Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China.
Guangzhou Key Laboratory for Sexually Transmitted Disease Control, Guangzhou, Guangdong, China.
Microbiol Spectr. 2022 Dec 21;10(6):e0157022. doi: 10.1128/spectrum.01570-22. Epub 2022 Nov 15.
Currently, antibiotic resistance (especially ceftriaxone and azithromycin dual resistance) in Neisseria gonorrhoeae is the main obstacle affecting the efficacy of treatment. As analysis of drug sensitivity, molecular features, and dissemination of dual-resistant strains is important for gonococcal prevention and control, MIC, genotyping, and genome analysis were conducted to reveal the molecular characteristics and phylogeny of N. gonorrhoeae isolates. During 2016 to 2019, 5 out of 4,113 strains were defined as dual-resistant clones, with ceftriaxone MICs of 0.25 to ≥1 mg/L and azithromycin MICs of 2 to ≥2,048 mg/L. In particular, two strains with a ceftriaxone MIC above 0.5 mg/L were characterized as -60.001 FC428-related clones, and two isolates with a high-level azithromycin MIC above 1,024 mg/L featuring a 23S rRNA mutation were identified. Furthermore, phylogenetic analysis confirmed that the dual-resistant strains were closer to the evolutionary origin of F89 in France, global FC428-related clones, and high-level dual-resistant clones in Australia and the United Kingdom. Dual-resistant strains, including FC428-related clones and high-level azithromycin-resistant clones, have circulated in Guangdong, China. The ability of laboratories to perform real-time drug susceptibility and genetic analyses should be strengthened to monitor the spread of threatening strains. Here, we report five sporadic dual-resistant isolates, including FC428-related ceftriaxone-resistant clones with MICs of ≥0.5 mg/L and high-level azithromycin resistance with MICs of ≥1,024 mg/L. This study highlights that dual-resistant clones with the same evolutionary origin as FC428, A2735, and F89 have circulated in Guangdong, China, which suggests that the capacity for antibiotic resistance testing and genome analysis should be strengthened in daily epidemiological surveillance.
目前，淋病奈瑟菌的抗生素耐药性（尤其是头孢曲松和阿奇霉素双重耐药性）是影响治疗效果的主要障碍。分析药物敏感性、分子特征和双重耐药菌株的传播对于淋病的预防和控制非常重要，因此进行了 MIC、基因分型和基因组分析，以揭示淋病奈瑟菌分离株的分子特征和系统发育。2016 年至 2019 年期间，在 4113 株菌株中发现 5 株为双重耐药克隆株，头孢曲松 MIC 值为 0.25 至≥1mg/L，阿奇霉素 MIC 值为 2 至≥2048mg/L。特别是，两株头孢曲松 MIC 值超过 0.5mg/L 的菌株被鉴定为-60.001 FC428 相关克隆株，两株高阿奇霉素 MIC 值（超过 1024mg/L）的分离株被鉴定为 23S rRNA 突变。此外，系统发育分析证实，这些双重耐药菌株与法国 F89、全球 FC428 相关克隆株以及澳大利亚和英国的高水平双重耐药克隆株的进化起源更为接近。包括 FC428 相关克隆株和高水平阿奇霉素耐药克隆株在内的双重耐药菌株在中国广东有传播。实验室应加强实时药物敏感性和基因分析的能力，以监测威胁性菌株的传播。在此，我们报告了五株散发性双重耐药分离株，包括 MIC 值≥0.5mg/L 的头孢曲松耐药 FC428 相关克隆株和 MIC 值≥1024mg/L 的高水平阿奇霉素耐药株。本研究表明，与 FC428、A2735 和 F89 具有相同进化起源的双重耐药克隆株在中国广东有传播，这表明在日常流行病学监测中应加强抗生素耐药性检测和基因组分析的能力。
