Neisseria gonorrhoeae arthritis in a patient with systemic lupus: resistance and virulence profiles

Vítor Falcão de Oliveira; Adriana Coracini Tonacio; Ana Paula Marchi; Marina Farrel Côrtes; Maria Luiza Bazzo; Gabriela Takeshigue Lemos; Jose Victor Bortolotto Bampi; Evelyn Patricia Sanchez Espinoza; Edson Luiz Tarsia Duarte; Roberta Cristina Ruedas Martins; Sânia Alves dos Santos; Lauro Vieira Perdigão Neto; Ana Paula Ramalho da Costa-Lourenço; Raquel Regina Bonelli; Maria Rita Elmore; Flavia Rossi; Gwenda Hughes; Silvia Figueiredo Costa

doi:10.1016/j.micinf.2022.105037

Neisseria gonorrhoeae arthritis in a patient with systemic lupus: resistance and virulence profiles

Vítor Falcão de Oliveira^*, Adriana Coracini Tonacio, Ana Paula Marchi, Marina Farrel Côrtes, Maria Luiza Bazzo, Gabriela Takeshigue Lemos, Jose Victor Bortolotto Bampi, Evelyn Patricia Sanchez Espinoza, Edson Luiz Tarsia Duarte, Roberta Cristina Ruedas Martins, Sânia Alves dos Santos, Lauro Vieira Perdigão Neto, Ana Paula Ramalho da Costa-Lourenço, Raquel Regina Bonelli, Maria Rita Elmore, Flavia Rossi, Gwenda Hughes, Silvia Figueiredo Costa

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

In this study, we describe a case report of gonococcal arthritis in a Systemic Lupus Erythematosus patient. Although several mechanisms favor disseminated gonococcal infection (DGI) in patients immunosuppressed by SLE, this association is rarely reported in literature. We performed whole genome sequencing (WGS) of the etiologic agent involved and molecular analysis using a global collection of Neisseria gonorrhoeae strains. Ours is the only sample derived from synovial fluid identified in this collection, the others being from the usual anatomical sites. Antimicrobial susceptibility was determined by disk diffusion and Etest, and WGS was conducted to determine multilocus sequence typing profiles, group isolates based on core genome single nucleotide polymorphisms (SNP), and identify virulence genes and antimicrobial resistance determinants. The N. gonorrhoeae samples in the global collection were highly heterogeneous. The SNP tree had a total 19,532 SNPs in 320 samples. Our sample displayed resistance to ciprofloxacin (MIC = 2 μg/mL) and tetracycline (zone diameter = 0 mm) belonged to ST 1588 and was not closely related to any isolate in the global collection of N. gonorrhoeae strains. The isolate had genetic features related to beta-lactam, tetracycline and quinolone resistance. Seventy-one virulence genes were identified in our sample, belonging to the following classes: adherence, efflux pump, immune modulator, invasion, iron uptake, protease and stress adaptation. Moreover, no virulence genes for immune evasion and toxin were identified.

Original language	English
Article number	105037
Journal	Microbes and Infection
Volume	25
Issue number	1-2
DOIs	https://doi.org/10.1016/j.micinf.2022.105037
Publication status	Published - 1 Jan 2023
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2022 Institut Pasteur

Keywords

Gonococcal arthritis
Neisseria gonorrhoeae
Resistance
Whole genome sequencing

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.micinf.2022.105037

Cite this

de Oliveira, V. F., Coracini Tonacio, A., Marchi, A. P., Farrel Côrtes, M., Luiza Bazzo, M., Takeshigue Lemos, G., Bortolotto Bampi, J. V., Patricia Sanchez Espinoza, E., Luiz Tarsia Duarte, E., Cristina Ruedas Martins, R., Alves dos Santos, S., Vieira Perdigão Neto, L., Ramalho da Costa-Lourenço, A. P., Regina Bonelli, R., Rita Elmore, M., Rossi, F., Hughes, G., & Figueiredo Costa, S. (2023). Neisseria gonorrhoeae arthritis in a patient with systemic lupus: resistance and virulence profiles. Microbes and Infection, 25(1-2), Article 105037. https://doi.org/10.1016/j.micinf.2022.105037

