Bioinformatics Unit, Department of Infectious Diseases, Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA, Avenida Padre Cruz, 1649-016, Lisbon, Portugal.
Laboratory of Microbiology, Department of Infectious Diseases, Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA, Avenida Padre Cruz, 1649-016, Lisbon, Portugal.
Eur J Clin Microbiol Infect Dis. 2020 Sep;39(9):1761-1770. doi: 10.1007/s10096-020-03907-7. Epub 2020 Jun 3.
Neisseria gonorrhoeae antimicrobial resistance (AMR) and gonorrhea disease burden remain major public health concerns worldwide. To contribute to the supranational demands to monitor and manage the spread of antimicrobial-resistant N. gonorrhoeae, the Portuguese NIH promoted the creation of the National Laboratory Network for Neisseria gonorrhoeae Collection (PTGonoNet). The present study reports the N. gonorrhoeae major AMR trends observed from 2003 up to 2018. All isolates described in the present study constitute the opportunistic ongoing N. gonorrhoeae isolate collection supported by the National Reference Laboratory for Sexually Transmitted Infections of the Portuguese NIH, enrolling strains isolated in 35 different public and private laboratories. Minimum inhibitory concentrations were determined using E-tests for azithromycin, benzylpenicillin, cefixime, ceftriaxone, ciprofloxacin, gentamicin, spectinomycin and tetracycline. Molecular typing was determined using NG-MAST. AMR data of 2596 country-spread isolates show that 87.67% of all N. gonorrhoeae isolates presented decreased susceptibility to at least one antimicrobial. A continuous decreased susceptibility and resistance to penicillin, tetracycline and ciprofloxacin can be observed along the years. However, no decreased susceptibility to cephalosporins was observed until 2018, while for azithromycin, this was always low. The most common observed NG-MAST genogroups were G1407, G7445, G225, G2, and G1034. This study evidences the advantages of a nationwide collection of isolates and of centralized AMR testing to respond to supranational (EURO-GASP) requirements while providing unprecedented data on AMR in the context of 15 years of surveillance.
淋病奈瑟菌的抗菌药物耐药性（AMR）和淋病疾病负担仍然是全球主要的公共卫生关注点。为了应对跨国界监测和管理耐抗菌药物淋病奈瑟菌传播的需求，葡萄牙 NIH 推动建立了淋病奈瑟菌收集国家实验室网络（PTGonoNet）。本研究报告了 2003 年至 2018 年期间观察到的淋病奈瑟菌主要 AMR 趋势。本研究中描述的所有分离株均构成国家性传播感染参考实验室支持的机会性持续淋病奈瑟菌分离株收集，该收集纳入了 35 个不同的公共和私人实验室分离的菌株。使用 E-试验法测定阿奇霉素、青霉素、头孢克肟、头孢曲松、环丙沙星、庆大霉素、壮观霉素和四环素的最低抑菌浓度。使用 NG-MAST 进行分子分型。2596 株全国流行株的 AMR 数据显示，所有淋病奈瑟菌分离株中有 87.67%至少对一种抗菌药物的敏感性降低。可以观察到青霉素、四环素和环丙沙星的敏感性持续降低和耐药性增加。然而，直到 2018 年才观察到头孢菌素的敏感性降低，而阿奇霉素的敏感性一直较低。最常见的观察到的 NG-MAST 基因群是 G1407、G7445、G225、G2 和 G1034。本研究证明了全国性分离株收集和集中 AMR 检测的优势，以应对跨国界（EURO-GASP）的要求，同时提供了 15 年监测背景下 AMR 的前所未有的数据。
