Molecular analyses of TEM genes and their corresponding penicillinase-producing Neisseria gonorrhoeae isolates in Bangkok, Thailand

Antimicrob Agents Chemother. 2012 Feb;56(2):916-20. doi: 10.1128/AAC.05665-11. Epub 2011 Dec 5.

Abstract

Neisseria gonorrhoeae is a major public health problem globally, especially because the bacterium has developed resistance to most antimicrobials introduced for first-line treatment of gonorrhea. In the present study, 96 N. gonorrhoeae isolates with high-level resistance to penicillin from 121 clinical isolates in Thailand were examined to investigate changes related to their plasmid-mediated penicillin resistance and their molecular epidemiological relationships. A β-lactamase (TEM) gene variant, bla(TEM-135), that may be a precursor in the transitional stage of a traditional bla(TEM-1) gene into an extended-spectrum β-lactamase (ESBL), possibly causing high resistance to all extended-spectrum cephalosporins in N. gonorrhoeae, was identified. Clonal analysis using multilocus sequence typing (MLST) and N. gonorrhoeae multiantigen sequence typing (NG-MAST) revealed the existence of a sexual network among patients from Japan and Thailand. Molecular analysis of the bla(TEM-135) gene showed that the emergence of this allele might not be a rare genetic event and that the allele has evolved in different plasmid backgrounds, which results possibly indicate that it is selected due to antimicrobial pressure. The presence of the bla(TEM-135) allele in the penicillinase-producing N. gonorrhoeae population may call for monitoring for the possible emergence of ESBL-producing N. gonorrhoeae in the future. This study identified a bla(TEM) variant (bla(TEM-135)) that is a possible intermediate precursor for an ESBL, which warrants international awareness.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Cephalosporins / pharmacology
  • Gonorrhea / drug therapy
  • Gonorrhea / epidemiology*
  • Gonorrhea / microbiology
  • Humans
  • Internationality
  • Japan
  • Microbial Sensitivity Tests
  • Molecular Epidemiology
  • Mutation
  • Neisseria gonorrhoeae / classification
  • Neisseria gonorrhoeae / enzymology
  • Neisseria gonorrhoeae / genetics*
  • Neisseria gonorrhoeae / isolation & purification
  • Penicillinase / biosynthesis*
  • Penicillinase / genetics
  • Plasmids
  • Polymerase Chain Reaction / methods
  • Public Health
  • Thailand / epidemiology
  • beta-Lactam Resistance / genetics
  • beta-Lactamases / genetics*

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • Penicillinase
  • beta-Lactamases
  • beta-lactamase TEM-1