Microbiology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.
SpeeDx Pty Ltd, Sydney, Australia.
J Clin Microbiol. 2019 Oct 23;57(11). doi: 10.1128/JCM.00886-19. Print 2019 Nov.
causes a common sexually transmitted infection with a marked propensity to develop antimicrobial resistance. As few treatment options exist, this poses significant challenges to clinicians. Recent diagnostic advances have resulted in tests that report the simultaneous detection of and any resistance to macrolides, the first-line treatment. This allows for therapy to be tailored to the individual, thereby optimizing treatment outcomes. However, resistance to fluoroquinolones, the second-line treatment, is increasing in In this study, we describe a new assay, MG+parC (beta), which simultaneously reports the detection of and five mutations that have been associated with resistance to fluoroquinolones. These mutations affect the amino acid sequence of ParC at residues S83R (A247C), S83I (G248T), D87N (G259A), D87Y (G259T), and D87H (G259C). The study tested the MG+parC (beta) assay with 202 -positive clinical samples from Australia ( = 141) and Spain ( = 61). Compared to Sanger sequencing, the assay performed with a kappa value of 0.985 (95% confidence interval [CI], 0.955 to 1.000), with a mutation detection sensitivity of 97.6% (95% CI, 87.4 to 99.9), and specificity of 100.0% (95% CI, 97.7 to 100.0). Fluoroquinolone resistance-associated mutations in targeted by the assay were more prevalent among the Australian cohort (23.4% [95% CI,16.3 to 31.8]) compared to the Spanish population (8.8% [95% CI, 2.9% to 19.3%]) (0.019). The MG+parC (beta) kit is a simple and reliable method for simultaneous detection of and fluoroquinolone resistance-associated mutations in clinical settings. This novel diagnostic tool may extend the utility of the second line of antimicrobial therapies in infection.
引起一种常见的性传播感染，具有明显的产生抗生素耐药性的倾向。由于治疗选择很少，这给临床医生带来了重大挑战。最近的诊断进展导致了能够同时检测和对抗生素大环内酯类药物（一线治疗药物）耐药性的检测方法。这使得治疗可以根据个体情况进行调整，从而优化治疗结果。然而，氟喹诺酮类药物（二线治疗药物）的耐药性在不断增加。在本研究中，我们描述了一种新的检测方法 MG+parC（beta），它可以同时报告检测到 和与氟喹诺酮类药物耐药性相关的五个 突变。这些突变影响 ParC 蛋白的氨基酸序列，在 S83R（A247C）、S83I（G248T）、D87N（G259A）、D87Y（G259T）和 D87H（G259C）处的氨基酸残基。该研究用 202 例来自澳大利亚（ = 141）和西班牙（ = 61）的阳性临床样本对 MG+parC（beta）检测方法进行了测试。与 Sanger 测序相比，该检测方法的kappa 值为 0.985（95%置信区间 [CI]，0.955 至 1.000），突变检测灵敏度为 97.6%（95%CI，87.4%至 99.9%），特异性为 100.0%（95%CI，97.7%至 100.0%）。该检测方法针对的目标 中与氟喹诺酮类药物耐药性相关的突变在澳大利亚队列中更为普遍（23.4%[95%CI，16.3%至 31.8%]），而在西班牙人群中则较少见（8.8%[95%CI，2.9%至 19.3%]）（0.019）。MG+parC（beta）试剂盒是一种简单可靠的方法，可用于在临床环境中同时检测 和与氟喹诺酮类药物耐药性相关的突变。这种新的诊断工具可能会扩大二线抗生素治疗在 感染中的应用。
