Cooperative Recognition of Internationally Disseminated Ceftriaxone-Resistant Neisseria gonorrhoeae Strain

• Published in: Emerging infectious diseases Vol. 24; no. 4; pp. 735 - 740
• Main Authors: Lahra, Monica M., Martin, Irene, Demczuk, Walter, Jennison, Amy V., Lee, Ken-Ichi, Nakayama, Shu-Ichi, Lefebvre, Brigitte, Longtin, Jean, Ward, Alison, Mulvey, Michael R., Wi, Teodora, Ohnishi, Makoto, Whiley, David
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.04.2018; Centers for Disease Control and Prevention
• Subjects: beta-Lactam Resistance; beta-Lactamase Inhibitors - pharmacology; Care and treatment; cefixime; Ceftriaxone; Ceftriaxone - pharmacology; Cooperative Recognition of Internationally Disseminated Ceftriaxone-Resistant; Genome, Bacterial; Genomics - methods; gonorrhea; Gonorrhea - microbiology; gonorrhoeae; Humans; Microbial drug resistance; Microbial Sensitivity Tests; Neisseria gonorrhoeae - classification; Neisseria gonorrhoeae - drug effects; Neisseria gonorrhoeae - genetics; Neisseria N. gonorrhoeae; Phylogeny; Polymorphism, Single Nucleotide; Strain; Tetracyclines; β-lactam; gentamycin; penicillin; gonorrhea; Japan; spectinomycin; azithromycin; β-lactam; cephalosporin; Spain; Canada; ceftriaxone; Neisseria gonorrhoeae; antimicrobial resistance; China; cefixime; tetracycline; Australia; France; penA gene; ciprofloxacin; penicillinase
• ISSN: 1080-6040; 1080-6059; 1080-6059
• DOI: 10.3201/eid2404.171873

Ceftriaxone remains a first-line treatment for patients infected by Neisseria gonorrhoeae in most settings. We investigated the possible spread of a ceftriaxone-resistant FC428 N. gonorrhoeae clone in Japan after recent isolation of similar strains in Denmark (GK124) and Canada (47707). We report 2 instances of the FC428 clone in Australia in heterosexual men traveling from Asia. Our bioinformatic analyses included core single-nucleotide variation phylogeny and in silico molecular typing; phylogenetic analysis showed close genetic relatedness among all 5 isolates. Results showed multilocus sequence type 1903; N. gonorrhoeae sequence typing for antimicrobial resistance (NG-STAR) 233; and harboring of mosaic penA allele encoding alterations A311V and T483S (penA-60.001), associated with ceftriaxone resistance. Our results provide further evidence of international transmission of ceftriaxone-resistant N. gonorrhoeae. We recommend increasing awareness of international spread of this drug-resistant strain, strengthening surveillance to include identifying treatment failures and contacts, and strengthening international sharing of data.