Emergence and evolution of internationally disseminated cephalosporin-resistant Neisseria gonorrhoeae clones from 1995 to 2005 in Japan.
Emergence and evolution of internationally disseminated cephalosporin-resistant Neisseria gonorrhoeae clones from 1995 to 2005 in Japan.
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DOI：
10.1186/s12879-015-1110-x
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发表时间：
2015-09-17
影响因子：
3.7
通讯作者：
Ohnishi M
中科院分区：
文献类型：
--
作者：
Shimuta K;Watanabe Y;Nakayama S;Morita-Ishihara T;Kuroki T;Unemo M;Ohnishi M
对超广谱头孢菌素（ESC）耐药的淋病奈瑟菌菌株，淋病一线单药治疗的最后选择，可能出现并最初在日本传播，随后在国际传播。近年来，多位点序列分型（MLST）ST 1901和N.淋病多抗原序列分型（NG-MAST）ST 1407分离株与镶嵌青霉素结合蛋白（PBP）2XXXIV已占全球大多数ESC耐药。我们的目的是通过对N.日本神奈川1995年至2005年的淋病分离株。N.采用琼脂稀释法（头孢克肟、头孢曲松和环丙沙星）、佩纳基因测序、MLST和NG-MAST对690株淋病分离株进行表型和遗传学检查。早在1995年，就发现了一株头孢肟耐药（CFM-R）分离株，这是全球描述的第一株CFM-R分离株。1996年以后，CFM-R和CFM-DS的流行率显著增加，2002年达到高峰（57. 1% CFM-R）。1997-2002年，在CFM-R/DS分离物中，以PBP 2 X嵌合型的CFM-R MLST ST ST 7363型为主。第一个CFM-R/DS MLST ST ST 1901克隆（已在2003-2005年成为主要CFM-R/DS菌株类型）具有嵌合体PBP 2 X，其可能最初从MLST ST ST 7363菌株转移，随后获得嵌合体PBP 2 XXXIV。2003年，在神奈川已鉴别出首个MLST ST ST 1901和NG-MAST ST ST 1407分离株。两种主要的国际传播的头孢噻肟耐药淋球菌克隆MLST ST ST 7363和ST 1901（NG-MAST ST ST 1407在国际上最常见）也显示出其发展高水平头孢曲松耐药（超级细菌H 041和F89）的能力，可能出现、进化并开始在大都市地区传播，包括日本的神奈川，随后是全球传播。
Neisseria gonorrhoeae strains with resistance to extended-spectrum cephalosporins (ESCs), last options for first-line monotherapy of gonorrhoea, likely emerged and initially disseminated in Japan, followed by international transmission. In recent years, multi-locus sequence typing (MLST) ST1901 and N. gonorrhoeae multiantigen sequence typing (NG-MAST) ST1407 isolates with the mosaic penicillin-binding protein (PBP) 2 XXXIV have accounted for most ESC resistance globally. Our aim was to elucidate the initial emergence and transmission of ESC-resistant strains by detailed examination of N. gonorrhoeae isolates from 1995 to 2005 in Kanagawa, Japan. N. gonorrhoeae isolates were examined phenotypically (n = 690) and genetically (n = 372) by agar dilution method (cefixime, ceftriaxone and ciprofloxacin), penA gene sequencing, MLST and NG-MAST. Already in 1995, one cefixime-resistant (CFM-R) isolate was found, which is the first CFM-R isolate described globally. After 1996, the prevalence of CFM-R and CFM-decreased susceptibility (CFM-DS) isolates significantly increased, with the peak resistance level in 2002 (57.1 % CFM-R). In 1997–2002, the CFM-R MLST ST7363 strain type with the mosaic PBP 2 X was predominant among CFM-R/DS isolates. The first CFM-R/DS MLST ST1901 clone(s), which became the predominant CFM-R/DS strain type(s) already in 2003–2005, possessed the mosaic PBP 2 X, which was possibly originally transferred from the MLST ST7363 strains, and subsequently acquired the mosaic PBP 2 XXXIV. The first MLST ST1901 and NG-MAST ST1407 isolate was identified in Kanagawa already in 2003. The two main internationally spread cefixime-resistant gonococcal clones, MLST ST7363 and ST1901 (NG-MAST ST1407 most frequent internationally) that also have shown their capacity to develop high-level ceftriaxone resistance (superbugs H041 and F89), likely emerged, evolved and started to disseminate in the metropolitan area, including Kanagawa, in Japan, which was followed by global transmission.