Abstract
BackgroundThe widespread distribution of Neisseria gonorrhoeae strains that are resistant to previously used and clinically implemented antibiotics is a significant global public health problem. In line with WHO standards, the national Gonococcal Antimicrobial Surveillance Programme (RU-GASP) has been in existence in Russia since 2004; herein, the current status (2015) is described, including associations between N. gonorrhoeae antimicrobial susceptibility, primary genetic resistance determinants and specific strain sequence types.MethodsA total of 124 N. gonorrhoeae strains obtained from 9 regions in Russia in 2015 were examined using N. gonorrhoeae Multi-Antigen Sequence Typing (NG-MAST), an antimicrobial susceptibility test according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria and an oligonucleotide microarray for the identification of mutations in the penA, ponA, rpsJ, gyrA and parC genes responsible for penicillin G, tetracycline, and fluoroquinolone resistance. Genogroup (G) isolates were evaluated based on their porB and tbpB sequence types (STs).ResultsNG-MAST analysis showed a diversified population of N. gonorrhoeae in Russia with 58 sequence types, 35 of which were described for the first time. The STs 807, 1544, 1993, 5714, 9476 and 12531, which were typical for some Russian Federation regions and several countries of the former Soviet Union, were represented by five or more isolates. The internationally widespread ST 1407 was represented by a single strain in the present study. Division into genogroups facilitated an exploration of the associations between N. gonorrhoeae sequence type, antimicrobial resistance spectra and genetic resistance determinant contents. Preliminarily susceptible (G-807, G-12531) and resistant (G-5714, G-9476) genogroups were revealed. The variability in the most frequently observed STs and genogroups in each participating region indicated geographically restricted antimicrobial susceptibility in N. gonorrhoeae populations.ConclusionsResistance or intermediate susceptibility to previously recommended antimicrobials, such as penicillin G (60.5 %), ciprofloxacin (41.1 %) and tetracycline (25 %), is common in the N. gonorrhoeae population. Based on previous reports and current data, ceftriaxone and spectinomycin should be recommended for first-line empiric antimicrobial monotherapy for gonorrhoea in Russia.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1688-7) contains supplementary material, which is available to authorized users.
Highlights
The widespread distribution of Neisseria gonorrhoeae strains that are resistant to previously used and clinically implemented antibiotics is a significant global public health problem
Molecular typing of Neisseria gonorrhoeae isolates The study was performed with 124 N. gonorrhoeae isolates submitted from 9 regions of the Russian Federation over a 12-month period in 2015
The sequencing procedure with bacterial DNA extracts revealed 52 porB and 27 tbpB allele numbers. All these sequences were checked via the online N. gonorrhoeae Multi-Antigen Sequence Typing (NG-MAST) database, and 22 porB and 7 tbpB nucleotide sequences that were described for the first time were uploaded for Antimicrobials a Number (%) of isolates
Summary
The widespread distribution of Neisseria gonorrhoeae strains that are resistant to previously used and clinically implemented antibiotics is a significant global public health problem. The incidence of gonorrhoea in Russia (146 million inhabitants) has declined in the past 15 years; the rate of 23.5 reported cases per 100,000 members of the population is very high for the WHO European Region [http://data.euro.who.int/cisid/Default.aspx?TabID=394725]. This phenomenon presents with increased urgency because N. gonorrhoeae has developed resistance to antimicrobial drugs that were previously and are currently recommended for gonorrhoea treatment [6]. Numerous other chromosomal and plasmid drug resistance determinants have been described in clinical N. gonorrhoeae isolates worldwide [6] following the introduction of antimicrobials into clinical practice
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