title: Antimicrobial susceptibility of Neisseria gonorrhoeae isolated in Jiangsu Province, China, with a focus on fluoroquinolone resistance.
abstract: In this study, the phenotypic and genotypic resistance to fluoroquinolones in Neisseria gonorrhoeae isolated in Jiangsu Province, China, was analysed. In vitro susceptibility testing of eight antimicrobial agents, including ciprofloxacin and levofloxacin, against 95 clinical isolates was carried out. Detection of mutations in the gyrA and parC genes was performed by sequence analysis. The clinical isolates demonstrated 100% resistance to ciprofloxacin and 98.9% non-susceptibility to levofloxacin. All of the isolates were susceptible to cefotaxime and ceftriaxone. For cefepime, spectinomycin and tetracycline, 98.9, 94.7 and 1.1% of the isolates were susceptible, respectively. None of the isolates was susceptible to penicillin. Five types based on gyrA mutations could be categorized among 54 isolates with seven different mutation sites found on their parC gene. Analysis of sequence results showed that the gyrA mutation Asp-95-->Ala and the parC mutations Ser-87-->Arg and Ser-87-->Asn made a significant contribution to the resistance to fluoroquinolones, in addition to double mutations found in each gene. Therefore, the use of fluoroquinolones in the treatment of N. gonorrhoeae infections in Jiangsu Province is not recommended, while the use of third- and fourth-generation cephalosporins and spectinomycin is recommended.
authors.affiliation: School of Public Health, Southeast University, Nanjing, Jiangsu, People's Republic of China.
authors.forename: Bei
authors.initials: B
authors.lastname: Wang
authors.affiliation: School of Public Health, Southeast University, Nanjing, Jiangsu, People's Republic of China.
authors.forename: Jin-Shui
authors.initials: JS
authors.lastname: Xu
authors.affiliation: School of Public Health, Southeast University, Nanjing, Jiangsu, People's Republic of China.
authors.forename: Chang-Xian
authors.initials: CX
authors.lastname: Wang
authors.affiliation: Wuxi Clon-Gen Technique Institute, Wuxi, Jiangsu, People's Republic of China.
authors.forename: Zu-Huang
authors.initials: ZH
authors.lastname: Mi
authors.affiliation: School of Public Health, Southeast University, Nanjing, Jiangsu, People's Republic of China.
authors.forename: Yue-Pu
authors.initials: YP
authors.lastname: Pu
authors.affiliation: Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Adminstrative Region, People's Republic of China.
authors.forename: Mamie
authors.initials: M
authors.lastname: Hui
authors.affiliation: Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Adminstrative Region, People's Republic of China.
authors.forename: Thomas K W
authors.initials: TKW
authors.lastname: Ling
authors.affiliation: Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Adminstrative Region, People's Republic of China.
authors.forename: Chiu-Yeung
authors.initials: CY
authors.lastname: Chan
mesh_terms: D000328:Adult; D019943:Amino Acid Substitution; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002681:China; D027081:DNA Gyrase / Q000235:genetics; D027101:DNA Topoisomerase IV / Q000235:genetics; D004269:DNA, Bacterial / Q000235:genetics; D024881:Drug Resistance, Bacterial; D005260:Female; D024841:Fluoroquinolones / Q000494:pharmacology*; D006069:Gonorrhea / Q000382:microbiology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D020125:Mutation, Missense; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000235:genetics; D017422:Sequence Analysis, DNA
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D024841:Fluoroquinolones; D027101:DNA Topoisomerase IV; D027081:DNA Gyrase