Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 24, Number 4—April 2018
Research

Cooperative Recognition of Internationally Disseminated Ceftriaxone-Resistant Neisseria gonorrhoeae Strain

Monica M. Lahra, Irene Martin, Walter Demczuk, Amy V. Jennison, Ken-Ichi Lee, Shu-Ichi Nakayama, Brigitte Lefebvre, Jean Longtin, Alison Ward, Michael R. Mulvey, Teodora Wi, Makoto Ohnishi, and David WhileyComments to Author 
Author affiliations: World Health Organization, Sydney, New South Wales, Australia (M.M. Lahra); University of New South Wales School of Medical Sciences, Sydney (M.M. Lahra); Public Health Agency of Canada, Winnipeg, Manitoba, Canada (I. Martin, W. Demczuk, M.R. Mulvey); Health Support Queensland, Brisbane, Queensland, Australia (A.V. Jennison); National Institute of Infectious Diseases, Tokyo, Japan (K.-I. Lee, S.-I. Nakayama, M. Ohnishi); Institut National de Sante Publique Québec, Ste-Anne-de-Bellevue, Quebec, Canada (B. Lefebvre, J. Longtin); Royal Adelaide Hospital, Adelaide, South Australia, Australia (A. Ward); World Health Organization, Geneva, Switzerland (T. Wi); National Institute of Infectious Diseases, Tokyo (M. Ohnishi); The University of Queensland Faculty of Medicine, Brisbane (D. Whiley)

Main Article

Table 2

PenA types identified in ceftriaxone-resistant Neisseria gonorrhoeae strains*

PenA type Strain ID Amino acid position in PenA protein (2,18)
34711111222222222223333333333333333333333333344444444444444444444555555555555555555
51000467000013678891112222223333444445777788800011134456666677888001111344455555677
 01403123440295811263467890125123563467836914702384882356903146251367323602367756
↑ ↑ ↑
0 M32091 MCAKDDVNYGEDQQAADRRAIVAGTDLNERLQPSPR.SRGAEFEITLNRRPAVLQIFESRENPTTAFANVAAHGGAPPKII.A
37 H041 ....E.ASHAGEE..VEKQVMPS.V.TTDTFL.ATQ.TMTPK.DVSV.K..VEVKVIA.KKEASI.LVY...N.ST.VQVVNV
42 F89 ....E.ASHAGEE..VEKQ.MTS.V.ATDTFLSATQ.TMTPK.DV..S.QKVEVKVIA.KKEA..PLVY...N.S........
60 FC428/ FC460/ A7536/
A7846/ 47707 ...................VMTS.V.PTDTFL.ATQ.TMTPK.DV..S.QKVEVKVIA.KKEASI.LVY...N.ST.VQVVNV
64 A8806 ....E.ASHAGEE......VMTS.V.PTDTFL.ATQ.TMTPK.DV..S.QKVEVKVIA.KKEASI.LVY...N.ST.VQVVNV

*Arrows indicate key amino acid positions associated with high level β-lactam resistance. PenA, penicillin-binding protein 2.

