Evaluation of the accuracy of molecular assays targeting the mutation A2059G for detecting high-level azithromycin resistance in &lt;em&gt;Neisseria gonorrhoeae&lt;/em&gt;: a systematic review and meta-analysis

Wang, Feng; Liu, Jingwei; Liu, Hongye; Huang, Jing; Chen, Shaochun; Chen, Xiang-Sheng; Yin, Yue-Ping

doi:10.2147/idr.s183754

Cited by 7 publications

(9 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results confirm that the C2611T mutation is an important factor leading to the moderate level of azithromycin resistance of Neisseria gonorrhoeae . Previous studies [ 35 ] proved that there is a relationship between the A2059G mutation and a high level of azithromycin resistance. Molecular methods can be used in the detection of azithromycin resistance in N. gonorrhoeae by combining two molecular detection methods.…”

Section: Discussionmentioning

confidence: 99%

The Accuracy of Molecular Detection Targeting the Mutation C2611T for Detecting Moderate-Level Azithromycin Resistance in Neisseria gonorrhoeae: A Systematic Review and Meta-Analysis

Zhou¹,

Liu²,

Chen³

et al. 2021

Antibiotics

Self Cite

View full text Add to dashboard Cite

Background: Neisseria gonorrhoeae (N. gonorrhoeae) is now recognized as a commonly reported sexually transmitted pathogen, and the increasing drug resistance of N. gonorrhoeae has become a serious public health problem. The accuracy of molecular detection for detecting moderate-level azithromycin resistance is not well-established. We summarized the data from studies of the N. gonorrhoeae 23S rRNA mutation at position 2611 with azithromycin resistance to determine the relationship between the mutation and resistance. Methods and Findings: In this systematic review and meta-analysis, two researchers independently searched six databases for studies with data for the azithromycin minimum inhibitory concentrations (MICs) and the 23S rRNA mutation C2611T of each N. gonorrhoeae isolate. Since the breakpoint of moderate-level resistance to azithromycin (ML-AzmR) was not determined, we divided the moderate level into two groups according to the range of MICs (moderate resistance limited to 2–128 mg/L or 4–128 mg/L) for data extraction. A random-effects model was used to calculate the pooled sensitivity rate, the specificity rate, the pooled positive likelihood ratio (PLR), the negative likelihood ratio (NLR), and the diagnostic odds ratio (DOR). Meta-regression analyses by detection method, isolates sampling (a random sample or not), location, and sample size were performed to explore the possible causes of heterogeneity. The potential publication bias of the included studies was conducted by the Deeks’ test. We included 20 studies in our study: 20 studies have data of N. gonorrhoeae with MICs between 2 and 128 mg/L with mutation or without mutation at position 2611(4759 samples), and 14 studies have data of N. gonorrhoeae with MICs between 4 and 128 mg/L (3367 samples). In the group with the moderate level of 2–128 mg/L, the pooled sensitivity rate of the molecular assays was determined to be 71.9% (95% CI, 67.6–74%), the pooled specificity rate was 98.7% (95% CI, 98.2–99.0%), and the DOR ranged from 55.0 to 351.3 (mean, 139.1). In the 4–128 mg/L group, the pooled sensitivity rate was 91.9% (95% CI, 88.9–94.2%), the pooled specificity rate was 95.9% (95% CI, 95.1–96.6%), and the DOR ranged from 41.9 to 364.1 (mean, 123.6). Conclusion: Through this meta-analysis, we found that the C2611T mutation of 23S rRNA is valuable for the molecular diagnostic of moderate-level azithromycin resistance (ML-AzmR) in N. gonorrhoeae, especially when the moderate level is set at 4–128 mg/L. This rapid molecular detection method can be used for the rapid identification of ML-AzmR isolates in the clinic.

show abstract

Section: Discussionmentioning

confidence: 99%

The Accuracy of Molecular Detection Targeting the Mutation C2611T for Detecting Moderate-Level Azithromycin Resistance in Neisseria gonorrhoeae: A Systematic Review and Meta-Analysis

Zhou¹,

Liu²,

Chen³

et al. 2021

Antibiotics

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, this test is costly, requiring the use of strips that are expensive because of the manufacturer's patent protection, and these materials were not available in China because of no approved license by CFDA. 4,5 Disk diffusion method is relatively easy to perform; however, the results were qualitative and it is unable to measure differences in antimicrobial susceptibilities. In China, gonorrhea was the fourth most commonly reported notifiable communicable disease, with 133,156 reported cases in 2018.…”

Section: Discussionmentioning

confidence: 99%

“…4 However, the E-test strips are not commercially available for clinical use because it is not approved by the China Food and Drug Administration (CFDA) in China. 5 Moreover, with the decreasing susceptibility to the currently recommended firstline treatment option ceftriaxone, it urgent to determine susceptibility profiles qualitatively or quantitatively within minimal time. Therefore, a quality-assured, quantitative, timely, and scalable method is needed in clinics to determine the antimicrobial susceptibility of N. gonorrhoeae isolates, especially to find out clinical ceftriaxone resistant isolates promptly.…”

