Antimicrobial resistance and heterogeneity of Neisseria gonorrhoeae isolated from patients attending sexually transmitted infection clinics in Lusaka, Zambia.

Autor: Sarenje KL; Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, P.O. Box 50110, Zambia. kelvinsarenje@gmail.com.; Department of Dermato-venereology, University Teaching Hospital, Lusaka, Zambia. kelvinsarenje@gmail.com., van Zwetselaar M; Kilimanjaro Clinical Research Institute, Moshi, Kilimanjaro, Tanzania., Kumburu H; Kilimanjaro Clinical Research Institute, Moshi, Kilimanjaro, Tanzania.; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Sonda T; Kilimanjaro Clinical Research Institute, Moshi, Kilimanjaro, Tanzania.; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Mmbaga B; Kilimanjaro Clinical Research Institute, Moshi, Kilimanjaro, Tanzania.; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Ngalamika O; Department of Dermato-venereology, University Teaching Hospital, Lusaka, Zambia., Maimbolwa MC; Department of Midwifery Child, and Women's Health, School of Nursing Sciences, University of Zambia, Lusaka, Zambia., Siame A; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia., Munsaka S; Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, P.O. Box 50110, Zambia., Kwenda G; Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, P.O. Box 50110, Zambia.
Jazyk: angličtina
Zdroj: BMC genomics [BMC Genomics] 2024 Mar 18; Vol. 25 (1), pp. 290. Date of Electronic Publication: 2024 Mar 18.
DOI: 10.1186/s12864-024-10155-y
Abstrakt: Background: Antimicrobial resistance (AMR) of Neisseria gonorrhoeae is a threat to public health as strains have developed resistance to antimicrobials available for the treatment of gonorrhea. Whole genome sequencing (WGS) can detect and predict antimicrobial resistance to enhance the control and prevention of gonorrhea. Data on the molecular epidemiology of N. gonorrhoeae is sparse in Zambia. This study aimed to determine the genetic diversity of N. gonorrhoeae isolated from patients attending sexually transmitted infection (STI) clinics in Lusaka, Zambia.
Methods: A cross-sectional study that sequenced 38 N. gonorrhoeae isolated from 122 patients with gonorrhea from 2019 to 2020 was conducted. The AMR profiles were determined by the E-test, and the DNA was extracted using the NucliSens easyMaG magnetic device. Whole genome sequencing was performed on the Illumina NextSeq550 platform. The Bacterial analysis pipeline (BAP) that is readily available at: https://cge.cbs.dtu.dk/services/CGEpipeline-1.1 was used for the identification of the species, assembling the genome, multi-locus sequence typing (MLST), detection of plasmids and AMR genes. Phylogeny by single nucleotide polymorphisms (SNPs) was determined with the CCphylo dataset.
Results: The most frequent STs with 18.4% of isolates each were ST 7363 , ST 1921 and ST 1582 , followed by ST 1583 (13%), novel ST 17026 (7.9%), ST 1588 (7.9%), ST 1596 (5.3%), ST 11181 (5.3%), ST 11750 (2.6/%) and ST 11241 (2.6%) among the 38 genotyped isolates. The blaTeM-1B and tetM (55%) was the most prevalent combination of AMR genes, followed by blaTeM-1B (18.4%), tetM (15.8%), and the combination of blaTeM-1B, ermT, and tetL was 2.6% of the isolates. The AMR phenotypes were predicted in ciprofloxacin, penicillin, tetracycline, azithromycin, and cefixime. The combination of mutations 23.7% was gryA (S91F), parC (E91G), ponA (L421) and rpsJ (V57M), followed by 18.4% in gyrA (S91F), ponA (L421P), rpsJ (V57M), and 18.4% in gyrA (D95G, S91F), ponA (L421P), and rpsJ (V57M). The combinations in gyrA (D95G, S91F) and rpsJ (V57M), and gyrA (D95G, S91F), parC (E91F), ponA (L421P) and rpsJ (V57M) were 13.2% each of the isolates. Plasmid TEM-1 (84.2%), tetM (15.8%), and gonococcal genetic island (GGI) was detected in all isolates.
Conclusion: This study revealed remarkable heterogeneity of N. gonorrhoeae with bla TEM-1 , tetM, ponA, gyrA, and parC genes associated with high resistance to penicillin, tetracycline, and ciprofloxacin demanding revision of the standard treatment guidelines and improved antimicrobial stewardship in Zambia.
(© 2024. The Author(s).)
Databáze: MEDLINE
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