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Volume 22, Number 1—January 2016
Letter

New Clinical Strain of Neisseria gonorrhoeae with Decreased Susceptibility to Ceftriaxone, Japan

Takashi Deguchi1Comments to Author , Mitsuru Yasuda1, Kyoko Hatazaki1, Koji Kameyama, Kengo Horie, Taku Kato, Kohsuke Mizutani, Kensaku Seike, Tomohiro Tsuchiya, Shigeaki Yokoi, Masahiro Nakano, and Mutsumasa Yoh
Author affiliations: Gifu University, Gifu, Japan (T. Deguchi, M. Yasuda, K. Hatazaki, K. Kameyama, K. Horie, T. Kato, K. Mizutani, K. Seike, T. Tsuchiya, S. Yokoi, M. Nakano); Yoh Clinic, Inazawa, Japan (M. Yoh)

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Figure

Sequences of altered amino acids in penicillin-binding protein 2 (PBP2) of Neisseria gonorrhoeae strains with decreased susceptibility to oral cephalosporins and strains with resistance to ceftriaxone. Strain GU140106 was isolated from a urethral swab sample from a man in in Nagoya, Japan, who had received fellatio, without condom use, from a female sex worker. Sequences are aligned with wild-type PBP2 derived from nucleic acid sequence of the penA gene of penicillin-susceptible N. gonorrhoeae s

Figure. Sequences of altered amino acids in penicillin-binding protein 2 (PBP2) of Neisseria gonorrhoeae strains with decreased susceptibility to oral cephalosporins and strains with resistance to ceftriaxone. Strain GU140106 was isolated from a urethral swab sample from a man in in Nagoya, Japan, who had received fellatio, without condom use, from a female sex worker. Sequences are aligned with wild-type PBP2 derived from nucleic acid sequence of the penA gene of penicillin-susceptible N. gonorrhoeae strain LM306 (GenBank accession no. M32091). The PBP2 pattern X of strains with decreased susceptibility to oral cephalosporins is quoted from our previous study (6). The PBP2s of ceftriaxone-resistant strains H041 and F89 are derived from their penA genes (GenBank accession nos. AB546858 and JQ073701, respectively). The PBP2 of strain A8806, which has decreased susceptibility to ceftriaxone, is derived from the nucleic acid sequence of the penA gene (David M. Whiley, pers. comm., 2015). In strain H041, the concurrent presence of substitutions A311V, V316P, and T483S was reported to be responsible for conferring resistance to ceftriaxone (7). The PBP2 of strain GU140106 is derived from the nucleic acid sequence of the penA gene (GenBank accession no. LC056026); the strain has the same A311V and T483S substitutions as strain H041, but it has substitution V316T instead of V316P. The PBP2s of strains GU140106 and A8806 have the same amino acid substitutions at A311, V316, and T483. In addition, PBP2 of strain GU140106 has several amino acid changes in positions 227–281 that were not observed in other strains.

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References
  1. Ohnishi  M, Golparian  D, Shimuta  K, Sakai  T, Hoshina  S, Iwasaku  K, Is Neisseria gonorrhoeae initiating a future era of untreatable gonorrhea?: detailed characterization of the first strain with high-level resistance to ceftriaxone. Antimicrob Agents Chemother. 2011;55:353845. DOIPubMed
  2. Unemo  M, Golparian  D, Nicholas  R, Ohnishi  M, Gallay  A, Sednaoui  P. High-level cefixime- and ceftriaxone-resistant Neisseria gonorrhoeae in France: novel penA mosaic allele in a successful international clone causes treatment failure. Antimicrob Agents Chemother. 2012;56:127380. DOIPubMed
  3. Lahra  MM, Ryder  N, Whiley  DM. A new multidrug-resistant strain of Neisseria gonorrhoeae in Australia. N Engl J Med. 2014;371:18501. DOIPubMed
  4. Hjelmevoll  SO, Olsen  ME, Sollid  JU, Haaheim  H, Unemo  M, Skogen  V. A fast real-time polymerase chain reaction method for sensitive and specific detection of the Neisseria gonorrhoeae porA pseudogene. J Mol Diagn. 2006;8:57481. DOIPubMed
  5. European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 5.0, 2015 [cited 2015 May 1]. http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_5.0_Breakpoint_Table_01.pdf
  6. Ito  M, Deguchi  T, Mizutani  KS, Yasuda  M, Yokoi  S, Ito  S, Emergence and spread of Neisseria gonorrhoeae clinical isolates harboring mosaic-like structure of penicillin-binding protein 2 in Central Japan. Antimicrob Agents Chemother. 2005;49:13743. DOIPubMed
  7. Tomberg  J, Unemo  M, Ohnishi  M, Davies  C, Nicholas  RA. Identification of amino acids conferring high-level resistance to expanded-spectrum cephalosporins in the penA gene from Neisseria gonorrhoeae strain H041. Antimicrob Agents Chemother. 2013;57:302936. DOIPubMed
  8. Ohnishi  M, Watanabe  Y, Ono  E, Takahashi  C, Oya  H, Kuroki  T, Spread of a chromosomal cefixime-resistant penA gene among different Neisseria gonorrhoeae lineages. Antimicrob Agents Chemother. 2010;54:10607. DOIPubMed
  9. Unemo  M, Sjöstrand  A, Akhras  M, Gharizadeh  B, Lindbäck  E, Pourmand  N, Molecular characterization of Neisseria gonorrhoeae identifies transmission and resistance of one ciprofloxacin-resistant strain. APMIS. 2007;115:23141. DOIPubMed
  10. Chisholm  SA, Mouton  JW, Lewis  DA, Nichols  T, Ison  CA, Livermore  DM. Cephalosporin MIC creep among gonococci: time for a pharmacodynamic rethink? J Antimicrob Chemother. 2010;65:21418. DOIPubMed

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1These authors contributed equally to this article.

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