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abstract = "In this study, we describe a case report of gonococcal arthritis in a Systemic Lupus Erythematosus patient. Although several mechanisms favor disseminated gonococcal infection (DGI) in patients immunosuppressed by SLE, this association is rarely reported in literature. We performed whole genome sequencing (WGS) of the etiologic agent involved and molecular analysis using a global collection of Neisseria gonorrhoeae strains. Ours is the only sample derived from synovial fluid identified in this collection, the others being from the usual anatomical sites. Antimicrobial susceptibility was determined by disk diffusion and Etest, and WGS was conducted to determine multilocus sequence typing profiles, group isolates based on core genome single nucleotide polymorphisms (SNP), and identify virulence genes and antimicrobial resistance determinants. The N. gonorrhoeae samples in the global collection were highly heterogeneous. The SNP tree had a total 19,532 SNPs in 320 samples. Our sample displayed resistance to ciprofloxacin (MIC = 2 μg/mL) and tetracycline (zone diameter = 0 mm) belonged to ST 1588 and was not closely related to any isolate in the global collection of N. gonorrhoeae strains. The isolate had genetic features related to beta-lactam, tetracycline and quinolone resistance. Seventy-one virulence genes were identified in our sample, belonging to the following classes: adherence, efflux pump, immune modulator, invasion, iron uptake, protease and stress adaptation. Moreover, no virulence genes for immune evasion and toxin were identified.",

keywords = "Gonococcal arthritis, Neisseria gonorrhoeae, Resistance, Whole genome sequencing",

author = "{de Oliveira}, {V{\'i}tor Falc{\~a}o} and {Coracini Tonacio}, Adriana and Marchi, {Ana Paula} and {Farrel C{\^o}rtes}, Marina and {Luiza Bazzo}, Maria and {Takeshigue Lemos}, Gabriela and {Bortolotto Bampi}, {Jose Victor} and {Patricia Sanchez Espinoza}, Evelyn and {Luiz Tarsia Duarte}, Edson and {Cristina Ruedas Martins}, Roberta and {Alves dos Santos}, S{\^a}nia and {Vieira Perdig{\~a}o Neto}, Lauro and {Ramalho da Costa-Louren{\c c}o}, {Ana Paula} and {Regina Bonelli}, Raquel and {Rita Elmore}, Maria and Flavia Rossi and Gwenda Hughes and {Figueiredo Costa}, Silvia",

note = "Publisher Copyright: {\textcopyright} 2022 Institut Pasteur",

year = "2023",

month = jan,

day = "1",

doi = "10.1016/j.micinf.2022.105037",

language = "English",

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de Oliveira, VF, Coracini Tonacio, A, Marchi, AP, Farrel Côrtes, M, Luiza Bazzo, M, Takeshigue Lemos, G, Bortolotto Bampi, JV, Patricia Sanchez Espinoza, E, Luiz Tarsia Duarte, E, Cristina Ruedas Martins, R, Alves dos Santos, S, Vieira Perdigão Neto, L, Ramalho da Costa-Lourenço, AP, Regina Bonelli, R, Rita Elmore, M, Rossi, F, Hughes, G & Figueiredo Costa, S 2023, 'Neisseria gonorrhoeae arthritis in a patient with systemic lupus: resistance and virulence profiles', Microbes and Infection, vol. 25, no. 1-2, 105037. https://doi.org/10.1016/j.micinf.2022.105037

