通过基因组群体分析揭示，2014年至2019年间在荷兰阿姆斯特丹出现了一株对头孢菌素敏感性降低的淋病奈瑟菌克隆株。
Emergence of a Neisseria gonorrhoeae clone with reduced cephalosporin susceptibility between 2014 and 2019 in Amsterdam, The Netherlands, revealed by genomic population analysis.
作者信息
de Korne-Elenbaas Jolinda, Bruisten Sylvia M, de Vries Henry J C, Van Dam Alje P
机构信息
Department of Infectious Diseases, Public Health Laboratory, Public Health Service of Amsterdam, Amsterdam, The Netherlands.
Amsterdam UMC, University of Amsterdam, Department of Medical Microbiology, Amsterdam Institute for Infection and Immunity (AII), location Academic Medical Center, Amsterdam, The Netherlands.
出版信息
J Antimicrob Chemother. 2021 Jun 18;76(7):1759-1768. doi: 10.1093/jac/dkab082.
BACKGROUND
Emerging resistance to cephalosporins in Neisseria gonorrhoeae (Ng) is a major public health threat, since these are considered antibiotics of last resort. Continuous surveillance is needed to monitor the circulation of resistant strains and those with reduced susceptibility.
OBJECTIVES
For the purpose of epidemiological surveillance, genomic population analysis was performed on Ng isolates from Amsterdam with a focus on isolates with reduced susceptibility to ceftriaxone.
METHODS
WGS data were obtained from 318 isolates from Amsterdam, the Netherlands between 2014 and 2019. Isolates were typed according to MLST, Ng Multi-Antigen Sequence Typing (NG-MAST) and Ng Sequence Typing for Antimicrobial Resistance (NG-STAR) schemes and additional resistance markers were identified. Phylogenetic trees were created to identify genetic clusters and to compare Dutch and non-Dutch MLST7827 isolates.
RESULTS
MLST7363 and MLST1901 were the predominant strains having reduced susceptibility to ceftriaxone during 2014-16; MLST7827 emerged and dominated during 2017-19. NG-STAR38 and NG-MAST2318/10386 were predominant among MLST7827 isolates. MLST7827 reduced susceptibility isolates carried a non-mosaic 13.001 penA allele with an A501V mutation and porB1b G120K/A121D mutations, which were lacking in susceptible MLST7827 isolates. Phylogenetic analysis of all publicly available MLST7827 isolates showed strong genetic clustering of Dutch and other European MLST7827 isolates.
CONCLUSIONS
MLST7827 isolates with reduced ceftriaxone susceptibility have emerged during recent years in Amsterdam. Co-occurrence of penA A501V and porB1b G120K/A121D mutations was strongly associated with reduced susceptibility to ceftriaxone. Genetic clustering of Dutch and other European MLST7827 isolates indicates extensive circulation of this strain in Europe. Close monitoring of the spread of this strain having an alarming susceptibility profile is needed.
背景
淋病奈瑟菌（Ng）对头孢菌素的耐药性不断出现，这是一个重大的公共卫生威胁，因为这些药物被视为最后手段的抗生素。需要持续监测以监控耐药菌株和敏感性降低菌株的传播情况。
目的
为了进行流行病学监测，对来自阿姆斯特丹的淋病奈瑟菌分离株进行了基因组群体分析，重点关注对头孢曲松敏感性降低的分离株。
方法
获取了2014年至2019年间来自荷兰阿姆斯特丹的318株分离株的全基因组测序（WGS）数据。根据多位点序列分型（MLST）、淋病奈瑟菌多抗原序列分型（NG-MAST）和淋病奈瑟菌抗菌药物耐药性序列分型（NG-STAR）方案对分离株进行分型，并鉴定其他耐药标记。构建系统发育树以识别基因簇，并比较荷兰和非荷兰的MLST7827分离株。
结果
MLST7363和MLST1901是2014 - 2016年期间对头孢曲松敏感性降低的主要菌株；MLST7827在2017 - 2019年出现并占主导地位。在MLST7827分离株中，NG-STAR38和NG-MAST2318/10386占主导地位。MLST7827敏感性降低的分离株携带一个非镶嵌型的13.001 penA等位基因，带有A501V突变以及porB1b G120K/A121D突变，而敏感的MLST7827分离株中不存在这些突变。对所有公开可用的MLST7827分离株的系统发育分析表明，荷兰和其他欧洲的MLST7827分离株存在强烈的基因簇。
结论
近年来在阿姆斯特丹出现了对头孢曲松敏感性降低的MLST7827分离株。penA A501V和porB1b G120K/A121D突变的同时出现与对头孢曲松敏感性降低密切相关。荷兰和其他欧洲MLST7827分离株的基因簇表明该菌株在欧洲广泛传播。需要密切监测这种具有令人担忧的敏感性特征的菌株的传播情况。
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