&lt;p&gt;Antimicrobial Resistance And Molecular Characteristics Among Neisseria gonorrhoeae Clinical Isolates In A Chinese Tertiary Hospital&lt;/p&gt;

Zheng, Zhangqin; Liu, Li; Shen, Xiaofei; Yu, Jingyi; Chen, Lijiang; Zhan, Lingling; Chen, Han; Lin, Clement; Jiang, Ye; Xia, Hong; Wang, Liangxing; Yu, Fangyou

doi:10.2147/idr.s221109

Cited by 11 publications

(13 citation statements)

References 37 publications

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“…In line with this, we observed lower significance for the RplD unitig in the conditional GWAS model when the isolates were dichotomized into azithromycin susceptible versus non-susceptible ( p -value = 3.38 × 10 −09 versus 1.08 × 10 −11 in the continuous case). Follow up studies in the US, Eastern China, and a historical Danish collection also reported strains with the G70D mutation 36 – 38 , but other surveillance datasets from Canada, Switzerland, and Nanjing did not 10 , 39 – 41 , indicating geography-specific circulation. As a result of this ambiguity, previous studies modeling phenotypic azithromycin resistance from genotype did not include RplD mutations 27 , 42 .…”

Section: Discussionmentioning

confidence: 99%

Increased power from conditional bacterial genome-wide association identifies macrolide resistance mutations in Neisseria gonorrhoeae

et al. 2020

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The emergence of resistance to azithromycin complicates treatment of Neisseria gonorrhoeae, the etiologic agent of gonorrhea. Substantial azithromycin resistance remains unexplained after accounting for known resistance mutations. Bacterial genome-wide association studies (GWAS) can identify novel resistance genes but must control for genetic confounders while maintaining power. Here, we show that compared to single-locus GWAS, conducting GWAS conditioned on known resistance mutations reduces the number of false positives and identifies a G70D mutation in the RplD 50S ribosomal protein L4 as significantly associated with increased azithromycin resistance (p-value = 1.08 × 10−11). We experimentally confirm our GWAS results and demonstrate that RplD G70D and other macrolide binding site mutations are prevalent (present in 5.42% of 4850 isolates) and widespread (identified in 21/65 countries across two decades). Overall, our findings demonstrate the utility of conditional associations for improving the performance of microbial GWAS and advance our understanding of the genetic basis of macrolide resistance.

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Section: Discussionmentioning

confidence: 99%

Increased power from conditional bacterial genome-wide association identifies macrolide resistance mutations in Neisseria gonorrhoeae

et al. 2020

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“…The sequencing diagram is shown in Figure 1. According to whether the MIC value of azithromycin was ≥1 μg/mL, 28 37 strains of N. gonorrhoeae could be divided into azithromycin-sensitive and azithromycin-…”

Section: Detection Results Of Pathogenicity Islands Genes and Correla...mentioning

confidence: 99%

“…We published an article in 2019 and found that all nineteen highly tetracycline-resistant N. gonorrhoeae were positive for the Tet-M gene, which is consistent with Allen’s finding that the tetracycline resistance of N. gonorrhoeae is closely related to the Tet-M gene. 26 , 27 Therefore, gonococci with 30ug tetracycline disk zone diameters of =<19mm usually indicate a plasmid-mediated high-level tetracycline-resistant N. gonorrhoeae (TRNG) isolate. 24 Of the 17 tetracycline-resistant strains, 15 were TRNGs ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

Molecular Characteristics and Gonococcal Genetic Island Carrying Status of Thirty-Seven Neisseria gonorrhoeae Isolates in Eastern China

