Multidrug-resistant Neisseria gonorrhoeae isolate SE690: mosaic penA-60.001 gene causing ceftriaxone resistance internationally has spread to the more antimicrobial-susceptible genomic lineage, Sweden, September 2022

Abstract

We report a ceftriaxone-resistant, multidrug-resistant urogenital Neisseria gonorrhoeae in a female sex worker in Sweden, September 2022, who was treated with ceftriaxone 1 g, but did not return for test-of-cure. Whole genome sequencing of isolate SE690 identified MLST ST8130, NG-STAR CC1885 (new NG-STAR ST4859) and mosaic penA-60.001. The latter, causing ceftriaxone resistance in the internationally spreading FC428 clone, has now also spread to the more antimicrobial-susceptible genomic lineage B, showing that strains across the gonococcal phylogeny can develop ceftriaxone resistance.

In Vitro Bactericidal Activity of Biogenic Copper Oxide Nanoparticles for Neisseria gonorrhoeae with Enhanced Compatibility for Human Cells

“…Ceftriaxone, an extended-spectrum cephalosporin, is the last option for the treatment of uncomplicated gonorrhea in many countries. However, reduced effectiveness or resistance to ceftriaxone is progressively appearing worldwide. − Reports also indicate occasional treatment failures even with the recommended dual therapy (ceftriaxone plus azithromycin) and specifically with ceftriaxone alone, corroborating these concerns on a global scale. , In this context, we studied if the GT-CuO NPs also had antibacterial effects against some gonococcal isolates belonging to the CDC/FDA panel of gonococcal strains with reported resistance against ceftriaxone and azithromycin (Figure ). In the bactericidal assay, a concentration of 15.625 μg/mL of our GT CuNPs effectively killed 100% of strains AR-165, -166, -173, and -190 within 1 h. The SI for these strains was also determined and ranged from 14 to 74 for these strains and 203 for sensitive reference strain P9–17 (Table ).…”

Complete reference genomes of two ceftriaxone-resistant Neisseria gonorrhoeae strains identified in routine surveillance in Bangkok, Thailand, using Nanopore Q20+ chemistry, VolTRAX V2b, and Illumina sequencing

“…Both genomes contained sequences encoding 55 tRNA and 12 rRNA and harbored conjugative (39,060 bp; Dutch plasmid type) and cryptic (4,207 bp) plasmids. Phylogenomic analysis, performed as previously described ( 8 ), of 38,823 gonococcal genomes showed that both isolates belong to gonococcal genomic lineage B consisting mainly of isolates susceptible to currently used antimicrobials ( 4 , 8 , 9 ). The TH1713 and TH2288 genomes contained antimicrobial resistance determinants for ceftriaxone and ciprofloxacin, i.e., mosaic penA -60.001 and gyrA S91F/D95G, respectively.…”

“…However, they were very distant from the internationally spreading ceftriaxone-resistant FC428 ( 3 ) clade (>5,000 SNPs), and the first described high-level ceftriaxone-resistant gonococcal strains [WHO X and Y ( 10 )], all belonging to gonococcal genomic lineage A. Only one ceftriaxone-resistant isolate with mosaic penA -60.001 has been previously described in lineage B ( 8 ).…”

Addressing Sexually Transmitted Infections Due to Neisseria gonorrhoeae in the Present and Future

“…Evidence revealed that H041 is a subclone of the internationally spreading cefixime-resistant NG-MLST ST7363 (novel NG-MAST ST4220), proving that NG can develop resistance to ceftriaxone [13,69]. In addition, Golparian et al suggested that NG strains can develop ceftriaxone resistance through a single horizontal gene transfer, which raises great concern [70].…”