Neisseria gonorrhoeae FC428 Subclone, Vietnam, 2019–2020

Abstract

Among 114 clinical Neisseria gonorrhoeae isolates collected in Vietnam during 2019–2020, we detected 15 of subclone sequence type 13871 of the FC428 clonal complex. Fourteen sequence type 13871 isolates with mosaic penA allele 60.001 were ceftriaxone or cefixime nonsusceptible, and 3/14 were azithromycin nonsusceptible. Emergence of this subclone threatens treatment effectiveness.

Detection of 10 cases of ceftriaxone-resistant Neisseria gonorrhoeae in the United Kingdom, December 2021 to June 2022

“…Although all cases were successfully treated, not all partners of cases could be traced, and there is a risk of further transmission of ceftriaxone-resistant gonococcal infection within the UK.Neisseria gonorrhoeae has developed resistance to all antibiotics recommended for treatment, including ceftriaxone, the last-line option for empirical monotherapy. The N. gonorrhoeae FC428 clone, which is associated with ceftriaxone-resistance, has been detected in numerous countries, usually with epidemiological links to countries in the Asia-Pacific region including China, Japan, the Philippines, Thailand and Vietnam [1][2][3][4][5][6]. Between December 2015 and September 2021, nine cases of ceftriaxoneresistant N. gonorrhoeae were detected in the United Kingdom (UK), all associated with international travel.…”

Global Transmission of the penA Allele 60.001–Containing High-Level Ceftriaxone-Resistant Gonococcal FC428 Clone and Antimicrobial Therapy of Associated Cases: A Review

“…9 In 2018, the FC428 clone was encountered for the first time in Ireland, 36 the United Kingdom 30 and Singapore. 37 In 2019, the FC428 clone or strains containing the FC428-associated penA allele 60.001 were encountered in Vietnam 38 and in 2022 in Austria. 21 Overall, strains associated with the FC428 clone or containing penA allele 60.001 have shown global dissemination.…”

“…The FC428 clone has thus far been encountered in Singapore in 2018 37 and in 2019 and 2020 in Vietnam 38 . However, sexual encounters during travels to Southeast Asia have been associated with gonorrhea cases belonging to the FC428 clone or containing penA allele 60.001 in many countries 19,21,33,34,49,50 .…”

“…She was successfully treated with 500 mg of intramuscular ceftriaxone and 1-g oral azithromycin. In 2019 and 2020, 14 strains genetically related to the FC428 clone or containing penA allele 60.001 were identified in Vietnam in Ho Chi Minh City, Da Nang, Binh Duong, Buon Ma Thuok and Long An 38 . The ceftriaxone MICs for these isolates ranged between 0.38 and 0.75 mg/L, and all patients were clinically cured using 1 g of intramuscular ceftriaxone and 1-g oral azithromycin.…”

Antimicrobial Activity of Auranofin, Cannabidivarin, and Tolfenamic Acid against Multidrug-Resistant Neisseria gonorrhoeae

“… Neisseria gonorrhoeae is a multidrug-resistant human-specific bacterial pathogen ( 1 ), which requires urgent development of novel or alternative antimicrobial agents due to the rise in resistance against ceftriaxone, the currently last remaining recommended first-line antimicrobial therapy ( 1 ). Recent years have demonstrated increasing incidences of ceftriaxone-treatment failure ( 2 – 4 ), with a particular threat posed by strains associated with the high-level ceftriaxone-resistant FC428 clone or containing its mosaic penA allele 60.001, which has shown global dissemination ( 5 – 8 ) and have become widespread in China ( 9 – 11 ). Recent clinical trials for alternative clinically approved antimicrobials such as gentamicin and fosfomycin have largely been unsuccessful ( 12 , 13 ), with the possible exception of ertapenem ( 12 ).…”