Increasing Resistance to Azithromycin in Neisseria gonorrhoeae in Eastern Chinese Cities: Resistance Mechanisms and Genetic Diversity among Isolates from Nanjing.
Increasing Resistance to Azithromycin in Neisseria gonorrhoeae in Eastern Chinese Cities: Resistance Mechanisms and Genetic Diversity among Isolates from Nanjing.
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DOI：
10.1128/aac.02499-17
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发表时间：
2018-05
影响因子：
4.9
通讯作者：
Su XH
中科院分区：
文献类型：
--
作者：
Wan C;Li Y;Le WJ;Liu YR;Li S;Wang BX;Rice PA;Su XH
淋病奈瑟菌的阿奇霉素耐药性（AZM-R）正在成为临床和公共卫生的挑战。我们确定了最近AZM-R南京淋球菌分离株的分子特征，并跟踪了近年来中国东部城市AZM-R分离株的出现。共384个。检测了2013年至2014年从南京收集的淋病分离株对AZM和其他6种抗生素的敏感性;通过测序对所有AZM-R菌株的耐药决定簇进行遗传特征分析，并使用N.淋病多抗原序列分型（NG-MAST）。384株中AZM-R型124株，占32.3%。10.4%（40/384）的菌株具有高水平的耐药性（MIC ≥256 mg/L），所有菌株的4个23 S rRNA等位基因均存在A2143 G突变。21.9%（84/384）的菌株存在低至中等水平的耐药性（MIC，1至64 mg/L），其中59.5%的菌株在所有4个23 S rRNA等位基因中具有C2599 T突变。124株AZM-R菌株分布在71个不同的NG-MAST序列类型（ST）中。ST 1866是高水平AZM-R（HL-AZM-R）分离株中最常见的类型（45% [18/40]）。本研究结合以往的研究结果，揭示了AZM-R在N。从2008年到2014年，中国东部某些城市的淋病分离株增加了4倍以上（7%到32%）。南京地区近年来AZM耐药的主要机制是23 SrRNA等位基因的A2143 G突变（高水平耐药）和C2599 T突变（低至中等水平耐药）。NG-MAST序列特征和系统发育分析表明，N.结果表明，南京地区淋球菌中以ST 1866基因型为主，而HL-AZM-R菌株中以ST 1866基因型为主。
Azithromycin resistance (AZM-R) of Neisseria gonorrhoeae is emerging as a clinical and public health challenge. We determined molecular characteristics of recent AZM-R Nanjing gonococcal isolates and tracked the emergence of AZM-R isolates in eastern Chinese cities in recent years. A total of 384 N. gonorrhoeae isolates from Nanjing collected from 2013 to 2014 were tested for susceptibility to AZM and six additional antibiotics; all AZM-R strains were characterized genetically for resistance determinants by sequencing and were genotyped using N. gonorrhoeae multiantigen sequence typing (NG-MAST). Among the 384 isolates, 124 (32.3%) were AZM-R. High-level resistance (MIC, ≥256 mg/liter) was present in 10.4% (40/384) of isolates, all of which possessed the A2143G mutation in all four 23S rRNA alleles. Low- to mid-level resistance (MIC, 1 to 64 mg/liter) was present in 21.9% (84/384) of isolates, 59.5% of which possessed the C2599T mutation in all four 23S rRNA alleles. The 124 AZM-R isolates were distributed in 71 different NG-MAST sequence types (STs). ST1866 was the most prevalent type in high-level AZM-R (HL-AZM-R) isolates (45% [18/40]). This study, together with previous reports, revealed that the prevalence of AZM-R in N. gonorrhoeae isolates in certain eastern Chinese cities has risen >4-fold (7% to 32%) from 2008 to 2014. The principal mechanisms of AZM resistance in recent Nanjing isolates were A2143G mutations (high-level resistance) and C2599T mutations (low- to mid-level resistance) in the 23S rRNA alleles. Characterization of NG-MAST STs and phylogenetic analysis indicated the genetic diversity of N. gonorrhoeae in Nanjing; however, ST1866 was the dominant genotype associated with HL-AZM-R isolates.