Review and International Recommendation of Methods for Typing Neisseria gonorrhoeae Isolates and Their Implications for Improved Knowledge of Gonococcal Epidemiology, Treatment, and Biology

Unemo, Magnus; Dillon, Jo-Anne R.

doi:10.1128/cmr.00040-10

Cited by 126 publications

(113 citation statements)

References 183 publications

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“…Molecular epidemiology typing was performed using the reference method of multi-antigen sequence typing (NG-MAST) [5]. Comparing the sequences determined for the tpbB and porB genes to those of the NG-MAST database, the sequence type ST6360 was assigned to the NG isolate via the on line NG-MAST data base (http://www.ng-mast.net).…”

Section: Molecular Investigationmentioning

confidence: 99%

High-level azithromycin-resistant Neisseria gonorrhoeae clinical isolate in France, March 2014

et al. 2014

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We report the first case in France of a high-level azithromycin-resistant Neisseria gonorrhoeae (minimum inhibitory concentration (MIC) = 96 mg/L) assigned to MLST7363 (NG-MAST ST6360), also resistant to ciprofloxacin and tetracycline but susceptible to ceftriaxone. The patient was a 51 year-old heterosexual man who returned following 1g azithromycin monotherapy. Mechanisms of azithromycin resistance were a C2599T mutation in the four copies of the rrl gene and a novel mutation in the promoter of the mtrR gene.The surveillance of Neisseria gonorrhoeae (NG) susceptibility to antibiotics in France is based on a voluntary sentinel network of laboratories [1]. In March 2014, the first NG strain showing a high level of azithromycin resistance was isolated from the urine of a 51 year-old man living in the south of France. He had a history of a Chlamydia trachomatis infection 20 years ago. The patient was heterosexual and declared having sex with only two regular female partners (last sexual contact four and ten days before symptoms). Case descriptionAt the first visit, the patient presented with mild symptoms of urethritis. He was in good general state of health and his HIV test was negative. No microbiological analyses were performed and the patient was treated empirically with a single dose of azithromycin (1 g orally) for suspected C. trachomatis infection. The patient presented again with persisting symptoms 48 hours later. At that time, he was treated empirically with a single dose of spectinomycin (2 g intramuscularly) and bacteriological examination was performed with direct microscopic examination and culture. Culture results indicated the presence of an azithromycin-resistant NG isolate. The absence of C. trachomatis infection was determined retrospectively by negative nucleic acid amplification test. At a third visit, one week later the patient was successfully cured and free of clinical symptoms.In France, the first-line treatment of uncomplicated urogenital gonorrhoea is ceftriaxone (500 mg intramuscularly), whereas spectinomycin is used in cases of contraindication to beta-lactams. For our patient, the clinician chose spectinomycin because of his own prescribing practices. Infection with the azithromycinresistant-strain was presumably acquired in France since neither the patient nor his sexual contacts had travelled in the past six months or had other known sexual contacts. In addition, they had not received any antibiotic treatment in the preceding six months.

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Section: Molecular Investigationmentioning

confidence: 99%

High-level azithromycin-resistant Neisseria gonorrhoeae clinical isolate in France, March 2014

et al. 2014

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“…Typing methods can be used for a variety of purposes to understand phylogeny (evolution) and bacterial population genetics, to identify specific strains spreading globally in specific populations and/or in core groups, to identify temporal and geographic changes in strain types as well as the emergence and transmission of individual strains, to establish strain identity/difference in contact tracing or test of cure, to confirm/disprove treatment failures, to resolve medicolegal issues such as sexual abuse, and to confirm presumed epidemiological connections or discriminate isolates of suspected clusters and outbreaks. Finally, such information can be applied to design different public health preventive measures and interventions (Unemo and Dillon, 2011). WGS has become the ultimate method for the characterization of bacterial isolates as it provides the highest possible resolution in strain typing (i.e., the DNA sequence level) and represents a new paradigm for outbreak investigation and contamination-source tracking.…”

Section: Resultsmentioning

confidence: 99%

Molecular typing of bacteria for epidemiological surveillance and outbreak investigation / Molekulare Typisierung von Bakterien für die epidemiologische Überwachung und Ausbruchsabklärung

Ruppitsch

2016

Die Bodenkultur: Journal of Land Management, Food and Environment

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SummaryConstant confrontations with microbial threats pose major challenges to human and animal health, agricultural and food production, and public safety. Identifying pathogenic bacteria (species) and tracking strains (by series of well-characterized isolates) to their sources are especially important in outbreak investigations. Compared to the identification of the species, the identification of the source and spread of microbial infections represents a major-and many times futile-challenge. This is due to the multitude of ways microorganisms can occur and spread within healthcare facilities and in the community; how, when, and where they can contaminate the complex nutrition chain, leading to natural and man-made outbreaks. Typing is the characterization of isolates or strains below species or subspecies level. Typing of bacterial isolates is an essential procedure to identify the microbe causing the illness or to track down an outbreak to the suspected source. In the genomic era, the introduction of molecular methods has largely replaced phenotypic methods and "molecular epidemiology" has emerged as a new discipline. The current molecular typing methods can be classified into three categories: (a) PCR-based methods, (b) DNA fragment analysis-based methods, and (c) DNA sequence-based methods, including the new exciting era of high-throughput genome sequencing. Keywords

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“…Методы ДНК-типирования являются наиболее предпочтительны-ми для изучения генетики и филогении бактериаль-ных популяций ввиду высокой дискриминирующей способности этих методов, оцениваемой по индексу разнообразия Симпсона [84,85], высокой пропуск-ной способности, воспроизводимости, быстроте выполнения, возможности сопоставления и переда-чи результатов, выявления ранее неизвестных гене-тических полиморфизмов [86].…”

Section: современные подходы к эпидемиологическому наблюдению над расunclassified

“…www.ng-mast.net), при этом впервые обнаруженным сиквенс-типам при-сваиваются новые номера. По мнению M. Unemo, J. Dillon, метод NG-MAST, быстро выполняемый, объективный, хорошо воспроизводимый, обладаю-щий высокой пропускной и дискриминирующей способностью, наиболее удобно применять для из-учения эпидемических вспышек заболевания, от-слеживания путей передачи инфекции, получения молекулярных характеристик ядерных групп и кло-нов возбудителя, при необходимости -для прове-дения судебно-медицинской экспертизы [86].…”

Section: современные подходы к эпидемиологическому наблюдению над расunclassified

Modern aspects of epidemiological surveillance of gonococcal infection spread

Frigo¹

2015

Klin. dermatol. venerol.

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Review and International Recommendation of Methods for Typing Neisseria gonorrhoeae Isolates and Their Implications for Improved Knowledge of Gonococcal Epidemiology, Treatment, and Biology

Cited by 126 publications

References 183 publications

High-level azithromycin-resistant Neisseria gonorrhoeae clinical isolate in France, March 2014

High-level azithromycin-resistant Neisseria gonorrhoeae clinical isolate in France, March 2014

Molecular typing of bacteria for epidemiological surveillance and outbreak investigation / Molekulare Typisierung von Bakterien für die epidemiologische Überwachung und Ausbruchsabklärung

Modern aspects of epidemiological surveillance of gonococcal infection spread

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