RESUMO
INTRODUCTION: The increase in sexually transmitted infections (STI) caused by Neisseria gonorrhoeae (NG) worldwide, together with the decrease in antibiotic susceptibility, forced us to understand the epidemiology of gonococcal infection. METHODS: The GONOvig project analyzed, comparatively following CLSI and EUCAST criteria, the antibiotic susceptibility of 227 NG strains collected in thirteen representative hospitals of the Valencia Community (CV) between 2013 and 2018. Additionally, molecular typing of 175 strains using the NG multi-antigen sequence typing technique (NG-MAST) was performed. RESULTS: High rates of resistance to tetracycline (38.2% by CLSI and 50.9% by EUCAST) and ciprofloxacin (49.1% CLSI and 54% EUCAST), and low percentages of resistance to spectinomycin (0%), cefixime (0.5% CLSI but 5.9% EUCAST), and ceftriaxone (1.5% CLSI and 2.4% EUCAST) were detected. Azithromycin resistance was 6% (both CLSI and EUCAST). Molecular analysis revealed the presence of 86 different sequence types (ST), highlighting ST2992 (7.4%), ST3378 (6.9%), ST2400 (4.6%) and ST13288 (6.9%), which was associated with resistance to cefixime (P=.031). The main genogroups (G) were G1407 (13.1%), G2992 (10.3%), G2400 (6.3%) and G387 (3.4%). G1407 and G2400 were associated with resistance to ciprofloxacin (P<.03). CONCLUSION: Low resistance to ceftriaxone, a worrying resistance to azithromycin and a wide variety of circulating sequence types have been detected, some of which show correlation with certain resistance profiles.
Assuntos
Gonorreia , Neisseria gonorrhoeae , Humanos , Neisseria gonorrhoeae/genética , Cefixima/farmacologia , Ceftriaxona/farmacologia , Azitromicina , Espanha/epidemiologia , Testes de Sensibilidade Microbiana , Antibacterianos/farmacologia , Gonorreia/epidemiologia , Ciprofloxacina/farmacologia , GenótipoRESUMO
Introducción: El aumento de las infecciones de transmisión sexual (ITS) producidas por Neisseria gonorrhoeae (NG) a nivel mundial, junto con la disminución de la susceptibilidad antibiótica, obliga a profundizar en la epidemiología de la infección gonocócica (IG). Métodos: El proyecto GONOvig analizó, comparativamente siguiendo criterios CLSI y EUCAST, la sensibilidad antibiótica de 227 cepas de NG recogidas en trece hospitales representativos de la Comunidad Valenciana (CV) entre los años 2013 y 2018. Adicionalmente, se pudo realizar la tipificación molecular de 175 cepas mediante la técnica NG multi-antigen sequence typing (NG-MAST). Resultados: Se detectaron elevadas tasas de resistencia a tetraciclina (38,2% por CLSI y 50,9% por EUCAST) y ciprofloxacino (49,1% CLSI y 54% EUCAST), y bajos porcentajes de resistencia a espectinomicina (0%), cefixima (0,5% CLSI pero 5,9% EUCAST) y ceftriaxona (1,5% CLSI y 2,4% EUCAST). La resistencia a azitromicina fue de 6% (tanto CLSI como EUCAST). El análisis molecular reveló la presencia de 86 secuenciotipos (ST) distintos, destacando el ST2992 (7,4%), ST3378 (6,9%), ST2400 (4,6%) y ST13288 (6,9%) el cual presentaba asociación con resistencia a cefixima (p = 0,031). Los genogrupos (G) mayoritarios fueron el G1407 (13,1%), G2992 (10,3%), G2400 (6,3%) y G387 (3,4%); G1407 y G2400 mostraron asociación con resistencia a ciprofloxacino (p < 0,03). Conclusión: Se ha detectado una baja resistencia a ceftriaxona, una preocupante resistencia a azitromicina y una gran variedad de ST circulantes, algunos de los cuales presentan correlación con determinados perfiles de resistencia.(AU)
Introduction: The increase in sexually transmitted infections (STI) caused by Neisseria gonorrhoeae (NG) worldwide, together with the decrease in antibiotic susceptibility, forced us to understand the epidemiology of gonococcal infection. Methods: The GONOvig project analyzed, comparatively following CLSI and EUCAST criteria, the antibiotic susceptibility of 227 NG strains collected in thirteen representative hospitals of the Valencia Community (CV) between 2013 and 2018. Additionally, molecular typing of 175 strains using the NG multi-antigen sequence typing technique (NG-MAST) was performed. Results: High rates of resistance to tetracycline (38.2% by CLSI and 50.9% by EUCAST) and ciprofloxacin (49.1% CLSI and 54% EUCAST), and low percentages of resistance to spectinomycin (0%), cefixime (0.5% CLSI but 5.9% EUCAST), and ceftriaxone (1.5% CLSI and 2.4% EUCAST) were detected. Azithromycin resistance was 6% (both CLSI and EUCAST). Molecular analysis revealed the presence of 86 different sequence types (ST), highlighting ST2992 (7.4%), ST3378 (6.9%), ST2400 (4.6%) and ST13288 (6.9%), which was associated with resistance to cefixime (p = 0.031). The main genogroups (G) were G1407 (13.1%), G2992 (10.3%), G2400 (6.3%) and G387 (3.4%). G1407 and G2400 were associated with resistance to ciprofloxacin (p < 0.03). Conclusión: Low resistance to ceftriaxone, a worrying resistance to azithromycin and a wide variety of circulating sequence types have been detected, some of which show correlation with certain resistance profiles.(AU)
