Sexually Transmitted Bacteria Reference Laboratory, Health Protection Agency, Colindale, London, United Kingdom.
Euro Surveill. 2013 Jan 17;18(3):20358.
Treatment of gonorrhoea is threatened by antimicrobial resistance, and decreased susceptibility and resistance to recommended therapies is emerging in Europe. Current associations between resistance and molecular type remain poorly understood. Gonococcal isolates (n=1,066) collected for the 2009 and 2010 European Gonococcal Antimicrobial Surveillance Programme were typed by Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST). A total of 406 sequence types (STs) were identified, 125 of which occurred in ≥two isolates. Seven major genogroups of closely related STs (varying by ≤1% at just one of the two target loci) were defined. Genogroup 1407 (G1407), observed in 20/21 countries and predominant in 13/21 countries, accounted for 23% of all isolates and was associated with decreased susceptibility to cefixime and resistance to ciprofloxacin and raised minimum inhibitory concentrations for ceftriaxone and azithromycin. Genogroup 225 (G225), associated with ciprofloxacin resistance, was observed in 10% of isolates from 19/21 countries. None of the other genogroups were associated with antimicrobial resistance. The predominance of a multidrug-resistant clone (G1407) in Europe is worrying given the recent reports of recommended third generation cephalosporins failing to treat infections with this clone. Identifying associations between ST and antimicrobial resistance aids the understanding of the dissemination of resistant clones within a population and could facilitate development of targeted intervention strategies.
淋病的治疗受到抗菌药物耐药性的威胁，在欧洲，推荐疗法的敏感性降低和耐药性正在出现。目前，耐药性与分子型之间的关联仍知之甚少。为了 2009 年和 2010 年欧洲淋球菌抗菌药物监测计划，收集了淋病奈瑟菌分离株（n=1066），并通过淋病奈瑟菌多抗原序列分型（NG-MAST）进行了分型。共鉴定出 406 个序列型（ST），其中 125 个在≥2 个分离株中出现。定义了 7 个密切相关 ST 的主要基因群（在仅两个靶标位点中的一个位点仅相差 1%）。在 21 个国家中的 20 个国家中观察到的基因群 1407（G1407），在 13 个国家中占主导地位，占所有分离株的 23%，与头孢克肟的敏感性降低以及对环丙沙星的耐药性和头孢曲松和阿奇霉素的最低抑菌浓度升高有关。与环丙沙星耐药性相关的基因群 225（G225）在来自 21 个国家的 10%的分离株中观察到。其他基因群均与抗菌药物耐药性无关。鉴于最近有报道称，推荐的第三代头孢菌素未能治疗该克隆引起的感染，因此欧洲这种多药耐药克隆（G1407）的流行令人担忧。确定 ST 与抗菌药物耐药性之间的关联有助于了解耐药克隆在人群中的传播情况，并有助于制定有针对性的干预策略。
