Multidrug-resistant Neisseria gonorrhoeae infection in heterosexual men with reduced susceptibility to ceftriaxone, first report in Thailand
Year: 2021
Type: article
Abstract: The global rapid emergence of azithromycin/ceftriaxone resistant Neisseria gonorrhoeae threatens current recommend azithromycin/ceftriaxone dual therapy for gonorrhea to ensure effective treatment. Here, we identified the first two N. gonorrhoeae isolates with decreased ceftriaxone susceptibility in Thailand. Among 134 N. gonorrhoeae isolates collected from Thai Red Cross Anonymous Clinic, Bangkok, two isolates (NG-083 and NG-091) from urethral swab in male heterosexual patients had reduced susceptibility to ceftriaxone (MICs of 0.125 mg/L). Both were multidrug resistant and strong biofilm producers with ceftriaxone tolerance (MBEC > 128 mg/L). NG-083 and NG-091 remained susceptible to azithromycin (MIC of 1 mg/L and 0.5 mg/L, respectively). Reduced susceptibility to ceftriaxone was associated with alterations in PBP2, PBP1, PorB, MtrR, and mtrR promoter region. NG-083 belonged to sequence type (ST) 7235 and NG-091 has new allele number of tbpB with new ST. Molecular docking revealed ceftriaxone weakly occupied the active site of mosaic XXXIV penicillin-binding protein 2 variant in both isolates. Molecular epidemiology results revealed that both isolates display similarities with isolates from UK, USA, and The Netherlands. These first two genetically related gonococcal isolates with decreased ceftriaxone susceptibility heralds the threat of treatment failure in Thailand, and importance of careful surveillance.
Source: Scientific Reports
Authors: Naris Kueakulpattana, Dhammika Leshan Wannigama, Sirirat Luk-in, Parichart Hongsing, Cameron Hurst, Vishnu Nayak Badavath, Piroon Jenjaroenpun, Thidathip Wongsurawat, Nipat Teeratakulpisan, Stephen J. Kerr, Shuichi Abe, Phatthranit Phattharapornjaroen, Aye Mya Sithu Shein, Thammakorn Saethang, Naphat Chantaravisoot, Mohan Amarasiri, Paul G. Higgins, Tanittha Chatsuwan
Institutions: Thai Red Cross Society, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The University of Western Australia, Mahidol University, Mae Fah Luang University, Mae Fah Luang University Hospital, Mae Fah Luang University Hospital, Chiang Rai, QIMR Berghofer Medical Research Institute, Hebrew University of Jerusalem, Chitkara University, Siriraj Hospital, HIV Netherlands Australia Thailand Research Collaboration, Yamagata Prefectural Central Hospital, Ramathibodi Hospital, Kasetsart University, Kitasato University, University of Cologne, University Hospital Cologne
Language: English
Subfield: Microbiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,990
OpenAlex ID: W3209107905