Identification of multidrug-resistant Neisseria gonorrhoeae isolates with combined resistance to both ceftriaxone and azithromycin, China, 2017-2018

Emerg Microbes Infect. 2019;8(1):1546-1549. doi: 10.1080/22221751.2019.1681242.

Abstract

The growing multidrug-resistant Neisseria gonorrhoeae is a serious global threat to gonococcal therapy. During 2017-2018, we identified a rare multidrug-resistant (ceftriaxone and azithromycin) strain (GC250) and four strains (GC185, GC195, GC196 and GC249) with both resistance to ceftriaxone and decreased susceptibility to azithromycin. All strains belonged to NG-STAR ST1143, including the mosaic penA-60.001, which is closely related to ceftriaxone resistance. The characterization of antimicrobial resistance (AMR) determinants and phylogenetic analysis showed these five strains were closely related to internationally spreading ceftriaxone-resistant N. gonorrhoeae FC428, but with higher azithromycin MIC. Findings here demonstrated that this clone not only initiated clonal expansion in China, but acquired azithromycin resistance.

Keywords: Neisseria gonorrhoeae; azithromycin; ceftriaxone; multidrug-resistant; phylogeny.

Publication types

  • Letter

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Azithromycin / pharmacology*
  • Ceftriaxone / pharmacology*
  • China
  • Drug Resistance, Multiple, Bacterial*
  • Female
  • Gonorrhea / microbiology*
  • Heterosexuality
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Neisseria gonorrhoeae / classification
  • Neisseria gonorrhoeae / drug effects*
  • Neisseria gonorrhoeae / genetics
  • Neisseria gonorrhoeae / isolation & purification*
  • Phylogeny

Substances

  • Anti-Bacterial Agents
  • Ceftriaxone
  • Azithromycin

Grants and funding

This study were supported by the Chinese Academy Medical Sciences (CAMS) Initiative for Innovative Medicine [grant number 2016-I2M-3-021] and Natural Science Foundation of Hunan Province [grant number 2018JJ2559].