World Health Organization Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Department of Laboratory Medicine, Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Bangrak STIs Center, Division of AIDS and STIs, Department of Disease Control, Ministry of Public Health, Bangkok, Thailand.
J Antimicrob Chemother. 2022 Jul 28;77(8):2171-2182. doi: 10.1093/jac/dkac158.
Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a substantial global public health problem. Gonococcal infections acquired in or from Asia represent most verified ceftriaxone treatment failures, and several ceftriaxone-resistant strains have emerged in Asia and subsequently spread globally. Additionally, in Thailand the gonorrhoea incidence remains high. Herein, we investigate the genomic diversity, AMR and AMR determinants in gonococcal isolates cultured in 2018 in Bangkok, Thailand.
Gonococcal isolates from males (n = 37) and females (n = 62) were examined by Etest and WGS. AMR determinants and molecular epidemiological STs were characterized. For phylogenomic comparison, raw sequence data were included from China (432 isolates), Japan (n = 270), Vietnam (n = 229), Thailand (n = 3), a global dataset (n = 12 440) and the 2016 WHO reference strains plus WHO Q (n = 15).
In total, 88, 66 and 41 different NG-MAST, NG-STAR and MLST STs, respectively, and 31 different NG-STAR clonal complexes were found. A remarkably high frequency (88%) of β-lactamase TEM genes was detected and two novel TEM alleles were found. The phylogenomic analysis divided the isolates into the previously described lineages A and B, with a large proportion of Thai isolates belonging to the novel sublineage A3.
We describe the first molecular epidemiological study using WGS on gonococcal isolates from Thailand. The high prevalence of AMR and AMR determinants for ciprofloxacin, tetracycline and benzylpenicillin, and some strains belonging to clones/clades especially in sublineage A2 that are prone to develop resistance to extended-spectrum cephalosporins (ESCs) and azithromycin, should prompt continued and strengthened AMR surveillance, including WGS, of N. gonorrhoeae in Thailand.
淋病奈瑟菌（Neisseria gonorrhoeae）的抗微生物药物耐药性（AMR）是一个重大的全球公共卫生问题。亚洲地区或从亚洲获得的淋病感染代表了大多数经证实的头孢曲松治疗失败案例，并且亚洲已经出现了几种头孢曲松耐药菌株，随后这些菌株在全球范围内传播。此外，泰国的淋病发病率仍然很高。在此，我们研究了 2018 年在泰国曼谷培养的淋病奈瑟菌分离株的基因组多样性、AMR 和 AMR 决定因素。
对来自男性（n=37）和女性（n=62）的淋病奈瑟菌分离株进行 Etest 和 WGS 检测。对 AMR 决定因素和分子流行病学 ST 进行了特征描述。为了进行系统发育比较，包括了来自中国（432 株）、日本（n=270）、越南（n=229）、泰国（n=3）、全球数据集（n=12440）和 2016 年世界卫生组织参考菌株加 WHO Q（n=15）的原始序列数据。
总共发现了 88、66 和 41 种不同的 NG-MAST、NG-STAR 和 MLST ST，以及 31 种不同的 NG-STAR 克隆复合体。检测到β-内酰胺酶 TEM 基因的频率非常高（88%），并且发现了两种新的 TEM 等位基因。系统发育分析将分离株分为先前描述的谱系 A 和 B，其中很大一部分泰国分离株属于新型亚谱系 A3。
我们描述了首次使用 WGS 对泰国淋病奈瑟菌分离株进行的分子流行病学研究。环丙沙星、四环素和青霉素的 AMR 和 AMR 决定因素的高流行率，以及某些属于克隆/谱系的菌株，特别是亚谱系 A2 中的菌株，容易对扩展谱头孢菌素（ESC）和阿奇霉素产生耐药性，应该促使泰国继续加强对淋病奈瑟菌的 AMR 监测，包括使用 WGS。
