1887
  1. Home
  2. Eurosurveillance
  3. Volume 27, Issue 50, 15/Dec/2022
  4. Article
Rapid communication Open Access
Like 0
Download

Abstract

We report a ceftriaxone-resistant, multidrug-resistant urogenital gonorrhoea case in a heterosexual woman in France, June 2022. The woman was successfully treated with azithromycin 2 g. She had unprotected sex with her regular partner, who developed urethritis following travel to Vietnam and Switzerland. Whole genome sequencing of the gonococcal isolate (F92) identified MLST ST1901, NG-STAR CC-199, and the novel mosaic , which caused ceftriaxone resistance. is 98.7% identical to , reported in various ceftriaxone-resistant strains, including the internationally spreading FC428 clone.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2022.27.50.2200899
2022-12-15
2024-12-22
/content/10.2807/1560-7917.ES.2022.27.50.2200899
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/27/50/eurosurv-27-50-3.html?itemId=/content/10.2807/1560-7917.ES.2022.27.50.2200899&mimeType=html&fmt=ahah

References

  1. European Committee on Antimicrobial Susceptibility Testing (EUCAST). Breakpoint tables for interpretation of MICs and zone diameters; version 12.0, 1 Jan 2022. EUCAST; 2022. Available from: https://www.eucast.org/clinical_breakpoints
  2. Taylor SN, Marrazzo J, Batteiger BE, Hook EW 3rd, Seña AC, Long J, et al. Single-dose Zoliflodacin (ETX0914) for treatment of urogenital gonorrhea. N Engl J Med. 2018;379(19):1835-45.  https://doi.org/10.1056/NEJMoa1706988  PMID: 30403954 
  3. Taylor SN, Morris DH, Avery AK, Workowski KA, Batteiger BE, Tiffany CA, et al. Gepotidacin for the treatment of uncomplicated urogenital gonorrhea: a phase 2, randomized, dose-ranging, single-oral dose evaluation. Clin Infect Dis. 2018;67(4):504-12.  https://doi.org/10.1093/cid/ciy145  PMID: 29617982 
  4. Jacobsson S, Paukner S, Golparian D, Jensen JS, Unemo M. In vitro activity of the novel pleuromutilin lefamulin (BC-3781) and effect of efflux pump inactivation on multidrug-resistant and extensively drug-resistant Neisseria gonorrhoeae. Antimicrob Agents Chemother. 2017;61(11):e01497-17.  https://doi.org/10.1128/AAC.01497-17  PMID: 28893785 
  5. Poncin T, Fouere S, Braille A, Camelena F, Agsous M, Bebear C, et al. Multidrug-resistant Neisseria gonorrhoeae failing treatment with ceftriaxone and doxycycline in France, November 2017. Euro Surveill. 2018;23(21):1800264.  https://doi.org/10.2807/1560-7917.ES.2018.23.21.1800264  PMID: 29845928 
  6. Pleininger S, Indra A, Golparian D, Heger F, Schindler S, Jacobsson S, et al. Extensively drug-resistant (XDR) Neisseria gonorrhoeae causing possible gonorrhoea treatment failure with ceftriaxone plus azithromycin in Austria, April 2022. Euro Surveill. 2022;27(24):2200455.  https://doi.org/10.2807/1560-7917.ES.2022.27.24.2200455  PMID: 35713023 
  7. Poncin T, Merimeche M, Braille A, Mainardis M, Bebear C, Jacquier H, et al. Two cases of multidrug-resistant Neisseria gonorrhoeae related to travel in south-eastern Asia, France, June 2019. Euro Surveill. 2019;24(36):1900528.  https://doi.org/10.2807/1560-7917.ES.2019.24.36.1900528  PMID: 31507264 
  8. Nakayama S, Shimuta K, Furubayashi K, Kawahata T, Unemo M, Ohnishi M. New ceftriaxone- and multidrug-resistant Neisseria gonorrhoeae strain with a novel mosaic penA gene isolated in Japan. Antimicrob Agents Chemother. 2016;60(7):4339-41.  https://doi.org/10.1128/AAC.00504-16  PMID: 27067334 