Zhang¹,

Hu²,

Chi³

et al. 2022

IDR

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To investigate the carrying situation of N. gonorrhoeae genetic island (GGI), and to understand the existence of GGI of different multilocus sequence types (MLST), so as to provide evidence for epidemiology. Methods: From January 2018 to December 2020, a total of 37 clinical isolates of N. gonorrhoeae were collected. Resistance to tetracycline, β-lactam, and azithromycin were measured. Genes in GGI (atlA, traG, and traH) were amplified via polymerase chain reaction (PCR). All clinical isolates were subjected to N. gonorrhoeae MLST. Results:The GGI of N. gonorrhoeae were widespread, and the positive detection rates of atlA, traG and traH were all 81.08% (30/37). In this study, atlA, traG and traH were always detected positive together. No significant difference in the positive rate of the GGI between the azithromycin-sensitive and the resistance groups or between the β-lactam positive and negative groups (P > 0.05) was found; however, there was a significant difference between the high-level tetracycline-resistant group and the non-high-level resistant group (P < 0.05), with the carrier rates being 60.00% and 94.45%, respectively. Among the 37 isolates studied, 12 distinct MLST were determined, while MLST ST8123 occurred most frequently, accounting for 18.91% (7/37), followed by ST1928, ST7367 and ST7822, all 13.51% (5/37). Conclusion: N. gonorrhoeae typed as ST1928, ST1901, ST1588 and ST7822, the GGI were all positive. These four types are more likely to become highly virulent strains.

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“…There were some limitations to our study. First, the number of AZM-R isolates was small without analysis of other mechanisms [mutations in ribosomal proteins L4 (rplD) and L22 (rplV) yield macrolide resistance] [8,39], and therefore may not be sufficient for full evaluation of AZM resistance trends. Second, not all AZM-S isolates were subject to WGA.…”

Section: Discussionmentioning

confidence: 99%

Genetic characteristics of azithromycin-resistant Neisseria gonorrhoeae collected in Hyogo, Japan during 2015–2019

Miura

Shigemura

Osawa

et al. 2022

Journal of Medical Microbiology

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Introduction. Azithromycin (AZM) is a therapeutic drug for sexually transmitted infections and is used for Neisseria gonorrhoeae when first- and second-line drugs are not available. Recently, the susceptibility of N. gonorrhoeae against AZM has been decreasing worldwide. Hypothesis/Gap Statement. Azithromycin-resistance (AZM-R) rates among N. gonorrhoeae in Japan are increasing, and the gene mutations and epidemiological characteristics of AZM-R in N. gonorrhoeae have not been fully investigated. Aim. We determined the susceptibility to AZM and its correlation with genetic characteristics of N. gonorrhoeae . Methodology. We investigated the susceptibility to AZM and genetic characteristics of N. gonorrhoeae . Mutations in domain V of the 23S rRNA gene and mtrR were examined in 93 isolates, including 13 AZM-R isolates. Spread and clonality were examined using sequence types (STs) of multi-antigen sequence typing for N. gonorrhoeae (NG-MAST), and whole genome analysis (WGA) to identify single nucleotide polymorphisms. Results. The number of AZM-R isolates increased gradually from 2015 to 2019 in Hyogo (P=0.008). C2599T mutations in 23S rRNA significantly increased in AZM-R isolates (P<0.001). NG-MAST ST4207 and ST6762 were frequently detected in AZM-R isolates, and they had higher MICs to AZM from 6 to 24 µg/ml. The phylogenic tree-based WGA showed that all isolates with ST4207 were contained in the same clade, and isolates with ST6762 were divided into two clades, AZM-S isolates and AZM-R isolates, which were different from the cluster containing ST1407. Conclusion. Our study showed yearly increases in AZM-R rates in N. gonorrhoeae . NG-MAST ST4207 and ST6762 were not detected in our previous study in 2015 and were frequently identified in isolates with higher MICs to AZM. WGA confirmed that isolates with these STs are closely related to each other. Continued surveillance is needed to detect the emergence and confirm the spread of NG-MAST ST4207 and ST6762.

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<p>Antimicrobial Resistance And Molecular Characteristics Among Neisseria gonorrhoeae Clinical Isolates In A Chinese Tertiary Hospital</p>

Cited by 11 publications

References 37 publications

Increased power from conditional bacterial genome-wide association identifies macrolide resistance mutations in Neisseria gonorrhoeae

Increased power from conditional bacterial genome-wide association identifies macrolide resistance mutations in Neisseria gonorrhoeae

Molecular Characteristics and Gonococcal Genetic Island Carrying Status of Thirty-Seven Neisseria gonorrhoeae Isolates in Eastern China

Genetic characteristics of azithromycin-resistant Neisseria gonorrhoeae collected in Hyogo, Japan during 2015–2019

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