, China, 2002–2012

Abstract

BackgroundGonococcal antimicrobial resistance is a global problem. Different resistance plasmids have emerged and spread among the isolates of Neisseria gonorrhoeae worldwide and in China. We conducted this study to monitor the plasmid-mediated penicillin and tetracycline resistance among N. gonorrhoeae isolates in Guangzhou from 2002 to 2012.MethodsConsecutive isolates of N. gonorrhoeae were collected from outpatients with gonorrhea attending the STD clinic in Guangdong Provincial Centre for Skin Diseases and STIs Control and Prevention. Penicillinase-producing N. gonorrhoeae (PPNG) isolates were analyzed by the paper acidometric method. Plasmid-mediated resistance to tetracycline in N. gonorrhoeae (TRNG) isolates was screened by the agar plate dilution method. Plasmid types were determined for TRNG and PPNG isolates using polymerase chain reaction (PCR). Minimum inhibitory concentrations (MICs) to penicillin and tetracycline were detected by the agar plate dilution.ResultsOf 1378 consecutive N. gonorrhoeae isolates, 429 PPNG and 639 TRNG isolates were identified. The prevalence of PPNG, TRNG, and PPNG/TRNG increased from 18.3 to 47.1 % (χ2 = 31.57, p < 0.001), from 29.4 to 52.1 % (χ2 = 16.28, p < 0.001) and from 10.0 to 26.2 % (χ2 = 10.46, p < 0.001) between 2002 and 2012, respectively. Genotyping of plasmids among PPNGs showed that the majority (93.7 %) of the isolates were the Asian type plasmids, while the African type plasmid emerged in 2008 and rapidly increased to 14.0 % in 2012 (χ2 = 25.03, p < 0.001). For TRNGs, all 639 isolates carried the Dutch type plasmid. MICs of penicillin G and tetracycline persisted at high levels and the MIC90s were 32-fold higher than the resistant cutoff point over 11 years. The prevalence rates of penicillin- and tetracycline-resistant N. gonorrhoeae varied from 90.9 to 91.1 % and from 88.3 to 89.3 % during 2002 to 2012, respectively.ConclusionsResistance to penicillin and tetracycline among N. gonorrhoeae isolates remained at high levels in Guangzhou. The Asian type PPNG continued to spread and Dutch type TRNG was still the dominant strain. The African type PPNG has emerged and is spreading rapidly.

Identification of Novel Neisseria gonorrhoeae Lineages Harboring Resistance Plasmids in Coastal Kenya

“…Therefore, use of doxycycline can coselect for p bla TEM and pTetM, resulting in spread of resistance to penicillin and tetracycline in a gonococcal population. Consistent with our findings, the frequency of p bla TEM mirrors that of pTetM in other gonococcal populations [ 10 , 22 , 25 ].…”

Surveillance of Antibiotic Susceptibility Patterns of <i>Neisseria gonorrhoeae</i> from 2013 to 2015 in Guangxi Province, China

“…The prevalence of PPNG isolates in Guangxi from 2013 to 2015 was 30.7 , which is consistent with that from 2009 to 2012 (31.8 ) but much higher than that before 2008 (5.6 during 2000-2003, 13.3 during 2003-2005, and 13.7 during 2006-2008). PPNG prevalence is similar to that of neighboring Guangdong province (31.1 ) (14). The multiple analyses revealed that the age older than 50 is a risk factor of resistance.…”

Availability of laboratory diagnosis of gonorrhoea and its meaning in case reporting in Shandong province, China

“…Drug-resistance of NG is increasing in China and other countries in the world. [35][36][37] By far, spread of drug-resistant NG has become a threat to effectively controlling gonorrhea in the world and led to an increasing need for antimicrobial-susceptibility testing. Low availability of laboratory tests of NG and antibiotics abuse may further aggravate drug-resistant.…”