Section: Infection and Drug Resistance Dovepressmentioning

confidence: 99%

<p>Comparison of Microdilution Method with Agar Dilution Method for Antibiotic Susceptibility Test of <em>Neisseria gonorrhoeae</em></p>

Chen¹,

Liu²,

Wu³

et al. 2020

IDR

Self Cite

View full text Add to dashboard Cite

Introduction: Antimicrobial resistance (AMR) of Neisseria gonorrhoeae (N. gonorrhoeae) becomes a grave public health problem in the world. A strengthened Antimicrobial Resistance Surveillance Program is needed to track the trend of AMR development. However, the lack of a proper antimicrobial susceptibility test (AST) method is a barrier to expand the AMR surveillance in China. Traditional agar dilution (AD) method is laborious and E-test strips have no approval license for clinical use. Herein, a Chinese group modified the microdilution (MD) method for clinical ASTs. The objective of this study is to compare the MD method with the AD method for N. gonorrhoeae AST. Materials and Methods: A total of 166 clinical isolates were tested for antimicrobial susceptibility of ceftriaxone, spectinomycin, azithromycin, ciprofloxacin, tetracycline, and penicillin using MD and AD method simultaneously. Results of MD method were read manually or automatically. Rates of essential agreement (EA), category agreement (CA), minor error, and very major error were compared. Results: The total EAs (compared with results read manually) of penicillin, tetracycline, ciprofloxacin, spectinomycin, ceftriaxone, and azithromycin were 90.4%, 97.0%, 85.5%, 100.0%, 94%, and 72.3%; and CAs were 82.5%, 94.0%, 100%, 100%, 95.2%, and 94%, respectively. Conclusion:We conclude that the MD method might be an alternative for clinical AST of N. gonorrhoeae in China. In particular, MD method has the potency of accurate differentiation of isolates resistant to ceftriaxone or azithromycin, which were empirically recommended for gonococcal treatment, but its quality remained suboptimal, and further improvement is needed for clinical use.

show abstract

“…Gonorrhea generally manifests as an acute purulent genital tract infection by Ng and is characterized by abundant activated neutrophils and exudates[ 2 ]. In most countries, antibiotics are the recommended first-line treatment for gonorrhea[ 3 ]. However, owing to the abuse of antibiotics, antimicrobial resistance in Ng has become a serious threat to global public health[ 4 ].…”

Section: Introductionmentioning

confidence: 99%

In vitro antimicrobial effect and mechanism of action of plasma-activated liquid on planktonic Neisseria gonorrhoeae

et al. 2021

View full text Add to dashboard Cite

Neisseria gonorrhoeae (Ng) is highly resistant to treatment, and there is an urgent need for new treatments to alleviate gonococcal resistance caused by antibiotic monotherapy. The antimicrobial effect and mechanism of plasma-activated liquid (PAL) on Ng were evaluated in this study. Upon PAL treatment, extensively analyses on cell culturability, metabolic capacity, intracellular reactive oxygen species (ROS),membrane integrity and nucleic acids for Ng were carried out and significant antimicrobial effects observed.PAL exerted antibacterial effect on Ng and induced bacterial death (6.71-log) following immersion for 30 min and treatment for 120 s. However, bacterial viability test revealed that after immersion in the same PAL, 10.17% of bacteria retained their metabolic capacity. This indicates that bacteria enter a physiological viable but nonculturable state to protect themselves from environmental stress. Confocal fluorescence microscopy and transmission electron microscopy demonstrated that PAL exerts bactericidal effect on Ng and disrupts its morphological structure. PAL may upregulate inflammatory factors and genes to modulate the resistance of Ng and affect the immune status of the host during infection.

show abstract

Evaluation of the accuracy of molecular assays targeting the mutation A2059G for detecting high-level azithromycin resistance in <em>Neisseria gonorrhoeae</em>: a systematic review and meta-analysis

Cited by 7 publications

References 35 publications

The Accuracy of Molecular Detection Targeting the Mutation C2611T for Detecting Moderate-Level Azithromycin Resistance in Neisseria gonorrhoeae: A Systematic Review and Meta-Analysis

The Accuracy of Molecular Detection Targeting the Mutation C2611T for Detecting Moderate-Level Azithromycin Resistance in Neisseria gonorrhoeae: A Systematic Review and Meta-Analysis

<p>Comparison of Microdilution Method with Agar Dilution Method for Antibiotic Susceptibility Test of <em>Neisseria gonorrhoeae</em></p>

In vitro antimicrobial effect and mechanism of action of plasma-activated liquid on planktonic Neisseria gonorrhoeae

Contact Info

Product

Resources

About