Right hip gonococcal septic arthritis treatment with successful transition to oral fluoroquinolone

Kiamos, Amy; Torrente, Natalie; Sands, Michael; Verdecia, Jorge

doi:10.1136/bcr-2022-251050

Cited by 3 publications

(2 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the assay could be useful in cases where targeted therapy with fluoroquinolones (if no resistance mutations are detected) is established in patients who have not received empirical treatment. In addition, the useful in joint fluid for gonococcal arthritis diagnoses should be studied due to the use of fluoroquinolones in this clinical entity [ 15 ]. Moreover, the detection of macrolide or fluoroquinolone resistance-associated mutations in NG by NAAT methods could be useful in direct clinical samples such as first-void urine or when NG strains cannot be isolated due to lack of growth.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of mutations associated with macrolide and fluoroquinolone resistance in Neisseria gonorrhoeae with Allplex™ NG&DR Assay (Seegene®) in a tertiary hospital from Madrid, Spain

Maldonado-Barrueco,

Sanz-González,

Falces-Romero

et al. 2023

Rev Esp Quimioter

View full text Add to dashboard Cite

Background. The prevalence of drug-resistant Neisseria gonorrhoeae (NG) infections is increasing. Studies report the prevalence of NG strains presenting A2059G/C2611T (rRNA 23S) and S91F (parC) mutations conferring resistance to azithromycin and ciprofloxacin. Material and methods. We conducted a prospective cohort study evaluating first void-urine urines, rectal, and oropharyngeal swabs collected from a cohort of patients in a tertiary hospital in Madrid between October 2022 and January 2023. Samples were screened by Allplex™ 7-STI Essential Assay (Seegene®). Drug resistances were performed by Allplex™ NG&DR Assay (Seegene®). Results. A total of 1,415 patients were included, of which 112 had a positive sample for NG infection. One patient had a C2611T mutation (0.9%) and neither patient showed A2059G mutation. We found 67 (59.8%) S91F-positive patients. Forty-four patients (39.3%) not had any mutations. Conclusions. We report a low-prevalence of mutations A2059G/C2611T to macrolides and a high-prevalence to S91F in NG infections. Molecular methods for the detection of NG resistance could be useful in direct non-culturable samples.

show abstract

Section: Discussionmentioning

confidence: 99%

Prevalence of mutations associated with macrolide and fluoroquinolone resistance in Neisseria gonorrhoeae with Allplex™ NG&DR Assay (Seegene®) in a tertiary hospital from Madrid, Spain

Maldonado-Barrueco,

Sanz-González,

Falces-Romero

et al. 2023

Rev Esp Quimioter

View full text Add to dashboard Cite

show abstract

“…Gc colonizes mucosal surfaces such as the urogenital tract, anal, ocular, and pharyngeal mucosa ( 2 – 5 ). In rare circumstances, Gc exits the genital tract and causes disseminated gonococcal infection which may lead to arthritis and endocarditis ( 6 ). Generating effective vaccines to prevent Gc is difficult, as the bacteria undergo extensive phase and antigenic variation, allowing for the creation of variant antigens to avoid immune recognition ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Development and implementation of a Type I-C CRISPR-based programmable repression system for Neisseria gonorrhoeae

Geslewitz,

Cardenas,

Zhou

et al. 2024

mBio

View full text Add to dashboard Cite

Clustered regularly interspaced short palindromic repeats (CRISPR) are prokaryotic adaptive immune systems regularly utilized as DNA-editing tools. While Neisseria gonorrhoeae does not have an endogenous CRISPR, the commensal species Neisseria lactamica encodes a functional Type I-C CRISPR-Cas system. We have established an isopropyl β-d-1-thiogalactopyranoside added (IPTG)-inducible, CRISPR interference (CRISPRi) platform based on the N. lactamica Type I-C CRISPR missing the Cas3 nuclease to allow locus-specific transcriptional repression. As proof of principle, we targeted a non-phase-variable version of the opaD gene. We show that CRISPRi can downregulate opaD gene and protein expression, resulting in bacterial inability to stimulate neutrophil oxidative responses and to bind to an N-terminal fragment of CEACAM1. Importantly, we used CRISPRi to effectively knockdown all the transcripts of all 11 opa genes using a five-spacer CRISPR array, allowing control of the entire phase-variable opa family in strain FA1090. We also report that repression is reversible following IPTG removal. Finally, we showed that the Type I-C CRISPRi system can conditionally reduce the expression of two essential genes. This CRISPRi system will allow the interrogation of every Gc gene, essential and non-essential, to study physiology and pathogenesis and aid in antimicrobial development. IMPORTANCE Clustered regularly interspaced short palindromic repeats (CRISPR)-Cas systems have proven instrumental in genetically manipulating many eukaryotic and prokaryotic organisms. Despite its usefulness, a CRISPR system had yet to be developed for use in Neisseria gonorrhoeae (Gc), a bacterium that is the main etiological agent of gonorrhea infection. Here, we developed a programmable and IPTG-inducible Type I-C CRISPR interference (CRISPRi) system derived from the commensal species Neisseria lactamica as a gene repression system in Gc. As opposed to generating genetic knockouts, the Type I-C CRISPRi system allows us to block transcription of specific genes without generating deletions in the DNA. We explored the properties of this system and found that a minimal spacer array is sufficient for gene repression while also facilitating efficient spacer reprogramming. Importantly, we also show that we can use CRISPRi to knockdown genes that are essential to Gc that cannot normally be knocked out under laboratory settings. Gc encodes ~800 essential genes, many of which have no predicted function. We predict that this Type I-C CRISPRi system can be used to help categorize gene functions and perhaps contribute to the development of novel therapeutics for gonorrhea.

show abstract

Increase in gonococcal arthritis in Madrid, Spain, 2022-2023

Maldonado-Barrueco,

Sanz-González,

Rico-Nieto

et al. 2024

Int J STD AIDS

View full text Add to dashboard Cite

In recent years, there has been an increase in Neisseria gonorrhoeae infections in Europe and Spain. Disseminated gonococcal infection is an uncommon clinical presentation that includes gonococcal arthritis. Improved antibiotic treatment has reduced the incidence of gonococcal arthritis. However, the increase in gonococcal infections may have increased the frequency of this clinical entity in recent times. We report five cases of gonococcal arthritis in patients in a tertiary-care hospital in the northern area of Madrid (Spain) from October 2022 to October 2023. Major cases occurred in male patients with unprotected sex and polyarticular symptoms requiring hospital admission and treatment with ceftriaxone and cefixime. The use of molecular techniques has allowed the detection of a greater number of culture-negative cases of gonococcal arthritis, as well as the detection of mutations associated with resistance to fluoroquinolone for switching to oral treatment.

show abstract

Right hip gonococcal septic arthritis treatment with successful transition to oral fluoroquinolone

Cited by 3 publications

References 11 publications

Prevalence of mutations associated with macrolide and fluoroquinolone resistance in Neisseria gonorrhoeae with Allplex™ NG&DR Assay (Seegene®) in a tertiary hospital from Madrid, Spain

Prevalence of mutations associated with macrolide and fluoroquinolone resistance in Neisseria gonorrhoeae with Allplex™ NG&DR Assay (Seegene®) in a tertiary hospital from Madrid, Spain

Development and implementation of a Type I-C CRISPR-based programmable repression system for Neisseria gonorrhoeae

Increase in gonococcal arthritis in Madrid, Spain, 2022-2023

Contact Info

Product

Resources

About