Johan H Melendez, Vonetta L Edwards, Adamaris Muniz Tirado, Justin Hardick, Aditya Mehta, Jain Aluvathingal, Adonis D'Mello, Charlotte A Gaydos, Yukari C Manabe, Hervé Tettelin
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Publicly available WGS data from global HLR-AZM Ng (<i>n</i> = 286) and the Baltimore HLR-AZM Ng (<i>n</i> = 3) were used to assess the distribution, clonality, and diversity of HLR-AZM Ng. The HLR-AZM Ng isolates from Baltimore identified as multi-locus sequencing typing sequence type (ST) 9363 and likely emerged from circulating strains. ST9363 was the most widely disseminated ST globally represented in eight countries and was associated with sustained transmission events. The number of global HLR-AZM Ng, countries reporting these isolates, and strain diversity increased in the last decade. The majority (89.9%) of global HLR-AZM Ng harbored the A2059G mutation in all four alleles of the 23S rRNA gene, but isolates with two or three A2059G alleles, and alternative HLR-AZM mechanisms were also identified. In conclusion, HLR-AZM in Ng has increased in the last few years, with ST9363 emerging as an important gonococcal lineage globally. The 23S rRNA A2059G mutation is the most common resistance mechanism, but alternative mechanisms are emerging. Continued surveillance of HLR-AZM Ng, especially ST9363, and extensively drug-resistant Ng is warranted.</p>","PeriodicalId":8152,"journal":{"name":"Antimicrobial Agents and Chemotherapy","volume":" ","pages":"e0092724"},"PeriodicalIF":4.1000,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619321/pdf/","citationCount":"0","resultStr":"{\"title\":\"Local emergence and global evolution of <i>Neisseria gonorrhoeae</i> with high-level resistance to azithromycin.\",\"authors\":\"Johan H Melendez, Vonetta L Edwards, Adamaris Muniz Tirado, Justin Hardick, Aditya Mehta, Jain Aluvathingal, Adonis D'Mello, Charlotte A Gaydos, Yukari C Manabe, Hervé Tettelin\",\"doi\":\"10.1128/aac.00927-24\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Antimicrobial resistance in <i>Neisseria gonorrhoeae</i> (Ng) has severely reduced treatment options, including azithromycin (AZM), which had previously been recommended as dual therapy with ceftriaxone. This study characterizes the emergence of high-level resistance to AZM (HLR-AZM) Ng in Baltimore, Maryland, USA, and describes the global evolution of HLR-AZM Ng. Whole genome sequencing (WGS) of 30 Ng isolates with and without HLR-AZM from Baltimore was used to identify clonality and resistance determinants. Publicly available WGS data from global HLR-AZM Ng (<i>n</i> = 286) and the Baltimore HLR-AZM Ng (<i>n</i> = 3) were used to assess the distribution, clonality, and diversity of HLR-AZM Ng. The HLR-AZM Ng isolates from Baltimore identified as multi-locus sequencing typing sequence type (ST) 9363 and likely emerged from circulating strains. ST9363 was the most widely disseminated ST globally represented in eight countries and was associated with sustained transmission events. The number of global HLR-AZM Ng, countries reporting these isolates, and strain diversity increased in the last decade. The majority (89.9%) of global HLR-AZM Ng harbored the A2059G mutation in all four alleles of the 23S rRNA gene, but isolates with two or three A2059G alleles, and alternative HLR-AZM mechanisms were also identified. In conclusion, HLR-AZM in Ng has increased in the last few years, with ST9363 emerging as an important gonococcal lineage globally. The 23S rRNA A2059G mutation is the most common resistance mechanism, but alternative mechanisms are emerging. Continued surveillance of HLR-AZM Ng, especially ST9363, and extensively drug-resistant Ng is warranted.