  9. Lahra MM, Martin I, Demczuk W, Jennison AV, Lee K-I, Nakayama S-I, et al. Cooperative recognition of internationally disseminated ceftriaxone-resistant Neisseria gonorrhoeae strain. Emerg Infect Dis. 2018;24(4):735-40.  https://doi.org/10.3201/eid2404.171873  PMID: 29553335 
  10. Zhou K, Chen SC, Yang F, van der Veen S, Yin YP. Impact of the gonococcal FC428 penA allele 60.001 on ceftriaxone resistance and biological fitness. Emerg Microbes Infect. 2020;9(1):1219-29.  https://doi.org/10.1080/22221751.2020.1773325  PMID: 32438866 
  11. Lin X, Chen W, Xie Q, Yu Y, Liao Y, Feng Z, et al. Dissemination and genome analysis of high-level ceftriaxone-resistant penA 60.001 Neisseria gonorrhoeae strains from the Guangdong Gonococcal antibiotics susceptibility Programme (GD-GASP), 2016-2019. Emerg Microbes Infect. 2022;11(1):344-50.  https://doi.org/10.1080/22221751.2021.2011618  PMID: 34994305 
  12. Day M, Pitt R, Mody N, Saunders J, Rai R, Nori A, et al. Detection of 10 cases of ceftriaxone-resistant Neisseria gonorrhoeae in the United Kingdom, December 2021 to June 2022. Euro Surveill. 2022;27(46):2200803.  https://doi.org/10.2807/1560-7917.ES.2022.27.46.2200803  PMID: 36398578 
  13. Unemo M, Shafer WM. Antimicrobial resistance in Neisseria gonorrhoeae in the 21st century: past, evolution, and future. Clin Microbiol Rev. 2014;27(3):587-613.  https://doi.org/10.1128/CMR.00010-14  PMID: 24982323 
  14. Unemo M, Golparian D, Nicholas R, Ohnishi M, Gallay A, Sednaoui P. High-level cefixime- and ceftriaxone-resistant Neisseria gonorrhoeae in France: novel penA mosaic allele in a successful international clone causes treatment failure. Antimicrob Agents Chemother. 2012;56(3):1273-80.  https://doi.org/10.1128/AAC.05760-11  PMID: 22155830 
  15. Centre National de Recherche (CNR) Infections Sexuellement Transmissibles (IST). Rapport d'activité 2017-2021. [French National Reference Centre reporting. Activity reports 2017-2021]. French. Available from: https://www.cnr-ist.fr/bilans-dactivites.html
  16. Day MJ, Jacobsson S, Spiteri G, Kulishev C, Sajedi N, Woodford N, et al. Significant increase in azithromycin "resistance" and susceptibility to ceftriaxone and cefixime in Neisseria gonorrhoeae isolates in 26 European countries, 2019. BMC Infect Dis. 2022;22(1):524.  https://doi.org/10.1186/s12879-022-07509-w  PMID: 35672671 
  17. Harris SR, Cole MJ, Spiteri G, Sánchez-Busó L, Golparian D, Jacobsson S, et al. Public health surveillance of multidrug-resistant clones of Neisseria gonorrhoeae in Europe: a genomic survey. Lancet Infect Dis. 2018;18(7):758-68.  https://doi.org/10.1016/S1473-3099(18)30225-1  PMID: 29776807 
  18. Vincent LR, Kerr SR, Tan Y, Tomberg J, Raterman EL, Dunning Hotopp JC, et al. In vivo-selected compensatory mutations restore the fitness cost of mosaic penA alleles that confer ceftriaxone resistance in Neisseria gonorrhoeae. MBio. 2018;9(2):e01905-17.  https://doi.org/10.1128/mBio.01905-17  PMID: 29615507 
  19. Unemo M, Lahra MM, Escher M, Eremin S, Cole MJ, Galarza P, et al. WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017-18: a retrospective observational study. Lancet Microbe. 2021;2(11):e627-36.  https://doi.org/10.1016/S2666-5247(21)00171-3  PMID: 35544082 
  20. Demczuk W, Sidhu S, Unemo M, Whiley DM, Allen VG, Dillon JR, et al. Neisseria gonorrhoeae sequence typing for antimicrobial resistance, a novel antimicrobial resistance multilocus typing scheme for tracking global dissemination of N. gonorrhoeae strains. J Clin Microbiol. 2017;55(5):1454-68.  https://doi.org/10.1128/JCM.00100-17  PMID: 28228492 
