Molecular epidemiological typing of Neisseria gonorrhoeae isolates identifies a novel association between genogroup G10557 (G7072) and decreased susceptibility to cefixime, Germany, 2014 to 2017

Sebastian Banhart; Klaus Jansen; Susanne Buder; Thalea Tamminga; Sebastien Calvignac-Spencer; Tanja Pilz; Andrea Martini; Sandra Dudareva; Sergejs Nikisins; Kerstin Dehmel; Gabriele Zuelsdorf; Eva Guhl; Ingeborg Graeber; Peter K. Kohl; Magnus Unemo; Viviane Bremer; Dagmar Heuer; GORENET study group

doi:10.2807/1560-7917.ES.2020.25.41.1900648

Molecular epidemiological typing of Neisseria gonorrhoeae isolates identifies a novel association between genogroup G10557 (G7072) and decreased susceptibility to cefixime, Germany, 2014 to 2017

Sebastian Banhart
, Klaus Jansen
, Susanne Buder
, Thalea Tamminga
, Sebastien Calvignac-Spencer
, Tanja Pilz
, Andrea Martini
, Sandra Dudareva
, Sergejs Nikisins
, Kerstin Dehmel
, Gabriele Zuelsdorf
, Eva Guhl
, Ingeborg Graeber
, Peter K. Kohl
, Magnus Unemo
, Viviane Bremer
, Dagmar Heuer^*
, GORENET study group

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

5 Citations (Scopus)

Abstract

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.

Original language	English
Journal	EUROSURVEILLANCE
Volume	25
Issue number	41
DOIs	https://doi.org/10.2807/1560-7917.ES.2020.25.41.1900648
Publication status	Published - 15 Oct 2020
Externally published	Yes

UN SDGs

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

SDG 3 Good Health and Well-being

Keywords*

Gonorrhea
Microbial Sensitivity Tests
Germany
Neisseria gonorrhoeae
Cefixime
Drug Resistance
Prevalence

Field of Science*

3.1 Basic medicine
3.3 Health sciences

Publication Type*

1.1. Scientific article indexed in Web of Science and/or Scopus database

Access to Document

10.2807/1560-7917.ES.2020.25.41.1900648Licence: CC BY

Cite this

Banhart, S., Jansen, K., Buder, S., Tamminga, T., Calvignac-Spencer, S., Pilz, T., Martini, A., Dudareva, S., Nikisins, S., Dehmel, K., Zuelsdorf, G., Guhl, E., Graeber, I., Kohl, P. K., Unemo, M., Bremer, V., Heuer, D., & GORENET study group (2020). Molecular epidemiological typing of Neisseria gonorrhoeae isolates identifies a novel association between genogroup G10557 (G7072) and decreased susceptibility to cefixime, Germany, 2014 to 2017. EUROSURVEILLANCE, 25(41). https://doi.org/10.2807/1560-7917.ES.2020.25.41.1900648

@article{47e87c3994ca4a85a0989d92ceff9973,

title = "Molecular epidemiological typing of Neisseria gonorrhoeae isolates identifies a novel association between genogroup G10557 (G7072) and decreased susceptibility to cefixime, Germany, 2014 to 2017",

abstract = "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.",

keywords = "Gonorrhea, Microbial Sensitivity Tests, Germany, Neisseria gonorrhoeae, Cefixime, Drug Resistance, Prevalence",

author = "Sebastian Banhart and Klaus Jansen and Susanne Buder and Thalea Tamminga and Sebastien Calvignac-Spencer and Tanja Pilz and Andrea Martini and Sandra Dudareva and Sergejs Nikisins and Kerstin Dehmel and Gabriele Zuelsdorf and Eva Guhl and Ingeborg Graeber and Kohl, \{Peter K.\} and Magnus Unemo and Viviane Bremer and Dagmar Heuer and \{GORENET study group\} and Thomas Back and Anja Berger and Valerie Chapot and J{\"o}rg Steinmann and Stephan Eicke and Claudia Friedrichs and Andreas Gro{\ss} and Hagedorn, \{Hans Jochen\} and Alexander Halfmann and Britt Hornei and Ralf Ignatius and Simone Korten and Hany Sahly and Elzbieta Kozub-Witkowski and Sabine Kr{\"a}mer and Margit K{\"u}hn and Anke Liebetrau and Thomas Meyer and Klaus Oberdorfer and Roland Pf{\"u}ller and Caroline Ruckert and Roman Schwarz and Daniela Walch and Madeleine Mai and Wichelhaus, \{Thomas A.\} and Hilmar Wisplinghoff and Nicole W{\"u}ppenhorst",

year = "2020",

month = oct,

day = "15",

doi = "10.2807/1560-7917.ES.2020.25.41.1900648",

language = "English",

volume = "25",

journal = "EUROSURVEILLANCE",

issn = "1025-496X",

publisher = "European Centre for Disease Prevention and Control (ECDC)",

number = "41",

}

Banhart, S, Jansen, K, Buder, S, Tamminga, T, Calvignac-Spencer, S, Pilz, T, Martini, A, Dudareva, S, Nikisins, S, Dehmel, K, Zuelsdorf, G, Guhl, E, Graeber, I, Kohl, PK, Unemo, M, Bremer, V, Heuer, D & GORENET study group 2020, 'Molecular epidemiological typing of Neisseria gonorrhoeae isolates identifies a novel association between genogroup G10557 (G7072) and decreased susceptibility to cefixime, Germany, 2014 to 2017', EUROSURVEILLANCE, vol. 25, no. 41. https://doi.org/10.2807/1560-7917.ES.2020.25.41.1900648

Molecular epidemiological typing of Neisseria gonorrhoeae isolates identifies a novel association between genogroup G10557 (G7072) and decreased susceptibility to cefixime, Germany, 2014 to 2017. / Banhart, Sebastian; Jansen, Klaus; Buder, Susanne et al.
In: EUROSURVEILLANCE, Vol. 25, No. 41, 15.10.2020.

Research output: Contribution to journal › Review article › peer-review

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

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 - https://www.scopus.com/pages/publications/85093494299

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 -

Molecular epidemiological typing of Neisseria gonorrhoeae isolates identifies a novel association between genogroup G10557 (G7072) and decreased susceptibility to cefixime, Germany, 2014 to 2017

Abstract

UN SDGs

Keywords*

Field of Science*

Publication Type*

Access to Document

Other files and links

Fingerprint

Cite this