Multidrug-resistant Isolate SE690: Mosaic Gene Causing Ceftriaxone Resistance Internationally Has Spread to the More Antimicrobial-susceptible Genomic Lineage, Sweden, September 2022

Overview

Journal Euro Surveill

Specialty Infectious Diseases

Date 2023 Mar 9

PMID 36892469

Authors

Daniel Golparian

Nora Vestberg

Wiktor Sodersten

Susanne Jacobsson

Makoto Ohnishi

Hong Fang

Karin Haij Bhattarai

Magnus Unemo

Affiliations

Soon will be listed here.

Abstract

We report a ceftriaxone-resistant, multidrug-resistant urogenital in a female sex worker in Sweden, September 2022, who was treated with ceftriaxone 1 g, but did not return for test-of-cure. Whole genome sequencing of isolate SE690 identified MLST ST8130, NG-STAR CC1885 (new NG-STAR ST4859) and mosaic . The latter, causing ceftriaxone resistance in the internationally spreading FC428 clone, has now also spread to the more antimicrobial-susceptible genomic lineage B, showing that strains across the gonococcal phylogeny can develop ceftriaxone resistance.

Citing Articles

Differential contribution of PBP occupancy and efflux on the effectiveness of β-lactams at their target site in clinical isolates of Neisseria gonorrhoeae.

Lopez-Arguello S, Alcoceba E, Ordonez P, Taltavull B, Cabot G, Gomis-Font M PLoS Pathog. 2024; 20(12):e1012783.

PMID: 39739989 PMC: 11729944. DOI: 10.1371/journal.ppat.1012783.

Multigeographic clinical assessment of a molecular diagnostic assay for detection of key codons to predict decreased susceptibility or resistance to cephalosporins in .

Wang L, Li Y, Xiu L, Hu L, Huang J, Yong G Antimicrob Agents Chemother. 2024; 68(12):e0116524.

PMID: 39470197 PMC: 11620283. DOI: 10.1128/aac.01165-24.

Data quality assessment of the Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP), Thailand, 2015-2021.

Tongtoyai J, Cherdtrakulkiat T, Girdthep N, Masciotra S, Winaitham S, Sangprasert P PLoS One. 2024; 19(7):e0305296.

PMID: 38968209 PMC: 11226028. DOI: 10.1371/journal.pone.0305296.

The novel 2024 WHO Neisseria gonorrhoeae reference strains for global quality assurance of laboratory investigations and superseded WHO N. gonorrhoeae reference strains-phenotypic, genetic and reference genome characterization.

Unemo M, Sanchez-Buso L, Golparian D, Jacobsson S, Shimuta K, Lan P J Antimicrob Chemother. 2024; 79(8):1885-1899.

PMID: 38889110 PMC: 11290888. DOI: 10.1093/jac/dkae176.

Addressing Sexually Transmitted Infections Due to in the Present and Future.

Colon Perez J, Villarino Fernandez R, Dominguez Lago A, Trevino Castellano M, Perez Del Molino Bernal M, Sanchez Poza S Microorganisms. 2024; 12(5).

PMID: 38792714 PMC: 11124187. DOI: 10.3390/microorganisms12050884.

References

Eyre D, Sanderson N, Lord E, Regisford-Reimmer N, Chau K, Barker L . Gonorrhoea treatment failure caused by a strain with combined ceftriaxone and high-level azithromycin resistance, England, February 2018. Euro Surveill. 2018; 23(27). PMC: 6152157. DOI: 10.2807/1560-7917.ES.2018.23.27.1800323. View

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(7):4339-41. PMC: 4914677. DOI: 10.1128/AAC.00504-16. View

Jacobsson S, Golparian D, Oxelbark J, Franceschi F, Brown D, Louie A . Pharmacodynamic Evaluation of Zoliflodacin Treatment of Strains With Amino Acid Substitutions in the Zoliflodacin Target GyrB Using a Dynamic Hollow Fiber Infection Model. Front Pharmacol. 2022; 13:874176. PMC: 9046595. DOI: 10.3389/fphar.2022.874176. View

Igawa G, Yamagishi Y, Lee K, Dorin M, Shimuta K, Suematsu H . Neisseria cinerea with High Ceftriaxone MIC Is a Source of Ceftriaxone and Cefixime Resistance-Mediating Sequences in Neisseria gonorrhoeae. Antimicrob Agents Chemother. 2018; 62(3). PMC: 5826163. DOI: 10.1128/AAC.02069-17. View

Lahra M, Martin I, Demczuk W, Jennison A, Lee K, Nakayama S . Cooperative Recognition of Internationally Disseminated Ceftriaxone-Resistant Neisseria gonorrhoeae Strain. Emerg Infect Dis. 2018; 24(4). PMC: 5875269. DOI: 10.3201/eid2404.171873. View

Jacobsson S, Golparian D, Oxelbark J, Wicha W, da Costa R, Franceschi F . Pharmacodynamic evaluation of lefamulin in the treatment of gonorrhea using a hollow fiber infection model simulating infections. Front Pharmacol. 2022; 13:1035841. PMC: 9702083. DOI: 10.3389/fphar.2022.1035841. View

