Abstract
Commensal Neisseria provide a reservoir of resistance genes that can be transferred to the pathogens Neisseria gonorrhoeae and N. meningitidis in the human oropharynx. Surveillance programs are thus needed to monitor resistance in oropharyngeal commensal Neisseria, but currently the isolation and antimicrobial susceptibility testing of these commensals is laborious, complex and expensive. In addition, the posterior oropharyngeal/tonsillar swab, which is commonly used to sample oropharyngeal Neisseria, is poorly tolerated by many individuals. We evaluated an alternative non-invasive method to isolate oropharyngeal commensal Neisseria and to detect decreased susceptibility to azithromycin using selective media (LBVT.SNR) with and without azithromycin (2 µg/mL). In this pilot study, we compared paired posterior oropharyngeal/tonsillar swabs and oral rinse-and-gargle samples from 10 participants and demonstrated that a similar Neisseria species diversity and number of colonies were isolated from both sample types. Moreover, the proportion of Neisseria colonies that had a decreased susceptibility to azithromycin was similar in the rinse samples compared to the swabs. This pilot study has produced encouraging data that a simple protocol of oral rinse-and-gargle and culture on plates selective for commensal Neisseria with and without a target antimicrobial can be used as a surveillance tool to monitor antimicrobial susceptibility in commensal oropharyngeal Neisseria. Larger studies are required to validate these findings.
Highlights
IntroductionIntroduction published maps and institutional affilCommensal Neisseria are an important part of the normal oropharyngeal human microbiome [1]
Introduction published maps and institutional affilCommensal Neisseria are an important part of the normal oropharyngeal human microbiome [1]
The most notable difference between the two methods was that in three participants (2, 7, 10) an additional Neisseria species was isolated in the oral rinse that was not detected in the swab samples (Table 1, Supplemental Table S1)
Summary
Introduction published maps and institutional affilCommensal Neisseria are an important part of the normal oropharyngeal human microbiome [1]. It has recently been shown that the acquisition of sections of the gene encoding the mtrCDE efflux pump by N. gonorrhoeae from commensal Neisseria played a crucial role in the emergence of macrolide resistance in N. gonorrhoeae [14]. These findings have led to calls to establish surveillance programs that monitor antimicrobial susceptibility in commensal Neisseria [2,10,15]. Surveillance of antimicrobial susceptibility of commensal Neisseria involves taking oropharyngeal swabs iations
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