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Molecular epidemiological typing of Neisseria gonorrhoeae isolates identifies a novel association between genogroup G10557 (G7072) and decreased susceptibility to cefixime, Germany, 2014 to 2017

BACKGROUND: Emerging antimicrobial resistance (AMR) challenges gonorrhoea treatment and requires surveillance. AIM: 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-...

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Detalles Bibliográficos
Autores principales: Banhart, Sebastian, Jansen, Klaus, Buder, Susanne, Tamminga, Thalea, Calvignac-Spencer, Sébastien, Pilz, Tanja, Martini, Andrea, Dudareva, Sandra, Nikisins, Sergejs, Dehmel, Kerstin, Zuelsdorf, Gabriele, Guhl, Eva, Graeber, Ingeborg, Kohl, Peter K, Unemo, Magnus, Bremer, Viviane, Heuer, Dagmar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Centre for Disease Prevention and Control (ECDC) 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7565851/
https://www.ncbi.nlm.nih.gov/pubmed/33063655
http://dx.doi.org/10.2807/1560-7917.ES.2020.25.41.1900648
Descripción
Sumario:BACKGROUND: Emerging antimicrobial resistance (AMR) challenges gonorrhoea treatment and requires surveillance. AIM: 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. METHODS: 1,220 gonococcal isolates underwent AMR testing and NG-MAST. Associations between genogroups and AMR or sex/age of patients were statistically assessed. RESULTS: 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. CONCLUSION: 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.