Neisseria gonorrhoeae antimicrobial susceptibility in Barcelona: penA, ponA, mtrR, and porB mutations and NG-MAST sequence types associated with decreased susceptibility to cephalosporins

  • J. Serra-Pladevall
  • M. J. Barberá
  • S. Rodriguez
  • R. Bartolomé-Comas
  • G. Roig
  • R. Juvé
  • A. Andreu
Original Article
First Online:
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Accepted:

Abstract

The aims of this study were to determine the antimicrobial susceptibility of Neisseria gonorrhoeae (NG) in our area, to analyze the molecular mechanisms involved in cephalosporins resistance, and to undertake molecular typing of our NG strains. Antimicrobial susceptibility was determined using the Etest. The genes penA, mtrR, penB, and ponA were studied. Molecular typing was performed by N. gonorrhoeae multiantigen sequence typing. Of 329 strains analyzed in 2013, none showed high-level cephalosporin resistance, but 8.2 % had resistance to cefixime [minimum inhibitory concentration (MIC) > 0.125 μg/mL] and 0.6 % to ceftriaxone (MIC > 0.125 μg/mL). Azithromycin resistance was documented in 4.3 % and ciprofloxacin resistance in 49.2 %. Among 48 strains with an MIC ≥ 0.125 μg/mL to cefixime, 58.3 % showed the penA mosaic pattern XXXIV, 98 % a Leu → Pro substitution at position 421 of the ponA gene, 100 % amino acid changes at positions 101 and 102 of the PorB1b porin, and 87.5 % of strains an adenine deletion in the promoter region of the MtrC-D-E efflux pump. A significant difference between strains with and without decreased cephalosporin susceptibility (MIC ≥ 0.125 μg/mL) was observed for these four genes. Of the 48 strains with an MIC ≥ 0.125 μg/mL to cefixime, 43.8 % belonged to the genogroup G1407 and 27.1 % belonged to the genogroup G2400. A significant association of G1407 with decreased susceptibility (MIC ≥ 0.125 μg/mL) and G2992 with susceptibility was found, and also between G1407 and mosaic pattern XXXIV and between G2400 and A501T substitution in penA. The NG resistance rate in our area is higher than the median of Europe. We have detected the emergence of G2400, which may be a source of antimicrobial resistance.

Keywords

Minimum Inhibitory Concentration Cephalosporin Ceftriaxone Cefixime Neisseria Gonorrhoeae 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Notes

Compliance with ethical standards

Funding

This study was funded by a grant (PI12/01808) from Instituto de Salud Carlos III, cofinanced by the European Regional Development Fund.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • J. Serra-Pladevall
    • 1
    • 2
  • M. J. Barberá
    • 3
  • S. Rodriguez
    • 4
  • R. Bartolomé-Comas
    • 1
    • 2
  • G. Roig
    • 1
  • R. Juvé
    • 1
  • A. Andreu
    • 1
    • 2
  1. 1.Microbiology DepartmentHospital Universitari Vall d’HebronBarcelonaSpain
  2. 2.Genetics and Microbiology DepartmentUniversitat Autonoma de BarcelonaCerdanyolaSpain
  3. 3.Infectious Disease DepartmentHospital Universitari Vall d’HebronBarcelonaSpain
  4. 4.Universitat de BarcelonaBarcelonaSpain

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