Epidemiology of <i>Neisseria gonorrhoeae</i> Gyrase A Genotype, Los Angeles, California, USA

Bhatti, Ashima; Allan‐Blitz, Lao‐Tzu; Castrejon, Mariana; Humphries, Romney M.; Hemarajata, Peera; Klausner, Jeffrey D.

doi:10.3201/eid2309.170215

Cited by 5 publications

(4 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We also found a relatively low rate of ciprofloxacin resistance (6%) in the N. gonorrhoeae isolates in our study, which is in contrast to the rapid increase in resistance to quinolone antibiotics seen nationwide (approximately 20 to 40% of isolates in 2016, depending on location) (1, 20). However, several of the ciprofloxacin-resistant isolates we identified contained a combination of mutations in the gyrA and parC genes known to confer high-level resistance to ciprofloxacin (15, 21).…”

Section: Discussioncontrasting

confidence: 76%

Genotypic and Phenotypic Characterization of Antimicrobial Resistance in Neisseria gonorrhoeae: a Cross-Sectional Study of Isolates Recovered from Routine Urine Cultures in a High-Incidence Setting

Bailey

Potter²,

Wallace

et al. 2019

mSphere

View full text Add to dashboard Cite

The objectives of this study were to perform genomic and phenotypic characterization of antimicrobial resistance in Neisseria gonorrhoeae isolates recovered from urine samples from patients in St. Louis, MO, USA. Sixty-four clinical isolates were banked over a 2-year period and subjected to antimicrobial susceptibility testing (AST) by Kirby-Bauer disk diffusion (penicillin, tetracycline, cefuroxime, and ciprofloxacin) and gradient diffusion (tetracycline, doxycycline, azithromycin, ceftriaxone, cefixime, ciprofloxacin, gemifloxacin, and delafloxacin). The medical records for the patients were evaluated to determine the demographics, location, and prescribed treatment regimen. Isolate draft genomes were assembled from Illumina shotgun sequencing data, and resistance determinants were identified by ResFinder and PointFinder. Of the 64 isolates, 97% were nonsusceptible to penicillin, with resistant isolates all containing the blaTEM-1b gene; 78 and 81% of isolates were nonsusceptible to tetracycline and doxycycline, respectively, with resistant isolates all containing the tet(M) gene. One isolate was classified as non-wild-type to azithromycin, and all isolates were susceptible to ceftriaxone; 89% of patients received this combination of drugs as first-line therapy. Six percent of isolates were resistant to ciprofloxacin, with most resistant isolates containing multiple gyrA and parC mutations. Correlation between disk and gradient diffusion AST devices was high for tetracycline and ciprofloxacin (R2 > 99% for both). The rates of N. gonorrhoeae antibiotic resistance in St. Louis are comparable to current rates reported nationally, except ciprofloxacin resistance was less common in our cohort. Strong associations between specific genetic markers and phenotypic susceptibility testing hold promise for the utility of genotype-based diagnostic assays to guide directed antibiotic therapy. IMPORTANCE Neisseria gonorrhoeae causes the sexually transmitted infection gonorrhea, which is most commonly diagnosed using a DNA-based detection method that does not require growth and isolation of N. gonorrhoeae in the laboratory. This is problematic because the rates of antibiotic resistance in N. gonorrhoeae are increasing, but without isolating the organism in the clinical laboratory, antibiotic susceptibility testing cannot be performed on strains recovered from clinical specimens. We observed an increase in the frequency of urine cultures growing N. gonorrhoeae after we implemented a total laboratory automation system for culture in our clinical laboratory. Here, we report on the rates of resistance to multiple historically used, first-line, and potential future-use antibiotics for 64 N. gonorrhoeae isolates. We found that the rates of antibiotic resistance in our isolates were comparable to national rates. Additionally, resistance to specific antibiotics correlated closely with the presence of genetic resistance genes, suggesting that DNA-based tests could also be designed to guide antibiotic therapy for treating gonorrhea.

show abstract

Section: Discussioncontrasting

confidence: 76%

Genotypic and Phenotypic Characterization of Antimicrobial Resistance in Neisseria gonorrhoeae: a Cross-Sectional Study of Isolates Recovered from Routine Urine Cultures in a High-Incidence Setting

Bailey

Potter²,

Wallace

et al. 2019

mSphere

View full text Add to dashboard Cite

show abstract

“…In addition, the population monitored by the Gonococcal Isolates Surveillance Program may not be representative of the general population. Thus, implementing routine gyr A reflex testing (23) may improve the overall surveillance of ciprofloxacin resistant Neisseria gonorrhoeae infections in the United States. Importantly, a separate cost analysis would need to be conducted to evaluate the expenses and benefits of using gyr A genotyping for surveillance purposes.…”

Section: Discussionmentioning

confidence: 99%

A Cost Analysis of Gyrase A Testing and Targeted Ciprofloxacin Therapy Versus Recommended 2-Drug Therapy for Neisseria gonorrhoeae Infection

Allan‐Blitz¹,

Hemarajata²,

Humphries³

et al. 2018

Sexual Trans Dis

Self Cite

View full text Add to dashboard Cite

show abstract

“…To address the need of enhanced susceptibility surveillance in the era of NAATs and resistant strains, molecular approaches to rapidly identify genetic resistance determinants have been previously developed and are widely accepted as suitable alternatives for determination of antimicrobial susceptibility. 8,9,10 Furthermore, the use of genotypic assays to predict susceptibility is quickly gaining attention as a new tool to monitor AMR NG 11 and helping to guide antimicrobial stewardship. 12…”

Section: Introductionmentioning

confidence: 99%

Molecular Characterization of Markers Associated With Antimicrobial Resistance in Neisseria gonorrhoeae Identified From Residual Clinical Samples

Melendez¹,

Hardick²,

Barnes³

et al. 2018

Sexual Trans Dis

View full text Add to dashboard Cite

show abstract

Epidemiology of Neisseria gonorrhoeae Gyrase A Genotype, Los Angeles, California, USA

Cited by 5 publications

References 8 publications

Genotypic and Phenotypic Characterization of Antimicrobial Resistance in Neisseria gonorrhoeae: a Cross-Sectional Study of Isolates Recovered from Routine Urine Cultures in a High-Incidence Setting

Genotypic and Phenotypic Characterization of Antimicrobial Resistance in Neisseria gonorrhoeae: a Cross-Sectional Study of Isolates Recovered from Routine Urine Cultures in a High-Incidence Setting

A Cost Analysis of Gyrase A Testing and Targeted Ciprofloxacin Therapy Versus Recommended 2-Drug Therapy for Neisseria gonorrhoeae Infection

Molecular Characterization of Markers Associated With Antimicrobial Resistance in Neisseria gonorrhoeae Identified From Residual Clinical Samples

Contact Info

Product

Resources

About