Molecular characterization of two high-level ceftriaxone-resistant Neisseria gonorrhoeae isolates detected in Catalonia, Spain
Molecular characterization of two high-level ceftriaxone-resistant Neisseria gonorrhoeae isolates detected in Catalonia, Spain
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DOI：
10.1093/jac/dks162
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发表时间：
2012-08-01
影响因子：
5.2
通讯作者：
Ardanuy, Carmen
中科院分区：
文献类型：
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作者：
Camara, Jordi;Serra, Judit;Ardanuy, Carmen
本研究的目的是分析前两株耐头孢菌素和多药耐药(MDR)淋病奈瑟菌的临床特征。聚合酶链式反应扩增涉及喹诺酮类、头孢曲松和多药耐药相关基因，并进行双向测序。两株淋球菌的多药耐药谱相同，对青霉素(MIC0.094 mg/L；-内酰胺酶阴性)、头孢曲松(MIC1.5 mg/L)、头孢克肟(MIC1.5 mg/L)、头孢克新(MIC1 mg/L)、环丙沙星(MIC32 mg/L)和四环素(MIC1.5 mg/L)耐药。NG-MAST分析表明，两株分离株均属于1407序列类型(porB-908和tbpB-110)。环丙沙星耐药是由于GyrA(S91F和D95G)和ParC(S87R)的氨基酸替换所致。检测到MtrCDE外排泵(MTRR)启动子A缺失。PilQ基因未检测到任何变化。外膜蛋白PorB在G120K和A121N有两处替换。在PBP1A(PONA)序列中观察到L421P替换。PBP2(Pena)的序列显示出与XXXIV基因型相关的嵌合体结构，并带有一个额外的氨基酸替换(A501P)。该基因与最近描述的法国分离株(F89)相同。这是报道的第一例高水平耐超广谱头孢菌素淋病奈瑟菌传播病例。分子分型和耐多药基因提示这种菌株可能在欧洲传播，这突显了监测的必要性和测试淋球菌对超广谱头孢菌素的敏感性的重要性。
The aim of this study was to characterize the first two extended-spectrum cephalosporin-resistant and multidrug-resistant (MDR) Neisseria gonorrhoeae isolates collected from two sexually related patients (men who have sex with men) in Spain.Antimicrobial susceptibility was studied by Etest. Genes involved in quinolone, ceftriaxone and multidrug resistance were amplified by PCR and sequenced in both directions. The isolates were typed by N. gonorrhoeae multi-antigen sequence typing (NG-MAST).The two isolates had the same MDR profile, showing resistance to penicillin (MIC 0.094 mg/L; -lactamase negative), ceftriaxone (MIC 1.5 mg/L), cefixime (MIC 1.5 mg/L), cefotaxime (MIC 1 mg/L), ciprofloxacin (MIC 32 mg/L) and tetracycline (MIC 1.5 mg/L). NG-MAST showed that both isolates belonged to sequence type (ST) 1407 (porB-908 and tbpB-110). Ciprofloxacin resistance was due to amino acid substitutions in GyrA (S91F and D95G) and ParC (S87R). An A deletion in the promoter of the MtrCDE efflux pump (mtrR) was detected. No changes were detected in the pilQ gene. The outer membrane protein PorB showed two substitutions at G120K and A121N. An L421P substitution was observed in the PBP1A (ponA) sequence. The sequence of PBP2 (penA) showed a mosaic structure related to genotype XXXIV with a single additional amino acid substitution (A501P). This genotype was identical to a recently described French isolate (F89).This is the first reported case of high-level extended-spectrum cephalosporin-resistant N. gonorrhoeae transmission. The molecular typing and MDR genotype suggest possible European spread of this strain, highlighting the need for surveillance and the importance of testing the susceptibility of N. gonorrhoeae to extended-spectrum cephalosporins.