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In vitro activity of the ketolide cethromycin in multidrug-resistant clinical Neisseria gonorrhoeae isolates and international reference strains
Örebro University, School of Medical Sciences. Örebro University Hospital. WHO Collaborating Centre for Gonorrhoea and other STIs, National Reference Laboratory for Sexually Transmitted Infections, Department of Laboratory Medicine.
Global Antibiotic Research & Development Partnership (GARDP), Geneva, Switzerland.
Örebro University, School of Medical Sciences. Örebro University Hospital. WHO Collaborating Centre for Gonorrhoea and other STIs, National Reference Laboratory for Sexually Transmitted Infections, Department of Laboratory Medicine.ORCID iD: 0000-0003-1710-2081
2019 (English)In: Journal of chemotherapy, ISSN 1120-009X, E-ISSN 1973-9478Article in journal (Refereed) Epub ahead of print
Abstract [en]

Antimicrobial resistance in Neisseria gonorrhoeae is a major public health problem, which compromises the treatment of gonorrhoea globally. We evaluated the in vitro activity of the ketolide cethromycin against a large panel of clinical gonococcal isolates and international reference strains (n = 254), including numerous multidrug-resistant and extensively drug-resistant isolates. Cethromycin showed potent in vitro activity against most of the gonococcal isolates with the following modal MIC, MIC50 and MIC90: 0.064 mg/L, 0.125 mg/L and 0.5 mg/L, respectively. However, cross-resistance between azithromycin and cethromycin was identified (Spearman's rank correlation coefficient 0.917) and isolates displaying high-level resistance to azithromycin (MIC >256 mg/L; n = 9) also showed high MICs of cethromycin (32-256 mg/L). In conclusion, the cross-resistance with azithromycin indicates that cethromycin may not be considered for empirical first-line monotherapy of gonorrhoea. However, cethromycin might be valuable in combination antimicrobial therapy and for second-line therapy e.g. for cases with ceftriaxone resistance or allergy.

Place, publisher, year, edition, pages
Taylor & Francis, 2019.
Keywords [en]
ABT-773, antimicrobial resistance, cethromycin, gonorrhoea, ketolide, treatment
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:oru:diva-74349DOI: 10.1080/1120009X.2019.1615724ISI: 000469038500001PubMedID: 31106713OAI: oai:DiVA.org:oru-74349DiVA, id: diva2:1317084
Note

Funding Agencies:

Örebro County Council Research Committee  

Foundation for Medical Research at Örebro University Hospital, Örebro, Sweden  

Available from: 2019-05-21 Created: 2019-05-21 Last updated: 2019-06-20Bibliographically approved

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Jacobsson, SusanneUnemo, Magnus

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