Molecular epidemiological typing of Neisseria gonorrhoeae isolates identifies a novel association between genogroup G10557 (G7072) and decreased susceptibility to cefixime, Germany, 2014 to 2017.
Molecular epidemiological typing of Neisseria gonorrhoeae isolates identifies a novel association between genogroup G10557 (G7072) and decreased susceptibility to cefixime, Germany, 2014 to 2017.
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DOI：
10.2807/1560-7917.es.2020.25.41.1900648
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发表时间：
2020-10
期刊：
影响因子：
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通讯作者：
GORENET study group
中科院分区：
文献类型：
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作者：
Banhart S;Jansen K;Buder S;Tamminga T;Calvignac-Spencer S;Pilz T;Martini A;Dudareva S;Nikisins S;Dehmel K;Zuelsdorf G;Guhl E;Graeber I;Kohl PK;Unemo M;Bremer V;Heuer D;GORENET study group
新出现的抗菌素耐药性(AMR)对淋病治疗提出了挑战，需要进行监测。这项观察性研究描述了2014-2017年间德国淋病奈瑟菌分离株的遗传多样性，并确定了与AMR或一些患者人口统计学相关的淋球菌多抗原序列分型(NG-MAST)基因组。对1220株淋球菌进行了AMR和NG-MAST检测。对患者的AMR或性别/年龄与基因组间的相关性进行统计学评估。患者的中位年龄为32 岁(四分位数范围： 25-44)；1,078株分离株(88.4%)来自男性。共鉴定出432个NG-MAST序列类型，其中包括156个新序列类型，17个主要基因组组占所有分离株的59.1%(721/1220)。G1407和G10557(G7072)基因群与头孢克肟敏感性降低显著相关(Kruskal-Wallis卡方： 549.3442，DF： 16，p <； 0.001)。在研究期间，其患病率分别从14.2%(15/106)和6.6%(7/106)下降到6.2%(30/481)和3.1%(15/481)。与此同时，几个头孢克辛敏感基因群的患病率似乎有所上升。男性分离株的比例在不同的基因组中有所不同(费舍尔精确检验，p <； 0.001)，例如，G25(G51)和G387的比例较低，而G5441和G2992的比例较高。在受影响患者的中位年龄方面，一些基因组彼此不同(Kruskal-Wallis X平方： 47.5358，DF： 16，p <； 0.001)，例如，G25(G51)和G387在≤ 30 年龄组中更常见，G359和G17420在≥ 40 年龄组中更常见。通过分子分型进行AMR监测很重要。2014年在德国推荐的双重疗法(头孢曲松加阿奇霉素)，或者只使用这种疗法的头孢曲松剂量，可能是导致头孢克辛耐药基因群减少的原因。
Emerging antimicrobial resistance (AMR) challenges gonorrhoea treatment and requires surveillance. This observational study describes the genetic diversity of Neisseria gonorrhoeae isolates in Germany from 2014 to 2017 and identifies N. gonorrhoeae multi-antigen sequence typing (NG-MAST) genogroups associated with AMR or some patient demographics. 1,220 gonococcal isolates underwent AMR testing and NG-MAST. Associations between genogroups and AMR or sex/age of patients were statistically assessed. Patients’ median age was 32 years (interquartile range: 25–44); 1,078 isolates (88.4%) originated from men. In total, 432 NG-MAST sequence types including 156 novel ones were identified, resulting in 17 major genogroups covering 59.1% (721/1,220) of all isolates. Genogroups G1407 and G10557 (G7072) were significantly associated with decreased susceptibility to cefixime (Kruskal–Wallis chi-squared: 549.3442, df: 16, p < 0.001). Their prevalences appeared to decline during the study period from 14.2% (15/106) to 6.2% (30/481) and from 6.6% (7/106) to 3.1% (15/481) respectively. Meanwhile, several cefixime susceptible genogroups’ prevalence seemed to increase. Proportions of isolates from men differed among genogroups (Fisher’s exact test, p < 0.001), being e.g. lower for G25 (G51) and G387, and higher for G5441 and G2992. Some genogroups differed relative to each other in affected patients’ median age (Kruskal–Wallis chi-squared: 47.5358, df: 16, p < 0.001), with e.g. G25 (G51) and G387 more frequent among ≤ 30 year olds and G359 and G17420 among ≥ 40 year olds. AMR monitoring with molecular typing is important. Dual therapy (ceftriaxone plus azithromycin) recommended in 2014 in Germany, or only the ceftriaxone dose of this therapy, might have contributed to cefixime-resistant genogroups decreasing.