Sustained Transmission of Neisseria gonorrhoeae Strains with High-Level Azithromycin Resistance (MIC ≥ 256 μg/mL) in Argentina, 2018 to 2022
ABSTRACT Azithromycin combined with ceftriaxone is the recommended dual therapy for uncomplicated gonorrhea in many countries. Nevertheless, the increasing prevalence of azithromycin resistance compromises the effectiveness of this treatment strategy. From 2018 to 2022, we collected 13 gonococcal is...
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| Format: | Article |
| Language: | English |
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American Society for Microbiology
2023-08-01
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| Series: | Microbiology Spectrum |
| Subjects: | |
| Online Access: | https://journals.asm.org/doi/10.1128/spectrum.00970-23 |
| _version_ | 1828717717779120128 |
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| author | Ricardo Ariel Gianecini Tomas Poklepovich Daniel Golparian Noelia Cuenca Laura Scocozza Silvina Bergese Liliana Fernández Canigia Viviana Vilches María Julia Lazzarino Elgart Magnus Unemo Josefina Campos Patricia Galarza |
| author_facet | Ricardo Ariel Gianecini Tomas Poklepovich Daniel Golparian Noelia Cuenca Laura Scocozza Silvina Bergese Liliana Fernández Canigia Viviana Vilches María Julia Lazzarino Elgart Magnus Unemo Josefina Campos Patricia Galarza |
| author_sort | Ricardo Ariel Gianecini |
| collection | DOAJ |
| description | ABSTRACT Azithromycin combined with ceftriaxone is the recommended dual therapy for uncomplicated gonorrhea in many countries. Nevertheless, the increasing prevalence of azithromycin resistance compromises the effectiveness of this treatment strategy. From 2018 to 2022, we collected 13 gonococcal isolates with high-level azithromycin resistance (MIC ≥ 256 μg/mL) across Argentina. Whole-genome sequencing revealed that these isolates were mainly represented by the internationally spreading Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST) genogroup G12302, containing the 23S rRNA A2059G mutation (in all four alleles) together with mosaic mtrD and mtrR promoter 2 loci. This information is important to develop targeted public health policies to control the spread of azithromycin-resistant N. gonorrhoeae in Argentina and internationally. IMPORTANCE Azithromycin resistance in Neisseria gonorrhoeae has been increasing in numerous populations worldwide, which is of concern, as azithromycin is part of the recommended dual treatment in many countries. Here, we report 13 N. gonorrhoeae isolates with high-level azithromycin resistance (MIC ≥ 256 μg/mL). This study observed that high-level azithromycin-resistant gonococcal strains have shown sustained transmission in Argentina and are related to the successful international clone NG-MAST G12302. Genomic surveillance together with real-time tracing and data-sharing networks will be crucial in controlling the spread of azithromycin resistance in gonococcus. |
| first_indexed | 2024-03-12T14:31:32Z |
| format | Article |
| id | doaj.art-8b894c7a969d4d9193f7001340fcafc1 |
| institution | Directory Open Access Journal |
| issn | 2165-0497 |
| language | English |
| last_indexed | 2024-03-12T14:31:32Z |
| publishDate | 2023-08-01 |
| publisher | American Society for Microbiology |
| record_format | Article |
| series | Microbiology Spectrum |
| spelling | doaj.art-8b894c7a969d4d9193f7001340fcafc12023-08-17T13:04:13ZengAmerican Society for MicrobiologyMicrobiology Spectrum2165-04972023-08-0111410.1128/spectrum.00970-23Sustained Transmission of Neisseria gonorrhoeae Strains with High-Level Azithromycin Resistance (MIC ≥ 256 μg/mL) in Argentina, 2018 to 2022Ricardo Ariel Gianecini0Tomas Poklepovich1Daniel Golparian2Noelia Cuenca3Laura Scocozza4Silvina Bergese5Liliana Fernández Canigia6Viviana Vilches7María Julia Lazzarino Elgart8Magnus Unemo9Josefina Campos10Patricia Galarza11World Health Organization Collaborating Centre for Antimicrobial Resistance, National Reference Laboratory of Sexually Transmitted Diseases (STD), National Institute of Infectious Diseases - ANLIS “Dr. Carlos G. Malbrán”, Ciudad Autónoma de Buenos Aires, ArgentinaNational Center of Genomics and Bioinformatics - ANLIS “Dr. Carlos G. Malbrán”, Ciudad Autónoma de Buenos Aires, ArgentinaWorld Health Organization Collaborating Centre for Gonorrhoea and Other STIs, Örebro University, Örebro, SwedenWorld Health Organization