Stefanelli Paola, Carannante Anna, Bonanno Carmen Luciana, Cusini Marco, Ghisetti Valeria, Mencacci Antonella, Barbui Anna Maria, Prignano Grazia, Vocale Caterina, Vacca Paola
1 Department of Infectious Diseases, Istituto Superiore di Sanità , Rome, Italy .
2 Laboratory of Microbiology and Virology, Sandro Pertini Hospital , Rome, Italy .
Microb Drug Resist. 2018 Jun;24(5):621-626. doi: 10.1089/mdr.2017.0218. Epub 2018 Jan 2.
The emergence of antibiotic resistant strains poses a great concern for gonorrhea treatment. The aim of this study was to characterize penicillinase-producing Neisseria gonorrhoeae (PPNG) isolates collected in Italy in two time frames, 2003-2004 and 2014-2015. A total of 80 PPNG were characterized for the bla gene variant and the plasmid type. Furthermore, gonococci were typed using Neisseria gonorrhoeae multiantigen sequence typing. Antibiotic susceptibility assay was performed for penicillin, ciprofloxacin, ceftriaxone, and spectinomycin by Etest and minimum inhibitory concentration (MIC) test strip methods. The β-lactamase production was detected using nitrocefin test. Among PPNG isolates, four bla alleles were identified as follows: bla, bla, blaP14S, and bla. The African plasmid possessed the bla, bla, and blaP14S, whereas bla was identified in Toronto/Rio and Asian plasmids. The percentage of isolates with the bla-carrying African plasmid increased from 42.5% in 2003-2004 to 55% in 2014-2015; conversely, the isolates with bla-carrying Toronto/Rio plasmid decreased from 57.5% to 35%. Among the isolates carrying the Toronto/Rio plasmids possessing bla, sequence type (ST)661 and ST5624 were found to be the predominant STs in both periods 2003-2004 and 2014-2015, respectively. More than half of the PPNG isolates were resistant to ciprofloxacin. Increase in the isolates carrying the African plasmid possessing bla and a parallel decrease of the bla-carrying Toronto/Rio plasmid was observed. Moreover, PPNG isolate harbored Toronto/Rio plasmid with bla belonged mainly to two major STs (ST661 and ST5624). Given the possible role of a mutated bla gene as an additional mechanism to extended spectrum β-lactamase resistance, it is crucial to monitor gonococci carrying these resistance genes.
抗生素耐药菌株的出现给淋病治疗带来了极大的担忧。本研究的目的是对2003 - 2004年和2014 - 2015年这两个时间段在意大利收集的产青霉素酶淋病奈瑟菌（PPNG）分离株进行特征分析。总共对80株PPNG进行了bla基因变异和质粒类型的特征分析。此外，使用淋病奈瑟菌多抗原序列分型对淋球菌进行分型。通过Etest和最低抑菌浓度（MIC）试纸条法对青霉素、环丙沙星、头孢曲松和壮观霉素进行抗生素敏感性测定。使用硝基头孢菌素试验检测β-内酰胺酶的产生。在PPNG分离株中，鉴定出四个bla等位基因，分别为：bla、bla、blaP14S和bla。非洲质粒携带bla、bla和blaP14S，而bla在多伦多/里约热内卢和亚洲质粒中被鉴定出来。携带bla的非洲质粒的分离株百分比从2003 - 2004年的42.5%增加到2014 - 2015年的55%；相反，携带bla的多伦多/里约热内卢质粒的分离株从57.5%下降到35%。在携带具有bla的多伦多/里约热内卢质粒的分离株中，序列类型（ST）661和ST5624分别被发现是2003 - 2004年和2014 - 2015年这两个时期的主要STs。超过一半的PPNG分离株对环丙沙星耐药。观察到携带具有bla的非洲质粒的分离株增加，而携带bla的多伦多/里约热内卢质粒则平行减少。此外，携带具有bla的多伦多/里约热内卢质粒的PPNG分离株主要属于两个主要的STs（ST661和ST5624）。鉴于突变的bla基因作为超广谱β-内酰胺酶耐药的额外机制的可能作用，监测携带这些耐药基因的淋球菌至关重要。
