Antimicrobial susceptibility of Neisseria gonorrhoeae isolated in Jiangsu Province, China, with a focus on fluoroquinolone resistance.
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.
Wang
Bei
B
School of Public Health, Southeast University, Nanjing, Jiangsu, People's Republic of China.
Xu
Jin-Shui
JS
School of Public Health, Southeast University, Nanjing, Jiangsu, People's Republic of China.
Wang
Chang-Xian
CX
School of Public Health, Southeast University, Nanjing, Jiangsu, People's Republic of China.
Mi
Zu-Huang
ZH
Wuxi Clon-Gen Technique Institute, Wuxi, Jiangsu, People's Republic of China.
Pu
Yue-Pu
YP
School of Public Health, Southeast University, Nanjing, Jiangsu, People's Republic of China.
Hui
Mamie
M
Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Adminstrative Region, People's Republic of China.
Ling
Thomas K W
TKW
Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Adminstrative Region, People's Republic of China.
Chan
Chiu-Yeung
CY
Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Adminstrative Region, People's Republic of China.
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
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D024841:Fluoroquinolones; D027101:DNA Topoisomerase IV; D027081:DNA Gyrase