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Clonally Related Neisseria gonorrhoeae Isolates with Decreased Susceptibility to the Extended-Spectrum Cephalosporin Cefotaxime in Amsterdam, the Netherlands
Public Health Laboratory, Cluster of Infectious Diseases, Health Service of Amsterdam, Netherlands.
Public Health Laboratory, Cluster of Infectious Diseases, Health Service of Amsterdam, Netherlands; University of Amsterdam, Department of Experimental Virology, Amsterdam, Netherlands.
WHO Collaborating Centre for Gonorrhoea and Other STIs, Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.
Örebro University Hospital. Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. WHO Collaborating Centre for Gonorrhoea and Other STIs, Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0003-1710-2081
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2012 (English)In: Antimicrobial Agents and Chemotherapy, ISSN 0066-4804, E-ISSN 1098-6596, Vol. 56, no 3, 1516-1522 p.Article in journal (Refereed) Published
Abstract [en]

From 2006 to 2008, Neisseria gonorrhoeae isolates were identified with decreased susceptibility to the extended-spectrum cephalosporin (ESC) cefotaxime among visitors of the Amsterdam sexually transmitted infections (STI) clinic, the Netherlands. Spread, clonality, and characteristics of 202 isolates were examined using antibiograms, conventional penA mosaic gene PCR, and N. gonorrhoeae multiple-locus variable-number tandem repeat analysis (NG-MLVA). A strictly defined subset was further characterized by N. gonorrhoeae multiantigen sequence typing (NG-MAST) and sequencing of ESC resistance determinants (penA, mtrR, and porB1b). Seventy-four N. gonorrhoeae isolates with a cefotaxime MIC of >0.125 mu g/ml (group A), 54 with a cefotaxime MIC of 0.125 mu g/ml (group B), and a control group of 74 with a cefotaxime MIC of <0.125 mu g/ml (group C) were included. Fifty-three clonally related penA mosaic-positive isolates (penicillin-binding protein 2 type XXXIV) were identified in group A (n = 47 isolates; 64%) and B (n = 6 isolates; 11%). The 53 penA mosaic-positive isolates were predominantly NG-MAST ST1407 (87%) and contained an mtrR promoter A deletion (98%) and porB1b alterations G101K/A102N. All were assigned to the same NG-MLVA cluster that comprised in total 56 isolates. A correlation was found between decreased cefotaxime susceptibility and ST1407 that was highly prevalent among visitors of the Amsterdam STI clinic. The rapid spread of this strain, which also has been identified in many other countries, might be facilitated by high-risk sexual behavior and should be monitored closely to identify potential treatment failure. Quality-assured surveillance of ESC susceptibility on the national and international levels and exploration of new drugs and/or strategies for treatment of gonorrhea are crucial.

Place, publisher, year, edition, pages
American Society for Microbiology , 2012. Vol. 56, no 3, 1516-1522 p.
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Pharmacology and Toxicology Microbiology in the medical area
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URN: urn:nbn:se:oru:diva-58678DOI: 10.1128/AAC.05481-11ISI: 000300623300048PubMedID: 22214779Scopus ID: 2-s2.0-84857185363OAI: oai:DiVA.org:oru-58678DiVA: diva2:1121830
Available from: 2017-07-12 Created: 2017-07-12 Last updated: 2017-10-18Bibliographically approved

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Golparian, DanielUnemo, Magnus

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Örebro University HospitalSchool of Health and Medical Sciences, Örebro University, Sweden
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Pharmacology and ToxicologyMicrobiology in the medical area

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