Prevalence of mutations associated with macrolide and fluoroquinolone resistance in Neisseria gonorrhoeae with Allplex NG-DR Assay (Seegene) in a tertiary hospital from Madrid, Spain

Rev Esp Quimioter. 2023 Dec;36(6):625-628. doi: 10.37201/req/058.2023. Epub 2023 Sep 18.

Abstract

Objective: The prevalence of drug-resistant Neisseria gonorrhoeae (NG) infections is increasing. Studies report the prevalence of NG strains presenting A2059G/C2611T (rRNA23S) and S91F (parC) mutations conferring resistance to azithromycin and ciprofloxacin.

Methods: We conducted a prospective cohort study evaluating first void-urine urines, rectal, and oropharyngeal swabs collected from a cohort of patients in a tertiary hospital in Madrid between October 2022 and January 2023. Samples were screened by Allplex 7-STI Essential Assay (Seegene). Drug resistances were performed by Allplex NG-DR Assay (Seegene).

Results: A total of 1,415 patients were included, of which 112 had a positive sample for NG infection. One patient had a C2611T mutation (0.9%) and neither patient showed A2059G mutation. We found 67 (59.8%) S91F-positive patients. Forty-four patients (39.3%) not had any mutations.

Conclusions: We report a low-prevalence of mutations A2059G/C2611T to macrolides and a high-prevalence to S91F in NG infections. Molecular methods for the detection of NG resistance could be useful in direct non-culturable samples.

Introducción: La infección por Neisseria gonorrhoeae (NG) resistente está aumentando. Se ha descrito la prevalencia de cepas de NG con mutaciones A2059G/C2611T (rRNA 23S) y S91F (parC) que confieren resistencia a azitromicina y ciprofloxacino.

Material y métodos: Realizamos un estudio prospectivo evaluando orinas de primera micción, hisopos anales y faríngeos recogidos de una cohorte de pacientes en un hospital terciario de Madrid entre octubre de 2022 y enero de 2023. El cribado de las muestras se realizó mediante Allplex™ 7-STI Essential Assay (Seegene®). Las resistencias a macrólidos y fluoroquinolonas se realizaron mediante Allplex™ NG &DR Assay (Seegene®).

Resultados: . Se incluyeron 1.415 pacientes, de los cuales 112 fueron positivos para NG. Un paciente presentaba una mutación C2611T (0,9%) y en ningún paciente se detectó A2059G. Encontramos 67 pacientes (59,8%) positivos para S91F. Cuarenta y cuatro pacientes (39,3%) no presentaban mutaciones.

Conclusiones: Reportamos una baja prevalencia de mutaciones A2059G/C2611T a macrólidos y una alta prevalencia de S91F en NG. Los métodos moleculares para la detección de resistencias en NG podrían ser útiles en muestras directas no cultivables.

Keywords: Neisseria gonorrhoeae; antimicrobial resistance; azithromycin; ciprofloxacin; mutations.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Drug Resistance, Bacterial / genetics
  • Fluoroquinolones / pharmacology
  • Fluoroquinolones / therapeutic use
  • Gonorrhea* / drug therapy
  • Gonorrhea* / epidemiology
  • Humans
  • Macrolides / pharmacology
  • Macrolides / therapeutic use
  • Mutation
  • Neisseria gonorrhoeae* / genetics
  • Prevalence
  • Prospective Studies
  • Spain / epidemiology
  • Tertiary Care Centers

Substances

  • Fluoroquinolones
  • Macrolides
  • Anti-Bacterial Agents