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- Title
First nationwide study regarding ceftriaxone resistance and molecular epidemiology of Neisseria gonorrhoeae in China.
- Authors
Shao-Chun Chen; Yue-Ping Yin; Xiu-Qin Dai; Magnus Unemo; Xiang-Sheng Chen; Chen, Shao-Chun; Yin, Yue-Ping; Dai, Xiu-Qin; Unemo, Magnus; Chen, Xiang-Sheng
- Abstract
<bold>Objectives: </bold>Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a major public health concern worldwide. This is the first nationwide study, performed within the China Gonococcal Antimicrobial Susceptibility Programme (China-GASP), regarding AMR, including ceftriaxone genetic resistance determinants, and molecular epidemiology of gonococci in China.<bold>Methods: </bold>Gonococcal isolates (n = 1257) from consecutive patients were collected at 11 sentinel sites distributed across China during 2012-13. Susceptibility to ceftriaxone, spectinomycin, ciprofloxacin and tetracycline was determined using the agar dilution method. Ceftriaxone resistance determinants penA and penB were examined using sequencing. N. gonorrhoeae multiantigen sequence typing (NG-MAST) was performed for molecular epidemiology.<bold>Results: </bold>Among isolates, 0.2% were resistant to spectinomycin, 4.4% to ceftriaxone, 42.9% to tetracyclines (high-level resistance) and 99.8% to ciprofloxacin. Among 890 sequenced isolates, 16 (1.8%) possessed a penA mosaic allele; 4 of these isolates belonged to the MDR internationally spread NG-MAST genogroup G1407 (first description in China). Non-mosaic penA alleles with an A501T mutation and an A102D alteration in porB1b were statistically associated with decreased susceptibility/resistance to ceftriaxone. NG-MAST G10339, G1424 and G1053 were associated with decreased susceptibility/resistance to ceftriaxone.<bold>Conclusions: </bold>In China, ceftriaxone and spectinomycin can continue to be recommended for gonorrhoea treatment, with the possible exception of Hainan and Sichuan provinces where ceftriaxone resistance exceeded 5% and AMR surveillance needs to be strengthened. Molecular approaches including genotyping and AMR determinant analysis can be valuable to supplement and enhance conventional surveillance of gonococcal AMR in China.
- Subjects
CHINA; CEFTRIAXONE; MOLECULAR epidemiology; NEISSERIA gonorrhoeae; DRUG resistance in bacteria; TETRACYCLINES; GENOTYPES; CIPROFLOXACIN; ANTIBIOTICS; DNA; DRUG resistance in microorganisms; GENES; GONORRHEA; MICROBIAL sensitivity tests; NEISSERIA; SEQUENCE analysis; PHARMACODYNAMICS
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2016, Vol 71, Issue 1, p92
- ISSN
0305-7453
- Publication type
journal article
- DOI
10.1093/jac/dkv321