title: Molecular epidemiology of Neisseria gonorrhoeae- identification of the first presumed Swedish transmission chain of an azithromycin-resistant strain.
abstract: In the present study, 10 azithromycin-resistant Neisseria gonorrhoeae isolates from 6 Swedish male patients in 2004, 3 sporadic Swedish azithromycin-resistant N. gonorrhoeae isolates from recent years and one Swedish N. gonorrhoeae isolate from 2003 that was susceptible to azithromycin but assigned the same serological variant (serovar), i.e. IB-37, as the isolates from 2004 were included. The isolates were characterized phenotypically using antibiograms and serovar determination and genetically with pulsed-field gel electrophoresis (PFGE), entire porB gene sequencing and N. gonorrhoeae multiantigen sequence typing (NG-MAST). The epidemiological information and the results of the thorough phenotypic characterisation and genetic characterisation identified the first presumed domestic transmission of one azithromycin-resistant N. gonorrhoeae strain in Sweden in 2004. This stresses the need for continuous surveillance of the antibiotic susceptibility of N. gonorrhoeae in order to identify emergence of new resistance, monitor the changing patterns of the susceptibility, and be able to update treatment recommendations on a regular basis.
authors.affiliation: National Reference Laboratory for Pathogenic Neisseria, Department of Clinical Microbiology, Orebro University Hospital, Sweden.
authors.forename: David
authors.initials: D
authors.lastname: Lundbäck
authors.forename: Hans
authors.initials: H
authors.lastname: Fredlund
authors.forename: Torsten
authors.initials: T
authors.lastname: Berglund
authors.forename: Bengt
authors.initials: B
authors.lastname: Wretlind
authors.forename: Magnus
authors.initials: M
authors.lastname: Unemo
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017963:Azithromycin / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D006069:Gonorrhea / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission*; D006801:Humans; D008297:Male; D017720:Molecular Epidemiology; D009344:Neisseria gonorrhoeae / Q000145:classification / Q000187:drug effects* / Q000235:genetics*; D010802:Phylogeny; D018272:Porins / Q000235:genetics; D013548:Sweden / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D018272:Porins; C057699:porin protein, Neisseria; D017963:Azithromycin