title: Changing antimicrobial resistance profiles among Neisseria gonorrhoeae isolates in Italy, 2003 to 2012.
abstract: The emergence of Neisseria gonorrhoeae isolates displaying resistance to antimicrobial agents is a major public health concern and a serious issue related to the occurrence of further untreatable gonorrhea infections. A retrospective analysis on 1,430 N. gonorrhoeae isolates, collected from 2003 through 2012, for antimicrobial susceptibility by Etest and molecular characterization by Neisseria gonorrhoeae multiantigen sequence typing (NG-MAST) was carried out in Italy. Azithromycin-resistant gonococci decreased from 14% in 2007 to 2.2% in 2012. Similarly, isolates with high MICs to cefixime (>0.125 mg/liter) decreased from 11% in 2008 to 3.3% in 2012. The ciprofloxacin resistance rate remains quite stable, following an increasing trend up to 64% in 2012. The percentage of penicillinase-producing N. gonorrhoeae (PPNG) significantly declined from 77% in 2003 to 7% in 2012. A total of 81 multidrug-resistant (MDR) gonococci were identified, showing 11 different antimicrobial resistance patterns. These were isolated from men who have sex with men (MSM) and from heterosexual patients. Two sequence types (STs), ST661 and ST1407, were the most common. Genogroup 1407, which included cefixime-, ciprofloxacin-, and azithromycin-resistant isolates, was found. In conclusion, a change in the antimicrobial resistance profiles among gonococci was identified in Italy together with a percentage of MDR isolates.
authors: Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy.
authors: Anna
authors: A
authors: Carannante
authors: Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy.
authors: Giovanna
authors: G
authors: Renna
authors: STI Clinic, Department of Infectious Diseases, Amedeo di Savoia Hospital, Turin, Italy.
authors: Ivano
authors: I
authors: Dal Conte
authors: Microbiology and Virology Laboratory, Department of Infectious Diseases, Amedeo di Savoia Hospital, Turin, Italy.
authors: Valeria
authors: V
authors: Ghisetti
authors: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy.
authors: Alberto
authors: A
authors: Matteelli
authors: San Gallicano Dermatologic Institute, IRCSS, Rome, Italy.
authors: Grazia
authors: G
authors: Prignano
authors: San Gallicano Dermatologic Institute, IRCSS, Rome, Italy.
authors: Giampaolo
authors: G
authors: Impara
authors: Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors: Marco
authors: M
authors: Cusini
authors: Azienda Ospedaliero-Universitaria di Bologna Policlinico S. Orsola-Malpighi Unit of Dermatology, STDs Center, Bologna, Italy.
authors: Antonietta
authors: A
authors: D'Antuono
authors: Unit of Clinical Microbiology, CRREM Laboratory, St. Orsola-Malpighi, University Hospital, Bologna, Italy.
authors: Caterina
authors: C
authors: Vocale
authors: Department of Clinical Pathology, Azienda Ospedaliero-Universitaria OORR, Foggia, Italy.
authors: Raffaele
authors: R
authors: Antonetti
authors: Microbiology and Virology Laboratory, Santa Chiara Hospital, Trento, Italy.
authors: Marina
authors: M
authors: Gaino
authors: Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
authors: Marina
authors: M
authors: Busetti
authors: Laboratorio di Batteriologia, Ospedale Ostetrico Ginecologico Sant'Anna, Turin, Italy.
authors: Maria Agnese
authors: MA
authors: Latino
authors: Microbiology Section, Department of Experimental Medicine and Biochemical Sciences, University of Perugia, Perugia, Italy.
authors: Antonella
authors: A
authors: Mencacci
authors: Microbiology and Virology Laboratory, Sandro Pertini Hospital, Rome, Italy.
authors: Carmen
authors: C
authors: Bonanno
authors: Microbiology and Virology Laboratory, Sandro Pertini Hospital, Rome, Italy.
authors: Maria Carmela
authors: MC
authors: Cava
authors: Microbiology and Virology Laboratory, Molecular Clinic, PO Annunziata Azienda Ospedaliera di Cosenza, Cosenza, Italy.
authors: Cristina
authors: C
authors: Giraldi
authors: Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy paola.stefanelli@iss.it.
authors: Paola
authors: P
authors: Stefanelli
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017963:Azithromycin / Q000494:pharmacology; D020682:Cefixime / Q000494:pharmacology; D002939:Ciprofloxacin / Q000494:pharmacology; D006801:Humans; D007558:Italy; D008297:Male; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000201:enzymology; D010405:Penicillinase / Q000378:metabolism; D010406:Penicillins / Q000494:pharmacology; D012189:Retrospective Studies; D013752:Tetracycline / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins; D002939:Ciprofloxacin; D017963:Azithromycin; D020682:Cefixime; D010405:Penicillinase; D013752:Tetracycline