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Recent dynamics in Neisseria gonorrhoeae genomic epidemiology in Brazil: antimicrobial resistance and genomic lineages in 2017-20 compared to 2015-16.
Golparian, Daniel; Bazzo, Maria Luiza; Ahlstrand, Josefine; Schörner, Marcos André; Gaspar, Pamela Cristina; de Melo Machado, Hanalydia; Martins, Jéssica Motta; Bigolin, Alisson; Ramos, Mauro Cunha; Ferreira, William Antunes; Pereira, Gerson Fernando Mendes; Miranda, Angelica Espinosa; Unemo, Magnus.
Afiliación
  • Golparian D; WHO Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Department of Laboratory Medicine, Microbiology, Faculty of Medicine and Health, Örebro University, SE-701 85, Örebro, Sweden.
  • Bazzo ML; Molecular Biology, Microbiology and Serology Laboratory, Federal University of Santa Catarina, Florianópolis, Brazil.
  • Ahlstrand J; WHO Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Department of Laboratory Medicine, Microbiology, Faculty of Medicine and Health, Örebro University, SE-701 85, Örebro, Sweden.
  • Schörner MA; Molecular Biology, Microbiology and Serology Laboratory, Federal University of Santa Catarina, Florianópolis, Brazil.
  • Gaspar PC; Department of HIV/AIDS, Tuberculosis, and Sexually Transmitted Infection, Secretariat of Health Surveillance and Environment, Ministry of Health of Brazil, Brasília, Brazil.
  • de Melo Machado H; Molecular Biology, Microbiology and Serology Laboratory, Federal University of Santa Catarina, Florianópolis, Brazil.
  • Martins JM; Molecular Biology, Microbiology and Serology Laboratory, Federal University of Santa Catarina, Florianópolis, Brazil.
  • Bigolin A; Department of HIV/AIDS, Tuberculosis, and Sexually Transmitted Infection, Secretariat of Health Surveillance and Environment, Ministry of Health of Brazil, Brasília, Brazil.
  • Ramos MC; Brazilian STD Society, Porto Alegre, Brazil.
  • Ferreira WA; Alfredo da Mata Foundation, Manaus, Brazil.
  • Pereira GFM; Department of HIV/AIDS, Tuberculosis, and Sexually Transmitted Infection, Secretariat of Health Surveillance and Environment, Ministry of Health of Brazil, Brasília, Brazil.
  • Miranda AE; Department of HIV/AIDS, Tuberculosis, and Sexually Transmitted Infection, Secretariat of Health Surveillance and Environment, Ministry of Health of Brazil, Brasília, Brazil.
  • Unemo M; WHO Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Department of Laboratory Medicine, Microbiology, Faculty of Medicine and Health, Örebro University, SE-701 85, Örebro, Sweden.
J Antimicrob Chemother ; 79(5): 1081-1092, 2024 05 02.
Article en En | MEDLINE | ID: mdl-38517452
ABSTRACT

OBJECTIVES:

Regular quality-assured WGS with antimicrobial resistance (AMR) and epidemiological data of patients is imperative to elucidate the shifting gonorrhoea epidemiology, nationally and internationally. We describe the dynamics of the gonococcal population in 11 cities in Brazil between 2017 and 2020 and elucidate emerging and disappearing gonococcal lineages associated with AMR, compare to Brazilian WGS and AMR data from 2015 to 2016, and explain recent changes in gonococcal AMR and gonorrhoea epidemiology.

METHODS:

WGS was performed using Illumina NextSeq 550 and genomes of 623 gonococcal isolates were used for downstream analysis. Molecular typing and AMR determinants were obtained and links between genomic lineages and AMR (determined by agar dilution/Etest) examined.

RESULTS:

Azithromycin resistance (15.6%, 97/623) had substantially increased and was mainly explained by clonal expansions of strains with 23S rRNA C2611T (mostly NG-STAR CC124) and mtr mosaics (mostly NG-STAR CC63, MLST ST9363). Resistance to ceftriaxone and cefixime remained at the same levels as in 2015-16, i.e. at 0% and 0.2% (1/623), respectively. Regarding novel gonorrhoea treatments, no known zoliflodacin-resistance gyrB mutations or gepotidacin-resistance gyrA mutations were found. Genomic lineages and sublineages showed a phylogenomic shift from sublineage A5 to sublineages A1-A4, while isolates within lineage B remained diverse in Brazil.

CONCLUSIONS:

Azithromycin resistance, mainly caused by 23S rRNA C2611T and mtrD mosaics/semi-mosaics, had substantially increased in Brazil. This mostly low-level azithromycin resistance may threaten the recommended ceftriaxone-azithromycin therapy, but the lack of ceftriaxone resistance is encouraging. Enhanced gonococcal AMR surveillance, including WGS, is imperative in Brazil and other Latin American and Caribbean countries.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Gonorrea / Pruebas de Sensibilidad Microbiana / Azitromicina / Farmacorresistencia Bacteriana / Secuenciación Completa del Genoma / Antibacterianos / Neisseria gonorrhoeae Límite: Adolescent / Adult / Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Brasil Idioma: En Revista: J Antimicrob Chemother Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Gonorrea / Pruebas de Sensibilidad Microbiana / Azitromicina / Farmacorresistencia Bacteriana / Secuenciación Completa del Genoma / Antibacterianos / Neisseria gonorrhoeae Límite: Adolescent / Adult / Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Brasil Idioma: En Revista: J Antimicrob Chemother Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido