Cephalosporin-Resistant Neisseria gonorrhoeae Isolated in Portugal, 2019

Pinto, Miguel; Matias, Rui; Rodrigues, João; Duarte, Sílvia; Vieira, Luı́s; Gonçalves, Inês; Goncąlves, Maria Joaõ; Ramos, Maria da Conceição Pereira; Gomes, João Paulo; Borrego, Maria José

doi:10.1097/olq.0000000000001218

Cited by 8 publications

(5 citation statements)

References 12 publications

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“…differential MIC values). For instance, the first cephalosporin-resistant isolate detected in Portugal (end of 2019) revealed a single alteration (542S) in penA , while presenting MICs of 0.19 and 0.38 mg l −1 to ceftriaxone and cefixime, respectively [ 14 ]. Another genogroup that warrants particular attention is G001.005, where the carriage of the azithromycin-resistance-associated mutation A2045G was mostly observed.…”

Section: Discussionmentioning

confidence: 99%

“…Linked to disease burden, treatment strategies are being continuously challenged due to N. gonorrhoeae's ability to acquire antimicrobial resistance (AMR) to multiple classes of antimicrobials, including β-lactams, tetracyclines, macrolides and quinolones, after the acquisition of genes or mutations conferring resistance [4][5][6][7]. During the last decade, there has been a steady rise in minimum inhibitory concentrations (MICs) for cephalosporins, with resistant strains and clinical failures being described [8][9][10][11][12][13][14]. A worldwide increase in azithromycin resistance is also being reported [15][16][17][18][19], with resistant strains being associated with recent outbreaks [20][21][22].…”

Section: Introductionmentioning

confidence: 99%

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Neisseria gonorrhoeae clustering to reveal major European whole-genome-sequencing-based genogroups in association with antimicrobial resistance

et al. 2021

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Neisseria gonorrhoeae , the bacterium responsible for the sexually transmitted disease gonorrhoea, has shown an extraordinary ability to develop antimicrobial resistance (AMR) to multiple classes of antimicrobials. With no available vaccine, managing N. gonorrhoeae infections demands effective preventive measures, antibiotic treatment and epidemiological surveillance. The latter two are progressively being supported by the generation of whole-genome sequencing (WGS) data on behalf of national and international surveillance programmes. In this context, this study aims to perform N. gonorrhoeae clustering into genogroups based on WGS data, for enhanced prospective laboratory surveillance. Particularly, it aims to identify the major circulating WGS-genogroups in Europe and to establish a relationship between these and AMR. Ultimately, it enriches public databases by contributing with WGS data from Portuguese isolates spanning 15 years of surveillance. A total of 3791 carefully inspected N. gonorrhoeae genomes from isolates collected across Europe were analysed using a gene-by-gene approach (i.e. using cgMLST). Analysis of cluster composition and stability allowed the classification of isolates into a two-step hierarchical genogroup level determined by two allelic distance thresholds revealing cluster stability. Genogroup clustering in general agreed with available N. gonorrhoeae typing methods [i.e. MLST (multilocus sequence typing), NG-MAST ( N. gonorrhoeae multi-antigen sequence typing) and PubMLST core-genome groups], highlighting the predominant genogroups circulating in Europe, and revealed that the vast majority of the genogroups present a dominant AMR profile. Additionally, a non-static gene-by-gene approach combined with a more discriminatory threshold for potential epidemiological linkage enabled us to match data with previous reports on outbreaks or transmission chains. In conclusion, this genogroup assignment allows a comprehensive analysis of N. gonorrhoeae genetic diversity and the identification of the WGS-based genogroups circulating in Europe, while facilitating the assessment (and continuous monitoring) of their frequency, geographical dispersion and potential association with specific AMR signatures. This strategy may benefit public-health actions through the prioritization of genogroups to be controlled, the identification of emerging resistance carriage, and the potential facilitation of data sharing and communication.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Neisseria gonorrhoeae clustering to reveal major European whole-genome-sequencing-based genogroups in association with antimicrobial resistance

et al. 2021

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“…Moreover, we recently validated two of our algorithms in a report of a ceftriaxone-resistant Neisseria gonorrhoeae strain from Portugal. 7,8 The genetic distinctness of the Amsterdam and Portugal strains with respect to sequence-type combinations (MLST-MAST) of N. gonorrhoeae isolates and different countries of origin further illustrates the value of incorporating several genetic markers into molecular tests to predict decreased susceptibility to ceftriaxone. In light of the urgent global health threat posed by antibiotic resistance in N. gonorrhoeae, utilizing genetic targets for the rapid prediction of ceftriaxone resistance is critical.…”

Section: Dear Editormentioning

confidence: 99%

Applying molecular algorithms to predict decreased susceptibility to ceftriaxone from a report of strains of Neisseria gonorrhoeae in Amsterdam, the Netherlands

Lin

Adamson

Klausner

2021

Journal of Antimicrobial Chemotherapy

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“…noting that all strains with resistance had a penA allele with an A501V mutation and penB G120K/A121D mutations, which were lacking in susceptible strains. Pinto et al reported that strains with reduced susceptibility to ceftriaxone from Portugal contained a nonmosaic penA allele containing mutation G542S as well as penB mutation G120K and A121D [33]. Various mutations such as V316T, G545S, I312M, and N512Y may contribute to reduced susceptibility, as reverting these alterations in vitro reduces the observed MIC [26].…”

Section: Molecular Determinants Of N Gonorrhoeae Decreased Susceptibi...mentioning

confidence: 99%

Resistance-Guided Therapy for Neisseria gonorrhoeae

Allan‐Blitz

Adamson

Klausner

2022

Clinical Infectious Diseases

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Antimicrobial-resistant Neisseria gonorrhoeae infections are a threat to public health. Novel strategies for combating such resistance include the development of molecular assays to facilitate real-time prediction of antimicrobial susceptibility. Resistance to ciprofloxacin is determined by the presence of a single mutation at codon 91 of the gyrase A gene; molecular assays to guide therapy are commercially available. Resistance to cefixime is conferred via 1 of 6 critical mutations in either the mosaic penA gene or specific loci in the nonmosaic region. Resistance to ceftriaxone is conferred through mutations in 1 of 4 genes: penA, ponA, penB, and mtr; however, the ability to predict reduced susceptibility based on those genes varies by geographic region. Here, we highlight the work done toward the development of 3 such assays for ciprofloxacin, cefixime, and ceftriaxone, discuss the status of our current understanding and ongoing challenges, and suggest future directions.

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Cephalosporin-Resistant Neisseria gonorrhoeae Isolated in Portugal, 2019

Cited by 8 publications

References 12 publications

Neisseria gonorrhoeae clustering to reveal major European whole-genome-sequencing-based genogroups in association with antimicrobial resistance

Neisseria gonorrhoeae clustering to reveal major European whole-genome-sequencing-based genogroups in association with antimicrobial resistance

Applying molecular algorithms to predict decreased susceptibility to ceftriaxone from a report of strains of Neisseria gonorrhoeae in Amsterdam, the Netherlands

Resistance-Guided Therapy for Neisseria gonorrhoeae

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