Department of Microbiology, and Department of Dermatology of Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Zhejiang University-University of Edinburgh Institute, School of Medicine, Zhejiang University, Haining, China.
J Antimicrob Chemother. 2024 Nov 4;79(11):2854-2857. doi: 10.1093/jac/dkae297.
Neisseria gonorrhoeae strains associated with the high-level ceftriaxone-resistant FC428 clone or containing its main resistance determinant, penA allele 60.001, have shown global transmission. In Hangzhou, China, 10% of the isolates were associated with the FC428 clone in 2019. Here, we investigated ceftriaxone resistance and the prevalence of FC428-associated strains in Hangzhou in 2020-22.
A total of 209 gonococcal isolates were investigated for antimicrobial susceptibility to ceftriaxone and other antibiotics by agar dilution method. Sequence types and penA alleles were determined by PCR and sequence analysis.
Resistance to ceftriaxone (MIC > 0.125 mg/L) was observed for 16% (33/209) of the isolates, whereas 6.7% (14/209) of the isolates displayed high-level ceftriaxone resistance (MIC = 1 mg/L). These 14 high-level ceftriaxone-resistant isolates and another isolate displaying an MIC = 0.25 mg/L contained penA allele 60.001, with eight of these isolates, all from 2020 to 2021 belonging to MLST ST1903, the sequence type commonly associated with the original FC428 clone. Importantly, the six penA allele 60.001-containing isolates from 2022 belonged to MLST ST8123, ST7365 and ST7367, which are among the most frequently encountered sequence types found in China. Therefore, these results indicate that endemic lineages in China have acquired penA allele 60.001.
Here, we report continued transmission of gonococcal strains associated with the FC428 clone or containing penA allele 60.001 in Hangzhou. A major concern for public health is the acquisition of penA allele 60.001 by successful endemic lineages, which might enhance the transmission of this high-level ceftriaxone resistance trait.
与高水平头孢曲松耐药 FC428 克隆相关或含有其主要耐药决定因素 penA 等位基因 60.001 的淋病奈瑟菌株已显示出全球传播。在中国杭州，2019 年 10%的分离株与 FC428 克隆有关。在此，我们调查了 2020-22 年杭州头孢曲松耐药和 FC428 相关菌株的流行情况。
采用琼脂稀释法检测 209 株淋病奈瑟菌对头孢曲松和其他抗生素的药敏性。通过 PCR 和序列分析确定序列类型和 penA 等位基因。
16%（33/209）的分离株对头孢曲松耐药（MIC>0.125mg/L），6.7%（14/209）的分离株对头孢曲松高度耐药（MIC=1mg/L）。这 14 株高水平头孢曲松耐药分离株和另一株 MIC=0.25mg/L 的分离株含有 penA 等位基因 60.001，其中 8 株分离株均来自 2020 年至 2021 年，属于与原始 FC428 克隆常见的 MLST ST1903。重要的是，2022 年分离的 6 株含有 penA 等位基因 60.001 的分离株属于 MLST ST8123、ST7365 和 ST7367，这些序列类型在中国最常见。因此，这些结果表明中国的地方性株系已获得 penA 等位基因 60.001。
本研究报告了杭州与 FC428 克隆相关或含有 penA 等位基因 60.001 的淋病奈瑟菌株的持续传播。一个令人关注的公共卫生问题是成功的地方性株系获得 penA 等位基因 60.001，这可能会增强这种高水平头孢曲松耐药性的传播。