Collaborating Centre for Antimicrobial Resistance, National Reference Laboratory of Sexually Transmitted Diseases (STD), National Institute of Infectious Diseases - ANLIS “Dr. Carlos G. Malbrán”, Ciudad Autónoma de Buenos Aires, ArgentinaLaboratorio Bacteriología, Hospital Fernández, Ciudad Autónoma de Buenos Aires, ArgentinaLaboratorio Bacteriología, Hospital Alemán, Ciudad Autónoma de Buenos Aires, ArgentinaLaboratorio Bacteriología, Hospital Alemán, Ciudad Autónoma de Buenos Aires, ArgentinaLaboratorio Microbiología, Hospital Universitario Austral, Buenos Aires, ArgentinaLaboratorio Bacteriología, Hospital Rawson, Córdoba, ArgentinaWorld Health Organization Collaborating Centre for Gonorrhoea and Other STIs, Örebro University, Örebro, SwedenNational Center of Genomics and Bioinformatics - ANLIS “Dr. Carlos G. Malbrán”, Ciudad Autónoma de Buenos Aires, ArgentinaWorld Health Organization Collaborating Centre for Antimicrobial Resistance, National Reference Laboratory of Sexually Transmitted Diseases (STD), National Institute of Infectious Diseases - ANLIS “Dr. Carlos G. Malbrán”, Ciudad Autónoma de Buenos Aires, ArgentinaABSTRACT Azithromycin combined with ceftriaxone is the recommended dual therapy for uncomplicated gonorrhea in many countries. Nevertheless, the increasing prevalence of azithromycin resistance compromises the effectiveness of this treatment strategy. From 2018 to 2022, we collected 13 gonococcal isolates with high-level azithromycin resistance (MIC ≥ 256 μg/mL) across Argentina. Whole-genome sequencing revealed that these isolates were mainly represented by the internationally spreading Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST) genogroup G12302, containing the 23S rRNA A2059G mutation (in all four alleles) together with mosaic mtrD and mtrR promoter 2 loci. This information is important to develop targeted public health policies to control the spread of azithromycin-resistant N. gonorrhoeae in Argentina and internationally. IMPORTANCE Azithromycin resistance in Neisseria gonorrhoeae has been increasing in numerous populations worldwide, which is of concern, as azithromycin is part of the recommended dual treatment in many countries. Here, we report 13 N. gonorrhoeae isolates with high-level azithromycin resistance (MIC ≥ 256 μg/mL). This study observed that high-level azithromycin-resistant gonococcal strains have shown sustained transmission in Argentina and are related to the successful international clone NG-MAST G12302. Genomic surveillance together with real-time tracing and data-sharing networks will be crucial in controlling the spread of azithromycin resistance in gonococcus.https://journals.asm.org/doi/10.1128/spectrum.00970-23gonorrheaazithromycinantimicrobial resistancetreatmentwhole-genome sequencing |
| spellingShingle | Ricardo Ariel Gianecini Tomas Poklepovich Daniel Golparian Noelia Cuenca Laura Scocozza Silvina Bergese Liliana Fernández Canigia Viviana Vilches María Julia Lazzarino Elgart Magnus Unemo Josefina Campos Patricia Galarza Sustained Transmission of Neisseria gonorrhoeae Strains with High-Level Azithromycin Resistance (MIC ≥ 256 μg/mL) in Argentina, 2018 to 2022 Microbiology Spectrum gonorrhea azithromycin antimicrobial resistance treatment whole-genome sequencing |
| title | Sustained Transmission of Neisseria gonorrhoeae Strains with High-Level Azithromycin Resistance (MIC ≥ 256 μg/mL) in Argentina, 2018 to 2022 |
| title_full | Sustained Transmission of Neisseria gonorrhoeae Strains with High-Level Azithromycin Resistance (MIC ≥ 256 μg/mL) in Argentina, 2018 to 2022 |
| title_fullStr | Sustained Transmission of Neisseria gonorrhoeae Strains with High-Level Azithromycin Resistance (MIC ≥ 256 μg/mL) in Argentina, 2018 to 2022 |
| title_full_unstemmed | Sustained Transmission of Neisseria gonorrhoeae Strains with High-Level Azithromycin Resistance (MIC ≥ 256 μg/mL) in Argentina, 2018 to 2022 |
| title_short | Sustained Transmission of Neisseria gonorrhoeae Strains with High-Level Azithromycin Resistance (MIC ≥ 256 μg/mL) in Argentina, 2018 to 2022 |
| title_sort | sustained transmission of neisseria gonorrhoeae strains with high level azithromycin resistance mic ≥ 256 μg ml in argentina 2018 to 2022 |
| topic | gonorrhea azithromycin antimicrobial resistance treatment whole-genome sequencing |
| url | https://journals.asm.org/doi/10.1128/spectrum.00970-23 |
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