Neisseria gonorrhoeae sequence typing for antimicrobial resistance, a novel antimicrobial resistance multilocus typing scheme for tracking global dissemination of N. Gonorrhoeae strains

W. Demczuk, S. Sidhu, M. Unemo, D. M. Whiley, V. G. Allen, J. R. Dillon, M. Cole, C. Seah, E. Trembizki, D. L. Trees, E. N. Kersh, A. J. Abrams, H. J.C. De Vries, A. P. Van Dam, I. Medina, A. Bharat, M. R. Mulvey, G. Van Domselaar, I. Martin*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    129 Citations (Scopus)

    Abstract

    A curated Web-based user-friendly sequence typing tool based on antimicrobial resistance determinants in Neisseria gonorrhoeae was developed and is publicly accessible (https://ngstar.Canada.ca). The N. gonorrhoeae Sequence Typing for Antimicrobial Resistance (NG-STAR) molecular typing scheme uses the DNA sequences of 7 genes (penA, mtrR, porB, ponA, gyrA, parC, and 23S rRNA) associated with resistance to β-lactam antimicrobials, macrolides, or fluoroquinolones. NG-STAR uses the entire penA sequence, combining the historical nomenclature for penA types I to XXXVIII with novel nucleotide sequence designations; the full mtrR sequence and a portion of its promoter region; portions of ponA, porB, gyrA, and parC; and 23S rRNA sequences. NG-STAR grouped 768 isolates into 139 sequence types (STs) (n = 660) consisting of 29 clonal complexes (CCs) having a maximum of a single-locus variation, and 76 NG-STAR STs (n = 109) were identified as unrelated singletons. NG-STAR had a high Simpson's diversity index value of 96.5% (95% confidence interval [CI] = 0.959 to 0.969). The most common STs were NG-STAR ST-90 (n = 100; 13.0%), ST-42 and ST-91 (n = 45; 5.9%), ST-64 (n = 44; 5.72%), and ST-139 (n = 42; 5.5%). Decreased susceptibility to azithromycin was associated with NGSTAR ST-58, ST-61, ST-64, ST-79, ST-91, and ST-139 (n = 156; 92.3%); decreased susceptibility to cephalosporins was associated with NG-STAR ST-90, ST-91, and ST-97 (n = 162; 94.2%); and ciprofloxacin resistance was associated with NG-STAR ST-26, ST-90, ST-91, ST-97, ST-150, and ST-158 (n = 196; 98.0%). All isolates of NG-STAR ST- 42, ST-43, ST-63, ST-81, and ST-160 (n = 106) were susceptible to all four antimicrobials. The standardization of nomenclature associated with antimicrobial resistance determinants through an internationally available database will facilitate the monitoring of the global dissemination of antimicrobial-resistant N. gonorrhoeae strains.

    Original languageEnglish
    Pages (from-to)1454-1468
    Number of pages15
    JournalJournal of Clinical Microbiology
    Volume55
    Issue number5
    DOIs
    Publication statusPublished - May 2017

    Bibliographical note

    Publisher Copyright:
    Copyright © 2017 American Society for Microbiology. All Rights Reserved.

    Keywords

    • Antimicrobial resistance
    • Molecular epidemiology
    • Neisseria gonorrhoeae
    • Sequence typing

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