Evidence for Clonally Associated Increasing Rates of Azithromycin Resistant Neisseria gonorrhoeae in Rio de Janeiro, Brazil

Azithromycin is one of the drugs used in the combined therapy for syndromic treatment of gonorrhoea in many countries, including Brazil. Our research group, which receives isolates from clinical laboratories since 2006, has detected, after 2016, a tendency of rising rates of azithromycin resistance,...

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Published inBioMed research international Vol. 2019; no. 2019; pp. 1 - 6
Main Authors Bonelli, Raquel R., Caniné, Maria Cristina A., Francisco Junior, Ronaldo da S., Medeiros, Raphael C., Justo-da-Silva, Livia H., Skaf, Larissa B., Barros dos Santos, Késia T., Fracalanzza, Sergio E. L.
Format Journal Article
LanguageEnglish
Published Cairo, Egypt Hindawi Publishing Corporation 01.01.2019
Hindawi
Hindawi Limited
Subjects
Antibiotics
Azithromycin
Ceftriaxone
Epidemiology
Females
Laboratories
Minimum inhibitory concentration
Multilocus sequence typing
Mutation
Penicillin
Therapy
Brazil
United States > US
Rio de Janeiro Brazil
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Summary:Azithromycin is one of the drugs used in the combined therapy for syndromic treatment of gonorrhoea in many countries, including Brazil. Our research group, which receives isolates from clinical laboratories since 2006, has detected, after 2016, a tendency of rising rates of azithromycin resistance, with isolates showing higher minimal inhibitory concentrations (MICs) than those previously reported in this country. In this study, we report the susceptibility to azithromycin of 93 N. gonorrhoeae isolates obtained between 2014 and 2017. Strains with MIC ≥2 μg/mL were characterized according to azithromycin resistance mechanisms and strain typing. Results indicate that azithromycin resistance has emerged in all these years in unrelated MLST-STs, but after 2016 a clonal complex connected with ST1901 has been more frequently detected, grouping isolates with MIC varying from 2 to 64 μg/mL, with DelA mutations at the mtrR promoter region associated or not with mutations at rrl alleles. High rates of azithromycin resistance may compromise the use of this drug in the combined therapy with ceftriaxone. Inclusion of Rio de Janeiro in the Brazilian gonococcal surveillance program is important to evaluate if this data indicates an epidemiological phenomenon in the country.
Bibliography:ObjectType-Article-1
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Academic Editor: Klaus P. Hunfeld
ISSN:2314-6133
2314-6141
DOI:10.1155/2019/3180580