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Abstract

We report a multidrug-resistant urogenital and pharyngeal infection with ceftriaxone resistance and intermediate resistance to azithromycin in a heterosexual woman in her 20s in France. Treatment with ceftriaxone plus doxycycline failed for the pharyngeal localisation. Whole-genome sequencing of isolate F90 identified MLST, NG-MAST ST, NG-STAR, and relevant resistance determinants. F90 showed phenotypic and genotypic similarities to an internationally spreading multidrug-resistant and ceftriaxone-resistant clone detected in Japan and subsequently in Australia, Canada and Denmark.

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/content/10.2807/1560-7917.ES.2018.23.21.1800264
2018-05-24
2024-04-19
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.21.1800264
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References

  1. Wi T, Lahra MM, Ndowa F, Bala M, Dillon JR, Ramon-Pardo P, et al. Antimicrobial resistance in Neisseria gonorrhoeae: Global surveillance and a call for international collaborative action. PLoS Med. 2017;14(7):e1002344.  https://doi.org/10.1371/journal.pmed.1002344  PMID: 28686231 
  2. World Health Organization (WHO). Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae. Geneva: WHO; 2012. Available from: http://www.who.int/reproductivehealth/publications/rtis/9789241503501/en/
  3. European Centre for Disease Prevention and Control (ECDC). Response plan to control and manage the threat of multidrugresistant gonorrhoea in Europe. Stockholm: ECDC; 2012. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/1206-ECDC-MDRgonorrhoea-response-plan.pdf2.
  4. Fifer H, Natarajan U, Jones L, Alexander S, Hughes G, Golparian D, et al. Failure of dual antimicrobial therapy in treatment of gonorrhea. N Engl J Med. 2016;374(25):2504-6.  https://doi.org/10.1056/NEJMc1512757  PMID: 27332921 
  5. Geisler WM, Uniyal A, Lee JY, Lensing SY, Johnson S, Perry RC, et al. Azithromycin versus Doxycycline for Urogenital Chlamydia trachomatis Infection. N Engl J Med. 2015;373(26):2512-21.  https://doi.org/10.1056/NEJMoa1502599  PMID: 26699167 
  6. European Committee on Antimicrobial Susceptibility Testing (Eucast). Breakpoint tables for interpretation of MICs and zone diameters Version 7.1, 2017. Europe: Eucast; 2017. Available from: http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_7.1_Breakpoint_Tables.pdf
  7. de Curraize C, Kumanski S, Micaëlo M, Fournet N, La Ruche G, Meunier F, et al. Ceftriaxone-resistant Neisseria gonorrhoeae isolates (2010 to 2014) in France characterized by using whole-genome sequencing. Antimicrob Agents Chemother. 2016;60(11):6962-4.  https://doi.org/10.1128/AAC.01568-16  PMID: 27600036 
  8. Bankevich A, Nurk S, Antipov D, Gurevich AA, Dvorkin M, Kulikov AS, et al. SPAdes: a new genome assembly algorithm and its applications to single-cell sequencing. J Comput Biol. 2012;19(5):455-77.  https://doi.org/10.1089/cmb.2012.0021  PMID: 22506599 
  9. Gurevich A, Saveliev V, Vyahhi N, Tesler G. QUAST: quality assessment tool for genome assemblies. Bioinformatics. 2013;29(8):1072-5.  https://doi.org/10.1093/bioinformatics/btt086  PMID: 23422339 
  10. Vallenet D, Calteau A, Cruveiller S, Gachet M, Lajus A, Josso A, et al. MicroScope in 2017: an expanding and evolving integrated resource for community expertise of microbial genomes. Nucleic Acids Res. 2017;45(D1):D517-28.  https://doi.org/10.1093/nar/gkw1101  PMID: 27899624 
