Antimicrobial susceptibility/resistance and NG-MAST characterisation of Neisseria gonorrhoeae in Belarus, Eastern Europe, 2010–2013

BMC Infectious Diseases

Research Article

Marius Domeika¹  Aliaksandr Lukyanau²  Irina Shimanskaya²  Nataliya Pankratava³  Fiodar Lebedzeu⁴  Slavyana Glazkova⁴  Leonid Titov⁴  Natallia Charniakova⁵  Magnus Unemo⁶  Daniel Golparian⁶ 

[1] Department of Prevention and Control of Communicable Diseases, Uppsala County Council, Uppsala, Sweden;Minsk City Dermato-Venerological Dispensary, Minsk, Belarus;Mogilev Regional Dermato-Venerological Dispensary, Mogilev, Belarus;The Republican Research and Practical Center for Epidemiology and Microbiology (RRPCEM), Minsk, Belarus;Vitebsk Regional Dermato-Venerological Dispensary, Vitebsk, Belarus;WHO Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Swedish Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Microbiology, Örebro University Hospital, Örebro, Sweden;

关键词: Neisseria gonorrhoeae;    Gonorrhoea;    Antimicrobial resistance;    Surveillance;    Extended-spectrum cephalosporins (ESCs);    Ceftriaxone;    Cefixime;    Treatment;    N. gonorrhoeae;    Belarus;   

DOI  :  10.1186/s12879-015-0755-9

 received in 2014-10-15, accepted in 2015-01-15,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundGonorrhoea and widely spread antimicrobial resistance (AMR) in its etiological agent Neisseria gonorrhoeae are major public health concerns worldwide. Gonococcal AMR surveillance nationally and internationally, to identify emerging resistance and inform treatment guidelines, is imperative for public health purposes. In 2009, AMR surveillance was initiated in Belarus, Eastern Europe because no gonococcal AMR data had been available for at least two decades. Herein, the prevalence and trends of gonococcal AMR and molecular epidemiological characteristics of N. gonorrhoeae strains from 2010 to 2013 in Belarus, are described.MethodsN. gonorrhoeae isolates (n=193) obtained in the Mogilev (n=142), Minsk (n=36) and Vitebsk (n=15) regions of Belarus in 2010 (n=72), 2011 (n=6), 2012 (n=75) and 2013 (n=40) were analyzed in regards to AMR using the Etest method and for molecular epidemiology with N. gonorrhoeae multi-antigen sequence typing (NG-MAST).ResultsDuring 2010–2013, the proportions of resistant N. gonorrhoeae isolates were as follows: tetracycline 36%, ciprofloxacin 28%, penicillin G 9%, azithromycin 5%, and cefixime 0.5%. Only one (0.5%) β-lactamase producing isolate was detected. No isolates resistant to ceftriaxone and spectinomycin were identified. Overall, the resistance levels to tetracycline, ciprofloxacin and penicillin G were relatively stable. Interestingly, the level of resistance to azithromycin declined from 12% in 2010 to 0% in 2013 (P < 0.05). In total, 70 NG-MAST STs were identified. The predominant STs were ST1993 (n=53), ST807 (n=13), ST285 (n=8) and ST9735 (n=8). Many novel STs (n=43, 61%), representing 41% of all isolates, were found.ConclusionsDuring 2010–2013, the N. gonorrhoeae population in Belarus displayed high and relatively stable resistance levels to tetracycline, ciprofloxacin, and penicillin G, while the resistance to azithromycin declined. One isolate was resistant to cefixime, but no resistance to ceftriaxone or spectinomycin was found. The results of the present surveillance initiated in 2009 were also used to replace penicillin G with ceftriaxone (1 g single dose intramuscularly) as the first-line drug for empiric treatment of gonorrhoea in the national treatment guidelines in Belarus in late 2009. It is essential to further strengthen the surveillance of gonococcal AMR and ideally survey also treatment failures and molecular epidemiological genotypes in Belarus.

【 授权许可】

Unknown   
© Lebedzeu et al.; licensee BioMed Central. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.