Enhanced Molecular Typing of Treponema pallidum subspecies pallidum Strains From 4 Italian Hospitals Shows Geographical Differences in Strain Type Heterogeneity, Widespread Resistance to Macrolides, and Lack of Mutations Associated With Doxycycline Resistance.
Enhanced Molecular Typing of Treponema pallidum subspecies pallidum Strains From 4 Italian Hospitals Shows Geographical Differences in Strain Type Heterogeneity, Widespread Resistance to Macrolides, and Lack of Mutations Associated With Doxycycline Resistance.
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DOI：
10.1097/olq.0000000000000741
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发表时间：
2018-04
影响因子：
3.1
通讯作者：
Drago F
中科院分区：
文献类型：
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作者：
Giacani L;Ciccarese G;Puga-Salazar C;Dal Conte I;Colli L;Cusini M;Ramoni S;Delmonte S;DʼAntuono A;Gaspari V;Drago F
虽然梅毒发病率相对较高，在意大利超过15年，没有数据的分子类型的梅毒螺旋体亚种。苍白球（T. pallidum）在这个国家流通的。同样，没有数据表明这些菌株对大环内酯类或四环素类抗生素的耐药性有多普遍。然而，这些数据将促进对意大利梅毒感染分子流行病学的全面研究，并为意大利和其他欧洲国家未来的梅毒控制干预措施提供信息。从米兰、都灵、热那亚和博洛尼亚的60名皮肤科诊所就诊的梅毒患者中获得口腔、生殖器、皮肤或肛门病变的拭子。T.进行苍白球DNA的检测以提供北方意大利流行的菌株的遗传多样性的快照。还对样品进行了突变筛查，这些突变赋予了对大环内酯类和四环素类的耐药性。T.苍白球DNA阳性率为88.3%（53/60）。完全和部分T.苍白球分型率分别为77.3%（41/53）和15.0%（8/53），而4例标本尽管存在T.检测到苍白球DNA最高的菌株类型异质性出现在博洛尼亚和米兰的样本中，其次是热那亚。尽管在都灵收集的可分类样本数量最多，但在那里的样本中检测到的多样性最小。94.3%（50/53）的菌株对大环内酯类抗生素耐药，未发现与四环素耐药相关的突变。在北方意大利流行的苍白球菌株在地理区域之间显著不同，而与物理距离无关。对大环内酯类药物的耐药性很普遍。
Although syphilis rates have been relatively high in Italy for over 15 years, no data on the molecular types of Treponema pallidum subsp. pallidum (T. pallidum) circulating in this country are yet available. Likewise, no data exist on how widespread is resistance to macrolide or tetracycline antibiotics in these strains. Such data would however promote comprehensive studies on the molecular epidemiology of syphilis infections in Italy and inform future interventions aiming at syphilis control in this and other European countries. Swabs from oral, genital, cutaneous, or anal lesions were obtained from 60 syphilis patients attending dermatology clinics in Milan, Turin, Genoa, and Bologna. Molecular typing of T. pallidum DNA was performed to provide a snapshot of the genetic diversity of strains circulating in Northern Italy. Samples were also screened for mutations conferring resistance to macrolides and tetracyclines. T. pallidum DNA was detected in 88.3% of the specimens (53/60) analyzed. Complete and partial T. pallidum typing data were obtained for 77.3% (41/53) and 15.0% (8/53) of samples, respectively, while four samples could not be typed despite T. pallidum DNA being detected. The highest strain type heterogeneity was seen in samples from Bologna and Milan, followed by Genoa. Minimal diversity was detected in samples from Turin, in spite of the highest number of typeable samples collected there. Resistance to macrolides was detected in 94.3% (50/53) of the strains, but no known mutations associated with tetracycline resistance were found. Genetic diversity among T. pallidum strains circulating in Northern Italy varies significantly among geographical areas regardless of physical distance. Resistance to macrolides is widespread.