Unemo M, Golparian D, Sanchez-Buso L, Grad Y, Jacobsson S, Ohnishi M . 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(11):3096-3108. PMC: 5079299. DOI: 10.1093/jac/dkw288. View

Golparian D, Ohlsson A, Janson H, Lidbrink P, Richtner T, Ekelund O . Four treatment failures of pharyngeal gonorrhoea with ceftriaxone (500 mg) or cefotaxime (500 mg), Sweden, 2013 and 2014. Euro Surveill. 2014; 19(30). DOI: 10.2807/1560-7917.es2014.19.30.20862. View

Unemo M, Shafer W . Antimicrobial resistance in Neisseria gonorrhoeae in the 21st century: past, evolution, and future. Clin Microbiol Rev. 2014; 27(3):587-613. PMC: 4135894. DOI: 10.1128/CMR.00010-14. View

10.

Kanesaka I, Ohno A, Kanayama Katsuse A, Takahashi H, Kobayashi I . The emergence of the ceftriaxone-resistant Neisseria gonorrhoeae FC428 clone by transfer of resistance from an oral Neisseria subflava reservoir of resistance. J Antimicrob Chemother. 2021; 77(2):364-373. DOI: 10.1093/jac/dkab390. View

11.

Unemo M, Lahra M, Escher M, Eremin S, Cole M, Galarza P . WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017-18: a retrospective observational study. Lancet Microbe. 2022; 2(11):e627-e636. DOI: 10.1016/S2666-5247(21)00171-3. View

12.

Hadad R, Golparian D, Velicko I, Ohlsson A, Lindroth Y, Ericson E . First National Genomic Epidemiological Study of Strains Spreading Across Sweden in 2016. Front Microbiol. 2022; 12:820998. PMC: 8794790. DOI: 10.3389/fmicb.2021.820998. View

13.

Poncin T, Merimeche M, Braille A, Mainardis M, Bebear C, Jacquier H . Two cases of multidrug-resistant related to travel in south-eastern Asia, France, June 2019. Euro Surveill. 2019; 24(36). PMC: 6737829. DOI: 10.2807/1560-7917.ES.2019.24.36.1900528. View

14.

Pleininger S, Indra A, Golparian D, Heger F, Schindler S, Jacobsson S . Extensively drug-resistant (XDR) causing possible gonorrhoea treatment failure with ceftriaxone plus azithromycin in Austria, April 2022. Euro Surveill. 2022; 27(24). PMC: 9205165. DOI: 10.2807/1560-7917.ES.2022.27.24.2200455. View

15.

Day M, Pitt R, Mody N, Saunders J, Rai R, Nori A . Detection of 10 cases of ceftriaxone-resistant in the United Kingdom, December 2021 to June 2022. Euro Surveill. 2022; 27(46). PMC: 9673238. DOI: 10.2807/1560-7917.ES.2022.27.46.2200803. View

16.

Golparian D, Jacobsson S, Sanchez-Buso L, Bazzo M, Lan P, Galarza P . GyrB in silico mining in 27 151 global gonococcal genomes from 1928-2021 combined with zoliflodacin in vitro testing of 71 international gonococcal isolates with different GyrB, ParC and ParE substitutions confirms high susceptibility. J Antimicrob Chemother. 2022; 78(1):150-154. DOI: 10.1093/jac/dkac366. View

17.

Golparian D, Pleininger S, Jacobsson S, Indra A, Unemo M . Complete Reference Genome Sequence of the Extensively Drug-Resistant Strain Neisseria gonorrhoeae AT159, with Ceftriaxone Resistance and High-Level Azithromycin Resistance, Using Nanopore Q20+ Chemistry and Illumina Sequencing. Microbiol Resour Announc. 2022; 11(9):e0074422. PMC: 9476915. DOI: 10.1128/mra.00744-22. View

18.

Taylor S, Marrazzo J, Batteiger B, Hook 3rd E, Sena A, Long J . Single-Dose Zoliflodacin (ETX0914) for Treatment of Urogenital Gonorrhea. N Engl J Med. 2018; 379(19):1835-1845. DOI: 10.1056/NEJMoa1706988. View

19.

Zhou K, Chen S, Yang F, van der Veen S, Yin Y . Impact of the gonococcal FC428 allele 60.001 on ceftriaxone resistance and biological fitness. Emerg Microbes Infect. 2020; 9(1):1219-1229. PMC: 7448936. DOI: 10.1080/22221751.2020.1773325. View

20.

Jacobsson S, Paukner S, Golparian D, Jensen J, Unemo M . Activity of the Novel Pleuromutilin Lefamulin (BC-3781) and Effect of Efflux Pump Inactivation on Multidrug-Resistant and Extensively Drug-Resistant Neisseria gonorrhoeae. Antimicrob Agents Chemother. 2017; 61(11). PMC: 5655042. DOI: 10.1128/AAC.01497-17. View