  21. Ohnishi M, Golparian D, Shimuta K, Saika T, Hoshina S, Iwasaku K, et al. Is Neisseria gonorrhoeae initiating a future era of untreatable gonorrhea?: detailed characterization of the first strain with high-level resistance to ceftriaxone. Antimicrob Agents Chemother. 2011;55(7):3538-45.  https://doi.org/10.1128/AAC.00325-11  PMID: 21576437 
  22. Eyre DW, Sanderson ND, Lord E, Regisford-Reimmer N, Chau K, Barker L, et al. Gonorrhoea treatment failure caused by a Neisseria gonorrhoeae strain with combined ceftriaxone and high-level azithromycin resistance, England, February 2018. Euro Surveill. 2018;23(27):1800323.  https://doi.org/10.2807/1560-7917.ES.2018.23.27.1800323  PMID: 29991383 
  23. Golparian D, Jacobsson S, Sánchez-Busó L, Bazzo ML, Lan PT, Galarza P, et al. GyrB in silico mining in 27 151 global gonococcal genomes from 1928-2021 combined with zoliflodacin in vitro testing of 71 international gonococcal isolates with different GyrB, ParC and ParE substitutions confirms high susceptibility. J Antimicrob Chemother. 2022;dkac366.  https://doi.org/10.1093/jac/dkac366  PMID: 36308328 
Ceftriaxone-resistant, multidrug-resistant Neisseria gonorrhoeae with a novel mosaic penA-237.001 gene, France, June 2022
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=B%C3%A9atrice+Ber%C3%A7ot&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Berçot Béatrice</a>, <a href="/search?value1=Fran%C3%A7ois+Cam%C3%A9l%C3%A9na&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Caméléna François</a>, <a href="/search?value1=Manel+M%C3%A9rim%C3%A8che&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mérimèche Manel</a>, <a href="/search?value1=Susanne+Jacobsson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jacobsson Susanne</a>, <a href="/search?value1=Ghalia+Sbaa&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sbaa Ghalia</a>, <a href="/search?value1=Mary+Mainardis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mainardis Mary</a>, <a href="/search?value1=Cyrille+Valin&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Valin Cyrille</a>, <a href="/search?value1=Jean-Michel+Molina&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Molina Jean-Michel</a>, <a href="/search?value1=C%C3%A9cile+B%C3%A9b%C3%A9ar&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bébéar Cécile</a>, <a href="/search?value1=Emilie+Chazelle&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chazelle Emilie</a>, <a href="/search?value1=Florence+Lot&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lot Florence</a>, <a href="/search?value1=Daniel+Golparian&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Golparian Daniel</a>, <a href="/search?value1=Magnus+Unemo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Unemo Magnus</a></span>. Ceftriaxone-resistant, multidrug-resistant Neisseria gonorrhoeae with a novel mosaic penA-237.001 gene, France, June 2022. <a href="/content/ecdc">Euro Surveill.</a> 2022;27(50):pii=2200899. <a href="https://doi.org/10.2807/1560-7917.ES.2022.27.50.2200899" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2022.27.50.2200899</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 25 Nov 2022;&nbsp;&nbsp; <span class="generated">Accepted</span>: 13 Dec 2022 </span> </p>
/content/10.2807/1560-7917.ES.2022.27.50.2200899
/content/10.2807/1560-7917.ES.2022.27.50.2200899
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error