title: Trend of ciprofloxacin resistance in Neisseria gonorrhoeae strains isolated in Italy and analysis of the molecular determinants.
abstract: A total of 599 Neisseria gonorrhoeae strains collected in Italy in 2 periods, 2003 to 2005 and 2007 to 2008, were screened for ciprofloxacin susceptibility by Etest. Ciprofloxacin-resistant strains (49.7%) were characterized by i) serovar determination, patterns of mutation in gyrA, and parC genes (38%, randomly selected) and ii) N. gonorrhoeae multiantigen sequence typing (56% of the strains isolated from patients who declared their sexual orientation). The percentage of ciprofloxacin-resistant strains increased from 42 (2003-2005) to 58 (2007-2008); in the second period, strains with MIC value >32 microg/mL have been observed. Mutations in gyrA and parC genes were identified in the majority of strains (88%). Ciprofloxacin-resistant isolates among men who have sex with men (MSM) increased from 24% in 2003 to 2005 to 47% in 2007 to 2008. However, sequence types exclusively found among MSM were mostly due to a single strain. This is the first study in Italy combining N. gonorrhoeae ciprofloxacin susceptibility testing with molecular analyses and comparing the results over time.
authors.affiliation: Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, 00161-Rome, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Starnino
authors.forename: Ivano
authors.initials: I
authors.lastname: Dal Conte
authors.forename: Alberto
authors.initials: A
authors.lastname: Matteelli
authors.forename: Emma
authors.initials: E
authors.lastname: Galluppi
authors.forename: Marco
authors.initials: M
authors.lastname: Cusini
authors.forename: Aldo
authors.initials: A
authors.lastname: Di Carlo
authors.forename: Sergio
authors.initials: S
authors.lastname: Delmonte
authors.forename: Paola
authors.initials: P
authors.lastname: Stefanelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002939:Ciprofloxacin / Q000494:pharmacology*; D027081:DNA Gyrase / Q000235:genetics; D027101:DNA Topoisomerase IV / Q000235:genetics; D004269:DNA, Bacterial / Q000235:genetics; D024881:Drug Resistance, Bacterial; D005260:Female; D005798:Genes, Bacterial; D006069:Gonorrhea / Q000382:microbiology*; D018451:Homosexuality, Male; D006801:Humans; D007558:Italy; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000302:isolation & purification; D017422:Sequence Analysis, DNA; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D002939:Ciprofloxacin; D027101:DNA Topoisomerase IV; D027081:DNA Gyrase