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Emergence and evolution of internationally disseminated cephalosporin-resistant Neisseria gonorrhoeae clones from 1995 to 2005 in Japan
National Institute of Infectious Diseases, Tokyo, Japan.
Kanagawa Prefectural Institute of Public Health, Kanagawa, Japan.
National Institute of Infectious Diseases, Tokyo, Japan.
National Institute of Infectious Diseases, Tokyo, Japan.
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2015 (English)In: BMC Infectious Diseases, ISSN 1471-2334, E-ISSN 1471-2334, Vol. 15, 378Article in journal (Refereed) Published
Abstract [en]

Background: Neisseria gonorrhoeae strains with resistance to extended-spectrum cephalosporins (ESCs), last options for first-line monotherapy of gonorrhoea, likely emerged and initially disseminated in Japan, followed by international transmission. In recent years, multi-locus sequence typing (MLST) ST1901 and N. gonorrhoeae multiantigen sequence typing (NG-MAST) ST1407 isolates with the mosaic penicillin-binding protein (PBP) 2 XXXIV have accounted for most ESC resistance globally. Our aim was to elucidate the initial emergence and transmission of ESC-resistant strains by detailed examination of N. gonorrhoeae isolates from 1995 to 2005 in Kanagawa, Japan.

Methods: N. gonorrhoeae isolates were examined phenotypically (n = 690) and genetically (n = 372) by agar dilution method (cefixime, ceftriaxone and ciprofloxacin), penA gene sequencing, MLST and NG-MAST.

Results: Already in 1995, one cefixime-resistant (CFM-R) isolate was found, which is the first CFM-R isolate described globally. After 1996, the prevalence of CFM-R and CFM-decreased susceptibility (CFM-DS) isolates significantly increased, with the peak resistance level in 2002 (57.1 % CFM-R). In 1997-2002, the CFM-R MLST ST7363 strain type with the mosaic PBP 2 X was predominant among CFM-R/DS isolates. The first CFM-R/DS MLST ST1901 clone(s), which became the predominant CFM-R/DS strain type(s) already in 2003-2005, possessed the mosaic PBP 2 X, which was possibly originally transferred from the MLST ST7363 strains, and subsequently acquired the mosaic PBP 2 XXXIV. The first MLST ST1901 and NG-MAST ST1407 isolate was identified in Kanagawa already in 2003.

Conclusions: The two main internationally spread cefixime-resistant gonococcal clones, MLST ST7363 and ST1901 (NG-MAST ST1407 most frequent internationally) that also have shown their capacity to develop high-level ceftriaxone resistance (superbugs H041 and F89), likely emerged, evolved and started to disseminate in the metropolitan area, including Kanagawa, in Japan, which was followed by global transmission.

Place, publisher, year, edition, pages
2015. Vol. 15, 378
National Category
Infectious Medicine
Research subject
Infectious Diseases
Identifiers
URN: urn:nbn:se:oru:diva-46075DOI: 10.1186/s12879-015-1110-xISI: 000361355100005PubMedID: 26381611Scopus ID: 2-s2.0-84941776218OAI: oai:DiVA.org:oru-46075DiVA: diva2:860657
Note

Funding Agencies:

Ministry of Health, Labor and Welfare of Japan H24-Shinko-Ippan-004

Research Program on Emerging and Re-emerging Infectious Diseases from Japan Agency for Medical Research and Development, AMED 15fk0108014h0001

Available from: 2015-10-13 Created: 2015-10-13 Last updated: 2017-10-17Bibliographically approved

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CiteExportLink to record
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