The Prevalence of Antibiotic Tolerance in Neisseria gonorrhoeae Varies by Anatomical Site

• Published in: Pathogens (Basel) Vol. 13; no. 7; p. 538
• Main Authors: Balduck, Margaux, Strikker, Akim, Gestels, Zina, Abdellati, Saïd, Van den Bossche, Dorien, De Baetselier, Irith, Kenyon, Chris, Manoharan-Basil, Sheeba Santhini
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 26.06.2024
• Subjects: Anorectal; anorectal infection; Antibiotic tolerance; Antibiotics; Antimicrobial agents; antimicrobial resistance; Azithromycin; Ceftriaxone; Ciprofloxacin; Clinical isolates; Drug resistance; Glycerol; Gonorrhea; Infections; Mutation; Neisseria gonorrhoeae; Nutrients; Strains (organisms); Test methods; tolerance; urogenital infection; France; United States > US; ceftriaxone; urogenital infection; Neisseria gonorrhoeae; antimicrobial resistance; azithromycin; anorectal infection; tolerance; ciprofloxacin
• ISSN: 2076-0817; 2076-0817
• DOI: 10.3390/pathogens13070538

Tolerance enables bacteria to survive intermittent antibiotic exposure without an increase in antimicrobial susceptibility. In this study, we investigated the presence of tolerance to three antimicrobials, ceftriaxone, azithromycin and ciprofloxacin, in clinical isolates and the WHO (World Health Organization) reference panel of . We used the modified tolerance disk (TD test) to assess for tolerance to ceftriaxone, azithromycin and ciprofloxacin in 14 WHO reference strains and 62 clinical isolates-evenly divided between anorectal and urogenital infections. The isolates underwent a three-step incubation process wherein the isolates were exposed to an antibiotic disk for 20 h of incubation (Step I), followed by the replacement of the antibiotic disk with a nutrient disk for overnight incubation (Step II) and additional overnight incubation with extra nutrients (Step III). A total of 4 of the 62 clinical anorectal isolates and none of the urogenital isolates exhibited tolerance to azithromycin ( = 0.033). Tolerance to ceftriaxone and ciprofloxacin was observed in eight and four isolates, respectively, with no difference between infection sites. Tolerance was also detected in 8 (K, M, N, O, P, U, V, W) out of the 14 WHO reference strains, with varying patterns of tolerance to ceftriaxone ( = 8), ciprofloxacin ( = 2) and azithromycin ( = 1). This study identified ceftriaxone, azithromycin and ciprofloxacin tolerance in clinical and WHO reference isolates. Azithromycin tolerance was more common in anorectal than urogenital infections.