增强梅毒螺旋体亚种苍白亚种菌株的分子分型显示来自 4 家意大利医院的菌株在菌株类型异质性、大环内酯类广泛耐药以及缺乏与强力霉素耐药相关的突变方面存在地理差异。
Enhanced Molecular Typing of Treponema pallidum subspecies pallidum Strains From 4 Italian Hospitals Shows Geographical Differences in Strain Type Heterogeneity, Widespread Resistance to Macrolides, and Lack of Mutations Associated With Doxycycline Resistance.
出版信息
Sex Transm Dis. 2018 Apr;45(4):237-242. doi: 10.1097/OLQ.0000000000000741.
BACKGROUND
Although syphilis rates have been relatively high in Italy for more than 15 years, no data on the molecular types of Treponema pallidum subspecies pallidum circulating in this country are yet available. Likewise, no data on how widespread is resistance to macrolide or tetracycline antibiotics in these strains exist. Such data would, however, promote comprehensive studies on the molecular epidemiology of syphilis infections in Italy and inform future interventions aiming at syphilis control in this and other European countries.
GOALS AND STUDY DESIGN
Swabs from oral, genital, cutaneous, or anal lesions were obtained from 60 syphilis patients attending dermatology clinics in Milan, Turin, Genoa, and Bologna. Molecular typing of T. pallidum DNA was performed to provide a snapshot of the genetic diversity of strains circulating in Northern Italy. Samples were also screened for mutations conferring resistance to macrolides and tetracyclines.
RESULTS
T. pallidum DNA was detected in 88.3% (53/60) of the specimens analyzed. Complete and partial T. pallidum typing data were obtained for 77.3% (41/53) and 15.0% (8/53) of samples, respectively, whereas 4 samples could not be typed despite T. pallidum DNA being detected. The highest strain type heterogeneity was seen in samples from Bologna and Milan, followed by Genoa. Minimal diversity was detected in samples from Turin, despite the highest number of typeable samples collected there. Resistance to macrolides was detected in 94.3% (50/53) of the strains, but no known mutations associated with tetracycline resistance were found.
CONCLUSIONS
Genetic diversity among T. pallidum strains circulating in Northern Italy varies significantly among geographical areas regardless of physical distance. Resistance to macrolides is widespread.
背景
尽管梅毒在意大利已经流行了 15 年以上，但目前尚无关于该国流行的苍白密螺旋体亚种苍白密螺旋体的分子类型的数据。同样，这些菌株对大环内酯类或四环素类抗生素的耐药性有多广泛也没有数据。然而，这些数据将促进对意大利梅毒感染分子流行病学的综合研究，并为未来在意大利和其他欧洲国家控制梅毒提供信息。
目的和研究设计
从米兰、都灵、热那亚和博洛尼亚皮肤科诊所的 60 例梅毒患者的口腔、生殖器、皮肤或肛门病变中采集拭子。对苍白密螺旋体 DNA 进行分子分型，以提供意大利北部流行菌株遗传多样性的快照。还对样本进行了筛选，以检测是否存在对抗生素大环内酯类和四环素类产生耐药性的突变。
结果
在分析的 60 份标本中，88.3%（53/60）检测到苍白密螺旋体 DNA。分别获得了 77.3%（41/53）和 15.0%（8/53）的完整和部分苍白密螺旋体分型数据，而 4 个样本尽管检测到苍白密螺旋体 DNA 但无法分型。博洛尼亚和米兰的样本显示出最高的菌株类型异质性，其次是热那亚。都灵的样本检测到的多样性最低，尽管那里收集的可分型样本数量最多。94.3%（50/53）的菌株对大环内酯类耐药，但未发现与四环素耐药相关的已知突变。
结论
意大利北部流行的苍白密螺旋体菌株的遗传多样性在不同地理区域之间存在显著差异，而与物理距离无关。对大环内酯类的耐药性很普遍。
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