Increase in Multidrug Resistant FC428-Like Isolates Harboring the Mosaic PenA 60.001 Gene, in Nanjing, China (2017-2020)

Overview

Journal Infect Drug Resist

Publisher Dove Medical Press

Date 2023 Jun 29

PMID 37383603

Authors

Yuanyuan Zhao

Wenjing Le

Caroline A Genco

Peter A Rice

Xiaohong Su

Affiliations

Soon will be listed here.

Abstract

Background: Since the first Chinese report of the ceftriaxone-resistant FC428 clone in 2016, additional FC428-like, 60.001 isolates have been identified in China.

Objective: To document the rise in 60.001 isolates in Nanjing, China, and characterize their molecular and epidemiological features.

Methods: minimum inhibitory concentrations (MICs, mg/L) for ceftriaxone, cefixime, penicillin, tetracycline, ciprofloxacin, azithromycin, spectinomycin, gentamicin and zoliflodacin were determined by agar dilution. MICs for ertapenem were measured by E-test. N. antimicrobial sequence typing (NG-STAR) of seven loci ( and ) was analyzed together with multiantigen sequence typing (NG-MAST) and multilocus sequence typing (MLST). Phylogenetic analysis was also performed using whole genomic sequencing (WGS).

Results: Fourteen FC428-related 60.001 infections were identified out of 677 infections from 2017 to 2020, in Nanjing, representing an incremental yearly rise in the percentage of the city's isolates that were FC428-related. Seven FC428-related N. infections were acquired in Nanjing, proper; four others in eastern Chinese cities and three from unknown locations. All FC428-related isolates were resistant to ceftriaxone, cefixime, ciprofloxacin, tetracycline and penicillin but susceptible to spectinomycin, gentamicin, ertapenem and zoliflodacin; three strains were resistant to azithromycin. 60.001 isolates displayed closely related MLST types and NG-STAR types but relatively distant NG-MAST types. WGS showed a phylogenetic analysis that intermingled with other international isolates.

Conclusion: 60.001 isolates emerged in Nanjing, China, beginning in 2017, and have continued to rise.

Citing Articles

Evaluating the efficacy of different antibiotics against Neisseria gonorrhoeae: a pharmacokinetic/pharmacodynamic analysis using Monte Carlo simulation.

Zhong J, Le W, Li X, Su X BMC Infect Dis. 2024; 24(1):104.

PMID: 38238655 PMC: 10797866. DOI: 10.1186/s12879-023-08938-x.

References

Su X, Jiang F, Qimuge , Dai X, Sun H, Ye S . Surveillance of antimicrobial susceptibilities in Neisseria gonorrhoeae in Nanjing, China, 1999-2006. Sex Transm Dis. 2007; 34(12):995-9. DOI: 10.1097/OLQ.0b013e3180ca8f24. 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

Wang H, Wang Y, Yong G, Li X, Yu L, Ma S . Emergence and genomic characterization of the ceftriaxone-resistant Neisseria gonorrhoeae FC428 clone in Chengdu, China. J Antimicrob Chemother. 2020; 75(9):2495-2498. DOI: 10.1093/jac/dkaa123. 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

Vincent L, Kerr S, Tan Y, Tomberg J, Raterman E, Dunning Hotopp J . -Selected Compensatory Mutations Restore the Fitness Cost of Mosaic Alleles That Confer Ceftriaxone Resistance in . mBio. 2018; 9(2). PMC: 5885032. DOI: 10.1128/mBio.01905-17. View

Lahra M, Ryder N, Whiley D . A new multidrug-resistant strain of Neisseria gonorrhoeae in Australia. N Engl J Med. 2014; 371(19):1850-1. DOI: 10.1056/NEJMc1408109. View

Ohnishi M, Golparian D, Shimuta K, Saika 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(7):3538-45. PMC: 3122416. DOI: 10.1128/AAC.00325-11. View

Demczuk W, Sidhu S, Unemo M, Whiley D, Allen V, Dillon J . 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(5):1454-1468. PMC: 5405263. DOI: 10.1128/JCM.00100-17. View

Chen S, Yuan L, Zhu X, van der Veen S, Yin Y . Sustained transmission of the ceftriaxone-resistant Neisseria gonorrhoeae FC428 clone in China. J Antimicrob Chemother. 2020; 75(9):2499-2502. DOI: 10.1093/jac/dkaa196. View

10.

Yang F, Zhang H, Chen Y, Zhai Y, Zhao F, Yu Y . Detection and analysis of two cases of the internationally spreading ceftriaxone-resistant Neisseria gonorrhoeae FC428 clone in China. J Antimicrob Chemother. 2019; 74(12):3635-3636. DOI: 10.1093/jac/dkz384. View

11.

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

12.

Yuan Q, Li Y, Xiu L, Zhang C, Fu Y, Jiang C . Identification of multidrug-resistant isolates with combined resistance to both ceftriaxone and azithromycin, China, 2017-2018. Emerg Microbes Infect. 2019; 8(1):1546-1549. PMC: 6830194. DOI: 10.1080/22221751.2019.1681242. View

13.

Terkelsen D, Tolstrup J, Johnsen C, Lund O, Larsen H, Worning P . Multidrug-resistant infection with ceftriaxone resistance and intermediate resistance to azithromycin, Denmark, 2017. Euro Surveill. 2017; 22(42). PMC: 5710115. DOI: 10.2807/1560-7917.ES.2017.22.42.17-00659. View

14.

Eyre D, Town K, Street T, Barker L, Sanderson N, Cole M . Detection in the United Kingdom of the FC428 clone, with ceftriaxone resistance and intermediate resistance to azithromycin, October to December 2018. Euro Surveill. 2019; 24(10). PMC: 6415501. DOI: 10.2807/1560-7917.ES.2019.24.10.1900147. View

15.

Jolley K, Maiden M . BIGSdb: Scalable analysis of bacterial genome variation at the population level. BMC Bioinformatics. 2010; 11:595. PMC: 3004885. DOI: 10.1186/1471-2105-11-595. View

16.

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

17.

Lee K, Nakayama S, Osawa K, Yoshida H, Arakawa S, Furubayashi K . Clonal expansion and spread of the ceftriaxone-resistant Neisseria gonorrhoeae strain FC428, identified in Japan in 2015, and closely related isolates. J Antimicrob Chemother. 2019; 74(7):1812-1819. DOI: 10.1093/jac/dkz129. View

18.

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

19.

Chen S, Han Y, Yuan L, Zhu X, Yin Y . Identification of Internationally Disseminated Ceftriaxone-Resistant Neisseria gonorrhoeae Strain FC428, China. Emerg Infect Dis. 2019; 25(7):1427-1429. PMC: 6590750. DOI: 10.3201/eid2507.190172. View

20.

Zhang L, Zhang C, Zeng Y, Li Y, Huang S, Wang F . Emergence and Characterization of a Ceftriaxone-Resistant FC428 Clone Evolving Moderate-Level Resistance to Azithromycin in Shenzhen, China. Infect Drug Resist. 2021; 14:4271-4276. PMC: 8541749. DOI: 10.2147/IDR.S336212. View