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Abstract

We describe a multidrug-resistant urethritis case with ceftriaxone resistance and azithromycin intermediate resistance in a heterosexual man in Ireland, August 2018. Whole-genome sequencing showed that the isolate IR72 belongs to the internationally spreading multidrug-resistant ceftriaxone-resistant FC428 clade, initially described in Japan in 2015. IR72 was assigned MSLT ST1903, NG-MAST ST17842 and NG-STAR type 1133, including the ceftriaxone resistance-mediating 60.001. Global awareness of spreading ceftriaxone-resistant gonococcal strains that threaten recommended dual therapies is essential.

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/content/10.2807/1560-7917.ES.2018.23.47.1800617
2018-11-22
2018-12-16
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.47.1800617
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References

  1. 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 
  2. Lahra MM, Martin I, Demczuk W, Jennison AV, Lee KI, Nakayama SI, et al. Cooperative recognition of internationally disseminated ceftriaxone-resistant Neisseria gonorrhoeae strain. Emerg Infect Dis. 2018;24(4):735-40.  https://doi.org/10.3201/eid2404.171873  PMID: 29553335 
  3. Lefebvre B, Martin I, Demczuk W, Deshaies L, Michaud S, Labbé AC, et al. Ceftriaxone-Resistant Neisseria gonorrhoeae, Canada, 2017. Emerg Infect Dis. 2018;24(2):381-3.  https://doi.org/10.3201/eid2402.171756  PMID: 29131780 
  4. Terkelsen D, Tolstrup J, Johnsen CH, Lund O, Larsen HK, Worning P, et al. Multidrug-resistant Neisseria gonorrhoeae infection with ceftriaxone resistance and intermediate resistance to azithromycin, Denmark, 2017. Euro Surveill. 2017;22(42):1273.  https://doi.org/10.2807/1560-7917.ES.2017.22.42.17-00659  PMID: 29067905 
  5. Poncin T, Fouere S, Braille A, Camelena F, Agsous M, Bebear C, et al. Multidrug-resistant Neisseria gonorrhoeae failing treatment with ceftriaxone and doxycycline in France, November 2017. Euro Surveill. 2018;23(21):1800264.  https://doi.org/10.2807/1560-7917.ES.2018.23.21.1800264  PMID: 29845928 
  6. Hjelmevoll SO, Olsen ME, Ericson Sollid JU, Haaheim H, Unemo M, Skogen V. A fast real-time PCR method for sensitive and specific detection of the Neisseria gonorrhoeae porA pseudogene. J Mol Diagn. 2006;8(5):574-81.  https://doi.org/10.2353/jmoldx.2006.060024  PMID: 17065426 
  7. European Committee on Antimicrobial Susceptibility Testing (EUCAST). Basel: EUCAST; 2018. Available from: www.eucast.org
  8. Hodge W, Ciak J, Tramont EC. Simple method for detection of penicillinase-producing Neisseria gonorrhoeae. J Clin Microbiol. 1978;7(1):102-3. PMID: 415067 
  9. Jacobsson S, Golparian D, Cole M, Spiteri G, Martin I, Bergheim T, et al. WGS analysis and molecular resistance mechanisms of azithromycin-resistant (MIC >2 mg/L) Neisseria gonorrhoeae isolates in Europe from 2009 to 2014. J Antimicrob Chemother. 2016;71(11):3109-16.  https://doi.org/10.1093/jac/dkw279  PMID: 27432597 
  10. Ryan L, Golparian D, Fennelly N, Rose L, Walsh P, Lawlor B, et al. Antimicrobial resistance and molecular epidemiology using whole-genome sequencing of Neisseria gonorrhoeae in Ireland, 2014-2016: focus on extended-spectrum cephalosporins and azithromycin. Eur J Clin Microbiol Infect Dis. 2018;37(9):1661-72.  https://doi.org/10.1007/s10096-018-3296-5  PMID: 29882175 
  11. Eyre DW, Sanderson ND, Lord E, Regisford-Reimmer N, Chau K, Barker L, et al. Gonorrhoea treatment failure caused by a Neisseria gonorrhoeae strain with combined ceftriaxone and high-level azithromycin resistance, England, February 2018. Euro Surveill. 2018;23(27):1800323.  https://doi.org/10.2807/1560-7917.ES.2018.23.27.1800323  PMID: 29991383 
  12. Igawa G, Yamagishi Y, Lee KI, Dorin M, Shimuta K, Suematsu H, et al. Neisseria cinerea with high ceftriaxone MIC is a source of ceftriaxone and cefixime resistance-mediating penA sequences in Neisseria gonorrhoeae. Antimicrob Agents Chemother. 2018;62(3):e02069-17.  https://doi.org/10.1128/AAC.02069-17  PMID: 29311079 
  13. 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 
  14. 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 
  15. Cole MJ, Spiteri G, Jacobsson S, Pitt R, Grigorjev V, Unemo MEuro-GASP Network. Is the tide turning again for cephalosporin resistance in Neisseria gonorrhoeae in Europe? Results from the 2013 European surveillance. BMC Infect Dis. 2015;15(1):321.  https://doi.org/10.1186/s12879-015-1013-x  PMID: 26259560 
  16. Kirkcaldy RD, Harvey A, Papp JR, Del Rio C, Soge OO, Holmes KK, et al. Neisseria gonorrhoeae antimicrobial susceptibility surveillance – The Gonococcal Isolate Surveillance Project, 27 sites, United States, 2014. MMWR Surveill Summ. 2016;65(7):1-19.  https://doi.org/10.15585/mmwr.ss6507a1  PMID: 27414503 
  17. Whiley DM, Jennison A, Pearson J, Lahra MM. Genetic characterisation of Neisseria gonorrhoeae resistant to both ceftriaxone and azithromycin. Lancet Infect Dis. 2018;18(7):717-8.  https://doi.org/10.1016/S1473-3099(18)30340-2  PMID: 29976521 
  18. Bignell C, Unemo MEuropean STI Guidelines Editorial Board. 2012 European guideline on the diagnosis and treatment of gonorrhoea in adults. Int J STD AIDS. 2013;24(2):85-92.  https://doi.org/10.1177/0956462412472837  PMID: 24400344 
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