</p>\",\"PeriodicalId\":8152,\"journal\":{\"name\":\"Antimicrobial Agents and Chemotherapy\",\"volume\":\" \",\"pages\":\"e0092724\"},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2024-12-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619321/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Antimicrobial Agents and Chemotherapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1128/aac.00927-24\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/24 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"MICROBIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Antimicrobial Agents and Chemotherapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1128/aac.00927-24","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/24 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"MICROBIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
淋病奈瑟菌(Ng)的抗菌药耐药性严重减少了包括阿奇霉素(AZM)在内的治疗选择,而阿奇霉素曾被推荐与头孢曲松一起作为双重疗法。本研究描述了美国马里兰州巴尔的摩市出现的对 AZM(HLR-AZM)具有高水平耐药性的 Ng 的特征,并描述了 HLR-AZM Ng 的全球演变过程。对来自巴尔的摩的 30 个具有和不具有 HLR-AZM 的 Ng 分离物进行了全基因组测序(WGS),以确定克隆性和抗性决定因素。来自全球 HLR-AZM Ng(n = 286)和巴尔的摩 HLR-AZM Ng(n = 3)的公开 WGS 数据被用来评估 HLR-AZM Ng 的分布、克隆性和多样性。巴尔的摩的 HLR-AZM Ng 分离物被鉴定为多焦点测序分型序列类型 (ST) 9363,很可能来自循环菌株。ST9363 是全球传播最广的 ST,分布于八个国家,并与持续传播事件有关。在过去十年中,全球 HLR-AZM Ng 的数量、报告这些分离物的国家以及菌株多样性都有所增加。全球大多数(89.9%)的 HLR-AZM Ng 在 23S rRNA 基因的所有四个等位基因中都含有 A2059G 突变,但也发现了含有两个或三个 A2059G 等位基因的分离株,以及另一种 HLR-AZM 机制。总之,过去几年中,伍氏淋球菌的 HLR-AZM 有所增加,ST9363 已成为全球重要的淋球菌菌系。23S rRNA A2059G 突变是最常见的耐药机制,但替代机制正在出现。有必要继续监测 HLR-AZM Ng,尤其是 ST9363,以及广泛耐药的 Ng。
Local emergence and global evolution of Neisseria gonorrhoeae with high-level resistance to azithromycin.
Antimicrobial resistance in Neisseria gonorrhoeae (Ng) has severely reduced treatment options, including azithromycin (AZM), which had previously been recommended as dual therapy with ceftriaxone. This study characterizes the emergence of high-level resistance to AZM (HLR-AZM) Ng in Baltimore, Maryland, USA, and describes the global evolution of HLR-AZM Ng. Whole genome sequencing (WGS) of 30 Ng isolates with and without HLR-AZM from Baltimore was used to identify clonality and resistance determinants. Publicly available WGS data from global HLR-AZM Ng (n = 286) and the Baltimore HLR-AZM Ng (n = 3) were used to assess the distribution, clonality, and diversity of HLR-AZM Ng. The HLR-AZM Ng isolates from Baltimore identified as multi-locus sequencing typing sequence type (ST) 9363 and likely emerged from circulating strains. ST9363 was the most widely disseminated ST globally represented in eight countries and was associated with sustained transmission events. The number of global HLR-AZM Ng, countries reporting these isolates, and strain diversity increased in the last decade. The majority (89.9%) of global HLR-AZM Ng harbored the A2059G mutation in all four alleles of the 23S rRNA gene, but isolates with two or three A2059G alleles, and alternative HLR-AZM mechanisms were also identified. In conclusion, HLR-AZM in Ng has increased in the last few years, with ST9363 emerging as an important gonococcal lineage globally. The 23S rRNA A2059G mutation is the most common resistance mechanism, but alternative mechanisms are emerging. Continued surveillance of HLR-AZM Ng, especially ST9363, and extensively drug-resistant Ng is warranted.
期刊介绍:
Antimicrobial Agents and Chemotherapy (AAC) features interdisciplinary studies that build our understanding of the underlying mechanisms and therapeutic applications of antimicrobial and antiparasitic agents and chemotherapy.