Emerg Infect Dis. 2018 Apr;24(4):735-40. doi: 10.3201/eid2404.171873.
Ceftriaxone remains a first-line treatment for patients infected by Neisseria gonorrhoeae in most settings. We investigated the possible spread of a ceftriaxone-resistant FC428 N. gonorrhoeae clone in Japan after recent isolation of similar strains in Denmark (GK124) and Canada (47707). We report 2 instances of the FC428 clone in Australia in heterosexual men traveling from Asia. Our bioinformatic analyses included core single-nucleotide variation phylogeny and in silico molecular typing; phylogenetic analysis showed close genetic relatedness among all 5 isolates. Results showed multilocus sequence type 1903; N. gonorrhoeae sequence typing for antimicrobial resistance (NG-STAR) 233; and harboring of mosaic penA allele encoding alterations A311V and T483S (penA-60.001), associated with ceftriaxone resistance. Our results provide further evidence of international transmission of ceftriaxone-resistant N. gonorrhoeae. We recommend increasing awareness of international spread of this drug-resistant strain, strengthening surveillance to include identifying treatment failures and contacts, and strengthening international sharing of data.
头孢曲松在大多数情况下仍然是淋病奈瑟菌感染患者的一线治疗药物。在丹麦（GK124）和加拿大（47707）最近分离出类似菌株后，我们调查了日本可能出现的头孢曲松耐药 FC428 淋病奈瑟菌克隆的传播情况。我们报告了澳大利亚 2 例来自亚洲的异性恋男性旅行者感染 FC428 克隆的情况。我们的生物信息学分析包括核心单核苷酸变异系统发育和计算机分子分型；系统发育分析显示所有 5 个分离株之间具有密切的遗传相关性。结果显示为多位点序列型 1903；耐抗生素淋病奈瑟菌序列分型（NG-STAR）233；以及携带编码 A311V 和 T483S （penA-60.001）改变的马赛克 penA 等位基因，与头孢曲松耐药相关。我们的研究结果进一步证实了国际传播的头孢曲松耐药淋病奈瑟菌。我们建议提高对这种耐药菌株国际传播的认识，加强监测以包括识别治疗失败和接触者，并加强国际数据共享。
