TY - JOUR
T1 - Molecular epidemiological typing of Neisseria gonorrhoeae isolates identifies a novel association between genogroup G10557 (G7072) and decreased susceptibility to cefixime, Germany, 2014 to 2017
AU - Banhart, Sebastian
AU - Jansen, Klaus
AU - Buder, Susanne
AU - Tamminga, Thalea
AU - Calvignac-Spencer, Sebastien
AU - Pilz, Tanja
AU - Martini, Andrea
AU - Dudareva, Sandra
AU - Nikisins, Sergejs
AU - Dehmel, Kerstin
AU - Zuelsdorf, Gabriele
AU - Guhl, Eva
AU - Graeber, Ingeborg
AU - Kohl, Peter K.
AU - Unemo, Magnus
AU - Bremer, Viviane
AU - Heuer, Dagmar
AU - GORENET study group
A2 - Back, Thomas
A2 - Berger, Anja
A2 - Chapot, Valerie
A2 - Steinmann, Jörg
A2 - Eicke, Stephan
A2 - Friedrichs, Claudia
A2 - Groß, Andreas
A2 - Hagedorn, Hans Jochen
A2 - Halfmann, Alexander
A2 - Hornei, Britt
A2 - Ignatius, Ralf
A2 - Korten, Simone
A2 - Sahly, Hany
A2 - Kozub-Witkowski, Elzbieta
A2 - Krämer, Sabine
A2 - Kühn, Margit
A2 - Liebetrau, Anke
A2 - Meyer, Thomas
A2 - Oberdorfer, Klaus
A2 - Pfüller, Roland
A2 - Ruckert, Caroline
A2 - Schwarz, Roman
A2 - Walch, Daniela
A2 - Mai, Madeleine
A2 - Wichelhaus, Thomas A.
A2 - Wisplinghoff, Hilmar
A2 - Wüppenhorst, Nicole
N1 - Publisher Copyright:
© 2020 European Centre for Disease Prevention and Control (ECDC). All rights reserved.
PY - 2020/10/15
Y1 - 2020/10/15
N2 - Background: Emerging antimicrobial resistance (AMR) challenges gonorrhoea treatment and requires surveillance. Aim: This observational study describes the genetic diversity of Neisseria gonorrhoeae isolates in Germany from 2014 to 2017 and identifies N. gonorrhoeae multi-antigen sequence typing (NG-MAST) genogroups associated with AMR or some patient demographics. Methods: 1,220 gonococcal isolates underwent AMR testing and NG-MAST. Associations between genogroups and AMR or sex/age of patients were statistically assessed. Results: Patients' median age was 32 years (interquartile range: 25-44); 1,078 isolates (88.4%) originated from men. In total, 432 NG-MAST sequence types including 156 novel ones were identified, resulting in 17 major genogroups covering 59.1% (721/1,220) of all isolates. Genogroups G1407 and G10557 (G7072) were significantly associated with decreased susceptibility to cefixime (Kruskal-Wallis chi-squared: 549.3442, df: 16, p < 0.001). Their prevalences appeared to decline during the study period from 14.2% (15/106) to 6.2% (30/481) and from 6.6% (7/106) to 3.1% (15/481) respectively. Meanwhile, several cefixime susceptible genogroups' prevalence seemed to increase. Proportions of isolates from men differed among genogroups (Fisher's exact test, p < 0.001), being e.g. lower for G25 (G51) and G387, and higher for G5441 and G2992. Some genogroups differed relative to each other in affected patients' median age (Kruskal-Wallis chi-squared: 47.5358, df: 16, p < 0.001), with e.g. G25 (G51) and G387 more frequent among = 30 year olds and G359 and G17420 among = 40 year olds. Conclusion: AMR monitoring with molecular typing is important. Dual therapy (ceftriaxone plus azithromycin) recommended in 2014 in Germany, or only the ceftriaxone dose of this therapy, might have contributed to cefixime-resistant genogroups decreasing.
AB - Background: Emerging antimicrobial resistance (AMR) challenges gonorrhoea treatment and requires surveillance. Aim: This observational study describes the genetic diversity of Neisseria gonorrhoeae isolates in Germany from 2014 to 2017 and identifies N. gonorrhoeae multi-antigen sequence typing (NG-MAST) genogroups associated with AMR or some patient demographics. Methods: 1,220 gonococcal isolates underwent AMR testing and NG-MAST. Associations between genogroups and AMR or sex/age of patients were statistically assessed. Results: Patients' median age was 32 years (interquartile range: 25-44); 1,078 isolates (88.4%) originated from men. In total, 432 NG-MAST sequence types including 156 novel ones were identified, resulting in 17 major genogroups covering 59.1% (721/1,220) of all isolates. Genogroups G1407 and G10557 (G7072) were significantly associated with decreased susceptibility to cefixime (Kruskal-Wallis chi-squared: 549.3442, df: 16, p < 0.001). Their prevalences appeared to decline during the study period from 14.2% (15/106) to 6.2% (30/481) and from 6.6% (7/106) to 3.1% (15/481) respectively. Meanwhile, several cefixime susceptible genogroups' prevalence seemed to increase. Proportions of isolates from men differed among genogroups (Fisher's exact test, p < 0.001), being e.g. lower for G25 (G51) and G387, and higher for G5441 and G2992. Some genogroups differed relative to each other in affected patients' median age (Kruskal-Wallis chi-squared: 47.5358, df: 16, p < 0.001), with e.g. G25 (G51) and G387 more frequent among = 30 year olds and G359 and G17420 among = 40 year olds. Conclusion: AMR monitoring with molecular typing is important. Dual therapy (ceftriaxone plus azithromycin) recommended in 2014 in Germany, or only the ceftriaxone dose of this therapy, might have contributed to cefixime-resistant genogroups decreasing.
KW - Gonorrhea
KW - Microbial Sensitivity Tests
KW - Germany
KW - Neisseria gonorrhoeae
KW - Cefixime
KW - Drug Resistance
KW - Prevalence
UR - http://www.scopus.com/inward/record.url?scp=85093494299&partnerID=8YFLogxK
U2 - 10.2807/1560-7917.ES.2020.25.41.1900648
DO - 10.2807/1560-7917.ES.2020.25.41.1900648
M3 - Review article
C2 - 33063655
AN - SCOPUS:85093494299
SN - 1025-496X
VL - 25
JO - EUROSURVEILLANCE
JF - EUROSURVEILLANCE
IS - 41
ER -