  11. Unemo M, Dillon J-AR. Review and international recommendation of methods for typing neisseria gonorrhoeae isolates and their implications for improved knowledge of gonococcal epidemiology, treatment, and biology. Clin Microbiol Rev. 2011;24(3):447-58.  https://doi.org/10.1128/CMR.00040-10  PMID: 21734242 
  12. Bennett JS, Jolley KA, Sparling PF, Saunders NJ, Hart CA, Feavers IM, et al. Species status of Neisseria gonorrhoeae: evolutionary and epidemiological inferences from multilocus sequence typing. BMC Biol. 2007;5(1):35.  https://doi.org/10.1186/1741-7007-5-35  PMID: 17825091 
  13. Demczuk W, Sidhu S, Unemo M, Whiley DM, Allen VG, Dillon JR, et al. Neisseria gonorrhoeae sequence typing for antimicrobial resistance, a novel antimicrobial resistance multilocus typing scheme for tracking global dissemination of N. gonorrhoeae strains. J Clin Microbiol. 2017;55(5):1454-68.  https://doi.org/10.1128/JCM.00100-17  PMID: 28228492 
  14. Nakayama S, Shimuta K, Furubayashi K, Kawahata T, Unemo M, Ohnishi M. New ceftriaxone- and multidrug-resistant Neisseria gonorrhoeae strain with a novel mosaic penA gene isolated in Japan. Antimicrob Agents Chemother. 2016;60(7):4339-41.  https://doi.org/10.1128/AAC.00504-16  PMID: 27067334 
  15. Unemo M, Shafer WM. Antimicrobial resistance in Neisseria gonorrhoeae in the 21st century: past, evolution, and future. Clin Microbiol Rev. 2014;27(3):587-613.  https://doi.org/10.1128/CMR.00010-14  PMID: 24982323 
  16. Unemo M, Golparian D, Nicholas R, Ohnishi M, Gallay A, Sednaoui P. High-level cefixime- and ceftriaxone-resistant Neisseria gonorrhoeae in France: novel penA mosaic allele in a successful international clone causes treatment failure. Antimicrob Agents Chemother. 2012;56(3):1273-80.  https://doi.org/10.1128/AAC.05760-11  PMID: 22155830 
  17. Harris SR, Cole MJ, Spiteri G, Sánchez-Busó L, Golparian D, Jacobsson S, et al. Euro-GASP study group. Public health surveillance of multidrug-resistant clones of Neisseria gonorrhoeae in Europe: a genomic survey. Lancet Infect Dis. 2018;S1473-3099(18)30225-1. (Forthcoming). PMID: 29776807 
  18. Cámara J, Serra J, Ayats J, Bastida T, Carnicer-Pont D, Andreu A, et al. Molecular characterization of two high-level ceftriaxone-resistant Neisseria gonorrhoeae isolates detected in Catalonia, Spain. J Antimicrob Chemother. 2012;67(8):1858-60.  https://doi.org/10.1093/jac/dks162  PMID: 22566592 
  19. Vincent LR, Kerr SR, Tan Y, Tomberg J, Raterman EL, Dunning Hotopp JC, et al. In vivo-selected compensatory mutations restore the fitness cost of mosaic penA alleles that confer ceftriaxone resistance in Neisseria gonorrhoeae. MBio. 2018;9(2):e01905-17.  https://doi.org/10.1128/mBio.01905-17  PMID: 29615507 
  20. Lahra MM, Martin I, Demczuk W, Jennison AV, Lee K-I, Nakayama S-I, et al. Cooperative recognition of internationally disseminated ceftriaxone-resistant Neisseria gonorrhoeae strain. Emerg Infect Dis. 2018;24(4):735-43.  https://doi.org/10.3201/eid2404.171873  PMID: 29553335 
  21. British Government. Multi-drug resistant gonorrhoea in England: 2018. March 2018. England: British Government; 2018. Available from: https://www.gov.uk/government/publications/multi-drug-resistant-gonorrhoea-in-england-2018
  22. Australian Government Department of Health. Multi-drug resistant gonorrhoea. April 2018. Australia: Department of Health; 2018. Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/mr-yr18-dept-dept004.htm
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