Emerging Azithromycin Resistance among the Neisseria gonorrhoeae Strains Isolated in Danyang, China
Emerging Azithromycin Resistance among the Neisseria gonorrhoeae Strains Isolated in Danyang, China
Jie Yang1, Wenjun Zhou2, Qi Zhang2, Lei Chu2, Zhenshi Chen1, Xiajun Zhang2, Weidong Wu3*, Shaoru Zhang1* and Lihui Wang1*
ABSTRACT
Neisseria gonorrhoeae is a human pathogen. Strain identification and effective antibiotic treatment are the main ways to prevent and control gonorrhea, but N. gonorrhoeae is now resistant to most antibiotics, and there is no vaccine available. The main purpose of this study was to understand the molecular characteristics of clinical isolates of N. gonorrhoeae and their resistance to azithromycin (AZM) in Danyang, China. Firstly, the clinical isolates of N. gonorrhoeae from January 2016 to December 2020 were collected by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS). Secondly, the drug sensitivity of all clinical isolates was analyzed. Thirdly, polymerase chain reaction (PCR) and DNA sequencing were used to analyze the genes related to AZM resistance (AZM-R), including 23s rRNA allele mutation, mtrR promoter and coding region mutation, rplD and rplV mutation. Finally, the clinical isolates resistant to AZM were typed by N. gonorrhoeae multiantigen sequence typing (NG-MAST). 388 clinical isolates of N. gonorrhoeae were identified, of which 373, 329, 298, 5, 11 and 5 strains were resistant to ciprofloxacin, penicillin, tetracycline, AZM, spectinomycin and ceftriaxone, respectively. The mutation detection of AZM-R related gene showed that there were single (A) nucleotide deletion mutation in mtrR promoter region, G45D mutation in mtrR coding region, G70 mutation in rplD and A2047G mutation in 23s rRNA allele, but no mutation was found in rplV. A total of 8 different STs were identified in 5 AZM-R strains, of which two ST1866 isolates showed a high level of AZM-R. The clinical isolates of N. gonorrhoeae in Danyang have high genetic diversity. ST1866 isolates showed a high level of AZM-R, Therefore, measures should be taken to monitor the spread of ST1866 N. gonorrhoeae clones in eastern China.
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