A multisite implementation of a real-time polymerase chain reaction assay to predict ciprofloxacin susceptibility in Neisseria gonorrhoeae

Ellis, Olivia; Hemarajata, Peera; Shahkolahi, Akbar; Masinde, Godfred; Buchs, Kerry; Humphries, Romney M.; Klausner, Jeffrey D.

doi:10.1016/j.diagmicrobio.2018.12.018

Cited by 9 publications

(2 citation statements)

References 17 publications

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“…Our study was conducted from October 2016 through December 2018 at sexual health clinics in [18]. In prior studies we found that assay to be in 100% concordance with agar dilution methods for detecting ciprofloxacin susceptibility [15].…”

Section: Methodsmentioning

confidence: 92%

Resistance-Guided Treatment of Gonorrhea: A Prospective Clinical Study

Klausner

Bristow

Soge

et al. 2020

Clinical Infectious Diseases

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Background Novel treatment strategies to slow the continued emergence and spread of antimicrobial resistance in Neisseria gonorrhoeae are urgently needed. A molecular assay that predicts in vitro ciprofloxacin susceptibility is now available but has not been systematically studied in human infections. Methods Using a genotypic polymerase chain reaction assay to determine the status of the N. gonorrhoeae gyrase subunit A serine 91 codon, we conducted a multisite prospective clinical study of the efficacy of a single oral dose of ciprofloxacin 500 mg in patients with culture-positive gonorrhea. Follow-up specimens for culture were collected to determine microbiological cure 5–10 days post-treatment. Results Of the 106 subjects possessing culture-positive infections with wild-type gyrA serine N. gonorrhoeae genotype, the efficacy of single-dose oral ciprofloxacin treatment in the per-protocol population was 100% (95% 1-sided confidence interval, 97.5–100%). Conclusions Resistance-guided treatment of N. gonorrhoeae infections with single-dose oral ciprofloxacin was highly efficacious. The widespread introduction and scale-up of gyrA serine 91 genotyping in N. gonorrhoeae infections could have substantial medical and public health benefits in settings where the majority of gonococcal infections are ciprofloxacin susceptible. Clinical Trials Registration NCT02961751.

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Section: Methodsmentioning

confidence: 92%

Resistance-Guided Treatment of Gonorrhea: A Prospective Clinical Study

Klausner

Bristow

Soge

et al. 2020

Clinical Infectious Diseases

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“…Because the prevalence of ciprofloxacin-resistant N. gonorrhoeae isolates in SK is much lower than in national reports (i.e., 33% versus 50% in 2017) (5), this antibiotic could be reintroduced for treatment provided that the isolate's susceptibility status is known. To this end, both commercial and experimental molecular tests have been developed for use in clinical settings (32)(33)(34)(35)(36)(37).…”

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confidence: 99%

Genomic Analysis Reveals Antibiotic-Susceptible Clones and Emerging Resistance in Neisseria gonorrhoeae in Saskatchewan, Canada

Parmar

Singh

Martín

et al. 2020

Antimicrob Agents Chemother

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Whole genome sequencing was used to identify mutations in antibiotic resistance-conferring genes, to compare susceptibility predictions with minimum inhibitory concentrations and to ascertain strain types in 99 isolates of Neisseria gonorrhoeae. Genotypes associated with susceptibility as well as MIC creep or emerging resistance were noted. Phylogenomic analysis revealed three distinctive clades and putative gonococcal transmission linkages involving a tetracycline resistant N. gonorrhoeae outbreak and the clonal spread of susceptible isolates in men.

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