High prevalence of blaTEM-135 and genetic epidemiology of blaTEM-135-carrying Neisseria gonorrhoeae isolates in Shandong, China, 2017–19

Abstract

Background Only one additional specific SNP in blaTEM-135 in penicillinase-producing Neisseria gonorrhoeae (PPNG) isolates is required for TEM-135 to evolve into an ESBL that is capable of degrading all extended-spectrum cephalosporins (ESCs). Methods Identification of the blaTEM-135 gene was achieved by performing a mismatch amplification mutation assay PCR. PPNG isolates were then genotyped using MLST and N. gonorrhoeae multiantigen sequence typing (NG-MAST) techniques. Finally, phylogenetic analyses based on MLST and NG-MAST were performed on all of the PPNG isolates, and genogroups were classified according to the phylogenetic relatedness on the basis of each MLST and NG-MAST gene typing and the blaTEM allele varieties. Results Among the 197 PPNG isolates, one (0.5%) isolate possessed the blaTEM-220 allele, 90 (45.7%) possessed the blaTEM-135 allele, and 106 (53.8%) possessed the blaTEM-1 allele. Among the blaTEM-135-carrying PPNG isolates, MLST ST8109 (n = 30) and NG-MAST ST12199 (n = 5), ST12754 (n = 5) and ST15073 (n = 5) were the most prevalent in the Shandong province of China. The phylogenetic analyses revealed that MLST ST8109, ST8140 and ST14417, mainly carrying the blaTEM-135 allele, belonged to the same genogroup, G1, while NG-MAST ST12199 and ST15073, mainly carrying the blaTEM-135 allele, belonged to the same genogroup, Ga. Conclusions This study has shown that the molecular epidemiology of PPNG isolates carrying the blaTEM-135 allele in Shandong has a dynamically changing status. Therefore, it is very pressing to continuously monitor the prevalence and mutation of the blaTEM-135 allele and the genetic epidemiology of PPNG isolates carrying the blaTEM-135 allele in this district.

Antimicrobial susceptibilities and genomic epidemiology of Neisseria gonorrhoeae in Stockholm, Sweden

“…Tetracycline-resistant gonococci were widespread internationally [ 7 ]. The bla TEM-135 genes have been reported to be located on β-lactamase plasmids, and the most common ones were the Asian, African, and Toronto/Rio plasmids [ 23 ]. Isolates carrying the bla TEM-135 genes have been found in China, Argentina, and Poland, among other countries [ 23 - 25 ].…”

“…The bla TEM-135 genes have been reported to be located on β-lactamase plasmids, and the most common ones were the Asian, African, and Toronto/Rio plasmids [ 23 ]. Isolates carrying the bla TEM-135 genes have been found in China, Argentina, and Poland, among other countries [ 23 - 25 ]. Sweden was one of the countries having the highest percentage of beta-lactamase-producing N. gonorrhoeae in Europe in 2016 [ 26 ].…”

Antibiotic Resistance in Neisseria gonorrhoeae: Challenges in Research and Treatment

“…Despite the situation with resistance to ceftriaxone being stable, there is concern that isolates with the pbla TEM-135 plasmid may become widespread in China and worldwide [20]. The presence of plasmid-mediated β-lactamases in gonococci causes a significant increase in the level of resistance to penicillins (MIC PEN ≥ 16 mg/L) compared with that related to chromosomal mutations (MIC PEN = 0.12-1.0 mg/L) [5,21].…”