Atypical Mutation in Neisseria gonorrhoeae 23S rRNA Associated with High-Level Azithromycin Resistance

Antimicrob Agents Chemother. 2021 Jan 20;65(2):e00885-20. doi: 10.1128/AAC.00885-20. Print 2021 Jan 20.

Abstract

A2059G mutation in the 23S rRNA gene is the only reported mechanism conferring high-level azithromycin resistance (HL-AZMR) in Neisseria gonorrhoeae Through U.S. gonococcal antimicrobial resistance surveillance projects, we identified four HL-AZMR gonococcal isolates lacking this mutational genotype. Genetic analysis revealed an A2058G mutation of 23S rRNA alleles in all four isolates. In vitro selected gonococcal strains with homozygous A2058G recapitulated the HL-AZMR phenotype. Taken together, we postulate that the A2058G mutation confers HL-AZMR in N. gonorrhoeae.

Keywords: 23s rRNA; A2058G; HL-AZMR; Neisseria gonorrhoeae; antibiotic resistance; azithromycin resistant; gonorrhea.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Azithromycin* / pharmacology
  • Drug Resistance, Bacterial / genetics
  • Gonorrhea* / drug therapy
  • Humans
  • Microbial Sensitivity Tests
  • Mutation
  • Neisseria gonorrhoeae / genetics
  • RNA, Ribosomal, 23S / genetics

Substances

  • Anti-Bacterial Agents
  • RNA, Ribosomal, 23S
  • Azithromycin

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