Siatravani Eirini, Panopoulou Anna-Danai, Polemis Michalis, Chryssou Stella-Eugenia, Moschos Ioannis, Magaziotou Ioanna, Beloukas Apostolos, Tzelepi Eva, Miriagou Vivi
National Reference Center for Neisseria gonorrhoeae, Laboratory of Bacteriology, Hellenic Pasteur Institute, Athens, Greece.
Department of Biomedical Sciences, University of West Attica, Egaleo, Athens, Greece.
Sex Transm Infect. 2025 Aug 28;101(6):395-404. doi: 10.1136/sextrans-2024-056279.
To monitor epidemiological characteristics and antibiotic susceptibility trends of in Greece during 2009-2023.
Microbiological and epidemiological data for 1756 gonococci received by the Greek National Reference Centre for were evaluated. Strains were isolated consecutively from gonorrhoea cases in hospitals throughout Greece. Minimum inhibitory concetrations of antibiotics were determined by E-test. Plasmid content analysis was performed for penicillinase-producing isolates (PPNG) and for isolates exhibiting tetracycline resistance (TRNG). , and genes were identified by PCR and RFLP/sequencing. Isolates were subjected to serotyping. Genomic analysis by pulsed-field gel electrophoresis (PFGE) was performed for extended-spectrum cephalosporin (ESC)-resistant isolates.
Only 2.8% of the isolates were fully susceptible to all antibiotics. High rates of resistance were observed for penicillin G (27.5%), tetracycline (59.2%) and ciprofloxacin (68.8%). PPNG and/or TRNG isolates accounted for 26% of the total sample, the majority (81.6%) being simultaneously quinolone-resistant (QRNG). The isolation frequency of QRNG isolates was stably high as in previous years. Interestingly, a proportion of QRNG isolates exhibited cross-resistance to all antibiotics except spectinomycin. Azithromycin resistance is showing an increasing trend since 2021 at alarming levels (32.7% in 2023). The percentage of isolates exhibiting decreased susceptibility to ESCs (CDS) remained stable until 2019, whereas no CDS strains were isolated from 2020 to 2023. Spectinomycin was active against all isolates. Serotyping results revealed a strong association of quinolone resistance with Bpyut, Bpyust and Bropyst serovars and I/S phenotypes with Bpyvut and Byut serovars. PFGE showed that CDS isolates were classified into eight groups, with the majority clustered in three main clones including the predominant CDS clone isolated during 2001-2008.
The gonococcal population showed a continuous change in the resistance phenotypes and predominating clones during 2009-2023 underlining the need for continuous monitoring of the traits of this pathogen.
监测2009 - 2023年希腊淋病奈瑟菌的流行病学特征及抗生素敏感性趋势。
对希腊国家淋病奈瑟菌参考中心接收的1756株淋病奈瑟菌的微生物学和流行病学数据进行评估。菌株连续从希腊各地医院的淋病病例中分离获得。采用E-test法测定抗生素的最低抑菌浓度。对产青霉素酶菌株（PPNG）和四环素耐药菌株（TRNG）进行质粒含量分析。通过PCR及RFLP/测序鉴定blaTEM、blaSHV和blaCTX-M基因。对分离株进行血清分型。对耐超广谱头孢菌素（ESC）的分离株采用脉冲场凝胶电泳（PFGE）进行基因组分析。
仅2.8%的分离株对所有抗生素均敏感。青霉素G、四环素和环丙沙星的耐药率较高，分别为27.5%、59.2%和68.8%。PPNG和/或TRNG分离株占总样本的26%，其中大多数（81.6%）同时对喹诺酮耐药（QRNG）。QRNG分离株的分离频率与往年一样持续处于较高水平。有趣的是，一部分QRNG分离株对除大观霉素外的所有抗生素均表现出交叉耐药。自2021年以来，阿奇霉素耐药呈上升趋势，且达到令人担忧的水平（2023年为32.7%）。对ESC敏感性降低（CDS）的分离株百分比在2019年之前保持稳定，而2020年至2023年未分离到CDS菌株。大观霉素对所有分离株均有活性。血清分型结果显示，喹诺酮耐药与Bpyut、Bpyust和Bropyst血清型密切相关，I/S表型与Bpyvut和Byut血清型密切相关。PFGE显示，CDS分离株分为八组，大多数聚集在三个主要克隆中，包括2001 - 2008年分离出的主要CDS克隆。
2009 - 2023年期间，淋病奈瑟菌群体的耐药表型和优势克隆持续变化，凸显了持续监测该病原体特征的必要性。
