Two mutations associated with macrolide resistance in Treponema pallidum: increasing prevalence and correlation with molecular strain type in Seattle, Washington.
Two mutations associated with macrolide resistance in Treponema pallidum: increasing prevalence and correlation with molecular strain type in Seattle, Washington.
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DOI：
10.1097/olq.0b013e31826ae7a8
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发表时间：
2012-12
影响因子：
3.1
通讯作者：
Lukehart SA
中科院分区：
文献类型：
--
作者：
Grimes M;Sahi SK;Godornes BC;Tantalo LC;Roberts N;Bostick D;Marra CM;Lukehart SA
虽然阿奇霉素有望成为一种安全有效的单剂量口服治疗早期梅毒，阿奇霉素治疗失败已被记录，并与相应的梅毒螺旋体菌株的23 S rDNA突变。携带这些突变的菌株的流行率在美国和世界各地各不相同。我们检查了T。2001-2010年在华盛顿西雅图流行的梅毒螺旋体菌株，以确定与大环内酯类耐药相关的两种突变的患病率，并确定这些突变是否与某些T.苍白球菌株类型。受试者入组了一项正在进行的梅毒患者脑脊液（CSF）异常的单独研究。T.从血液和T.分析从血液或CSF分离的苍白球菌株的两个23 S rDNA突变和用于增强的分子染色分型系统的分子靶标。9种分子菌株类型的T. 2001-2010年在西雅图发现了苍白球。在西雅图菌株中发现了两种大环内酯类耐药突变，耐药T. 2005年，苍白球超过80%，并在2010年继续上升。耐药突变与分离的分子菌株类型有关。苍白球大环内酯抗性T.苍白球菌株在西雅图高度流行，并且每个突变与离散的菌株类型相关。大环内酯类药物不应被考虑用于治疗梅毒的地区，流行的突变是高。将耐药突变与分子菌株分型相结合，可以对社区梅毒流行病学进行更精细的分析。
Although azithromycin promised to be a safe and effective single dose oral treatment for early syphilis, azithromycin treatment failure has been documented and is associated with mutations in the 23S rDNA of corresponding Treponema pallidum strains. The prevalence of strains harboring these mutations varies throughout the US and the world. We examined T. pallidum strains circulating in Seattle, Washington, from 2001–2010 to determine the prevalence of two mutations associated with macrolide resistance, and to determine whether these mutations were associated with certain T. pallidum strain types. Subjects were enrolled in a separate ongoing study of cerebrospinal fluid (CSF) abnormalities in patients with syphilis. T. pallidum DNA purified from blood and T. pallidum strains isolated from blood or CSF were analyzed for two 23S rDNA mutations and for the molecular targets used in an enhanced molecular stain typing system. Nine molecular strain types of T. pallidum were identified in Seattle from 2001–2010. Both macrolide resistance mutations were identified in Seattle strains, and the prevalence of resistant T. pallidum exceeded 80% in 2005 and increased through 2010. Resistance mutations were associated with discrete molecular strain types of T. pallidum. Macrolide resistant T. pallidum strains are highly prevalent in Seattle, and each mutation is associated with discrete strain types. Macrolides should not be considered for treatment of syphilis in regions where prevalence of the mutations is high. Combining the resistance mutations with molecular strain typing permits a finer analysis of the epidemiology of syphilis in a community.