TY - JOUR

T1 - Neisseria gonorrhoeae arthritis in a patient with systemic lupus

T2 - resistance and virulence profiles

AU - de Oliveira, Vítor Falcão

AU - Coracini Tonacio, Adriana

AU - Marchi, Ana Paula

AU - Farrel Côrtes, Marina

AU - Luiza Bazzo, Maria

AU - Takeshigue Lemos, Gabriela

AU - Bortolotto Bampi, Jose Victor

AU - Patricia Sanchez Espinoza, Evelyn

AU - Luiz Tarsia Duarte, Edson

AU - Cristina Ruedas Martins, Roberta

AU - Alves dos Santos, Sânia

AU - Vieira Perdigão Neto, Lauro

AU - Ramalho da Costa-Lourenço, Ana Paula

AU - Regina Bonelli, Raquel

AU - Rita Elmore, Maria

AU - Rossi, Flavia

AU - Hughes, Gwenda

AU - Figueiredo Costa, Silvia

PY - 2023/1/1

Y1 - 2023/1/1

N2 - In this study, we describe a case report of gonococcal arthritis in a Systemic Lupus Erythematosus patient. Although several mechanisms favor disseminated gonococcal infection (DGI) in patients immunosuppressed by SLE, this association is rarely reported in literature. We performed whole genome sequencing (WGS) of the etiologic agent involved and molecular analysis using a global collection of Neisseria gonorrhoeae strains. Ours is the only sample derived from synovial fluid identified in this collection, the others being from the usual anatomical sites. Antimicrobial susceptibility was determined by disk diffusion and Etest, and WGS was conducted to determine multilocus sequence typing profiles, group isolates based on core genome single nucleotide polymorphisms (SNP), and identify virulence genes and antimicrobial resistance determinants. The N. gonorrhoeae samples in the global collection were highly heterogeneous. The SNP tree had a total 19,532 SNPs in 320 samples. Our sample displayed resistance to ciprofloxacin (MIC = 2 μg/mL) and tetracycline (zone diameter = 0 mm) belonged to ST 1588 and was not closely related to any isolate in the global collection of N. gonorrhoeae strains. The isolate had genetic features related to beta-lactam, tetracycline and quinolone resistance. Seventy-one virulence genes were identified in our sample, belonging to the following classes: adherence, efflux pump, immune modulator, invasion, iron uptake, protease and stress adaptation. Moreover, no virulence genes for immune evasion and toxin were identified.

AB - In this study, we describe a case report of gonococcal arthritis in a Systemic Lupus Erythematosus patient. Although several mechanisms favor disseminated gonococcal infection (DGI) in patients immunosuppressed by SLE, this association is rarely reported in literature. We performed whole genome sequencing (WGS) of the etiologic agent involved and molecular analysis using a global collection of Neisseria gonorrhoeae strains. Ours is the only sample derived from synovial fluid identified in this collection, the others being from the usual anatomical sites. Antimicrobial susceptibility was determined by disk diffusion and Etest, and WGS was conducted to determine multilocus sequence typing profiles, group isolates based on core genome single nucleotide polymorphisms (SNP), and identify virulence genes and antimicrobial resistance determinants. The N. gonorrhoeae samples in the global collection were highly heterogeneous. The SNP tree had a total 19,532 SNPs in 320 samples. Our sample displayed resistance to ciprofloxacin (MIC = 2 μg/mL) and tetracycline (zone diameter = 0 mm) belonged to ST 1588 and was not closely related to any isolate in the global collection of N. gonorrhoeae strains. The isolate had genetic features related to beta-lactam, tetracycline and quinolone resistance. Seventy-one virulence genes were identified in our sample, belonging to the following classes: adherence, efflux pump, immune modulator, invasion, iron uptake, protease and stress adaptation. Moreover, no virulence genes for immune evasion and toxin were identified.

KW - Gonococcal arthritis

KW - Neisseria gonorrhoeae

KW - Resistance

KW - Whole genome sequencing

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U2 - 10.1016/j.micinf.2022.105037

DO - 10.1016/j.micinf.2022.105037

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C2 - 35940402

AN - SCOPUS:85143973249

SN - 1286-4579

VL - 25

JO - Microbes and Infection

JF - Microbes and Infection

IS - 1-2

M1 - 105037

ER -

Neisseria gonorrhoeae arthritis in a patient with systemic lupus: resistance and virulence profiles

Abstract

Bibliographical note

Keywords

UN SDGs

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