Main Article

References
  1. Ohnishi  M, Saika  T, Hoshina  S, Iwasaku  K, Nakayama  S, Watanabe  H, et al. Ceftriaxone-resistant Neisseria gonorrhoeae, Japan. Emerg Infect Dis. 2011;17:1489. DOIPubMedGoogle Scholar
  2. Ohnishi  M, Golparian  D, Shimuta  K, Saika  T, Hoshina  S, Iwasaku  K, et al. 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. DOIPubMedGoogle Scholar
  3. 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. DOIPubMedGoogle Scholar
  4. Cámara  J, Serra  J, Ayats  J, Bastida  T, Carnicer-Pont  D, Andreu  A, et al. Molecular characterization of two high-level ceftriaxone-resistant Neisseria gonorrhoeae isolates detected in Catalonia, Spain. J Antimicrob Chemother. 2012;67:185860. DOIPubMedGoogle Scholar
  5. Lahra  MM, Ryder  N, Whiley  DM. A new multidrug-resistant strain of Neisseria gonorrhoeae in Australia. N Engl J Med. 2014;371:18501. DOIPubMedGoogle Scholar
  6. Deguchi  T, Yasuda  M, Hatazaki  K, Kameyama  K, Horie  K, Kato  T, et al. New clinical strain of Neisseria gonorrhoeae with decreased susceptibility to ceftriaxone, Japan. Emerg Infect Dis. 2016;22:1424. DOIPubMedGoogle Scholar
  7. Nakayama  S, Shimuta  K, Furubayashi  K, Kawahata  T, Unemo  M, Ohnishi  M. New ceftriaxone- and multidrug-resistant Neisseria gonorrhoeae strain with a novel mosaic penA gene isolated in Japan. Antimicrob Agents Chemother. 2016;60:433941. DOIPubMedGoogle Scholar
  8. Lefebvre  B, Martin  I, Demczuk  W, Deshaies  L, Michaud  S, Labbé  AC, et al. Ceftriaxone-Resistant Neisseria gonorrhoeae, Canada, 2017. Emerg Infect Dis. 2018;24:3813. DOIPubMedGoogle Scholar
  9. Terkelsen  D, Tolstrup  J, Hundahl Johnsen  C, Lund  O, Kiellberg Larsen  H, Worning  P, et al. Multidrug-resistant Neisseria gonorrhoeae infection with ceftriaxone resistance and intermediate resistance to azithromycin, Denmark, 2017. Euro Surveill. 2017;22:42. DOIPubMedGoogle Scholar
  10. Unemo  M, Golparian  D, Sánchez-Busó  L, Grad  Y, Jacobsson  S, Ohnishi  M, et al. The novel 2016 WHO Neisseria gonorrhoeae reference strains for global quality assurance of laboratory investigations: phenotypic, genetic and reference genome characterization. J Antimicrob Chemother. 2016;71:3096108. DOIPubMedGoogle Scholar
  11. Clinical and Laboratory Standards Institute. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; approved standard, 10th edition (M07–A10). Wayne (PA): The Institute; 2015.
  12. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing: twenty-seventh informational supplement (M100–S27). Wayne (PA): The Institute; 2017.
  13. European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for the interpretation of MICs and zone diameters. 2017 [cited 2017 Oct 12]. http://www.eucast.org/clinical_breakpoints/
  14. Demczuk  W, Lynch  T, Martin  I, Van Domselaar  G, Graham  M, Bharat  A, et al. Whole-genome phylogenomic heterogeneity of Neisseria gonorrhoeae isolates with decreased cephalosporin susceptibility collected in Canada between 1989 and 2013. J Clin Microbiol. 2015;53:191200. DOIPubMedGoogle Scholar
  15. Bankevich  A, Nurk  S, Antipov  D, Gurevich  AA, Dvorkin  M, Kulikov  AS, et al. SPAdes: a new genome assembly algorithm and its applications to single-cell sequencing. J Comput Biol. 2012;19:45577. DOIPubMedGoogle Scholar
  16. Seemann  T. Prokka: rapid prokaryotic genome annotation. Bioinformatics. 2014;30:20689. DOIPubMedGoogle Scholar
  17. Petkau  A, Mabon  P, Sieffert  C, Knox  NC, Cabral  J, Iskander  M, et al. SNVPhyl: a single nucleotide variant phylogenomics pipeline for microbial genomic epidemiology. Microb Genom. 2017;3:e000116.PubMedGoogle Scholar
  18. Martin  IMC, Ison  CA, Aanensen  DM, Fenton  KA, Spratt  BG. Rapid sequence-based identification of gonococcal transmission clusters in a large metropolitan area. J Infect Dis. 2004;189:1497505. DOIPubMedGoogle Scholar
  19. Jolley  KA, Maiden  MCJ. BIGSdb: Scalable analysis of bacterial genome variation at the population level. BMC Bioinformatics. 2010;11:595. DOIPubMedGoogle Scholar
  20. Demczuk  W, Sidhu  S, Unemo  M, Whiley  DM, Allen  VG, Dillon  JR, et al. Neisseria gonorrhoeae sequence typing for antimicrobial resistance, a novel antimicrobial resistance multilocus typing scheme for tracking global dissemination of N. gonorrhoeae strains. J Clin Microbiol. 2017;55:145468. DOIPubMedGoogle Scholar
  21. World Health Organization. Report on global sexually transmitted infection surveillance 2015 Geneva: The Organization. 2016 [cited 16 Jan 2018]. http://apps.who.int/iris/bitstream/10665/249553/1/9789241565301-eng.pdf?ua=1
  22. Newman  L, Rowley  J, Vander Hoorn  S, Wijesooriya  NS, Unemo  M, Low  N, et al. Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting. PLoS One. 2015;10:e0143304. DOIPubMedGoogle Scholar
  23. 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. DOIPubMedGoogle Scholar
  24. Martin  I, Sawatzky  P, Liu  G, Allen  V, Lefebvre  B, Hoang  L, et al. Decline in decreased cephalosporin susceptibility and increase in azithromycin resistance in Neisseria gonorrhoeae, Canada. Emerg Infect Dis. 2016;22:657. DOIPubMedGoogle Scholar
  25. Wi  T, Lahra  MM, Ndowa  F, Bala  M, Dillon  JR, Ramon-Pardo  P, et al. Antimicrobial resistance in Neisseria gonorrhoeae: Global surveillance and a call for international collaborative action. PLoS Med. 2017;14:e1002344. DOIPubMedGoogle Scholar

Main Article

Page created: March 19, 2018
Page updated: March 19, 2018
Page reviewed: March 19, 2018
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external