Molecular monitoring and determination of N. gonorrhoeae sensitivity to antimicrobial drugs as tools to control the propagation of gonococcal infection in the Arkhangelsk Region

Abstract

As a result of studying the sensitivity indices concerning antimicrobial drugs (AMD) for 203 strains of N. gonorrhoeae obtained from patients suffering from the gonococcal infection in the Arkhangelsk region, it was established that the trends of N. gonorrhoeae strains propagation, which are resistant to AMD, match the trends in Russia in general. Ceftriaxone is the drug of choice to treat the gonococcal infection in the territory of the region. It was observed that N. gonorrhoeae strains started developing resistance to the AMD in the territory of the region. The authors conducted a study of 51 N. Gonorrhoeae strains obtained from patients suffering from the gonococcal infection in 2011 using molecular epidemiology methods (sequence and phylogenetic analysis). Heterogeneity in the sample of the N. gonorrhoeae strains circulating in the territory of the Arkhangelsk region as well as high rate of their genetic variability were revealed. It was noted that N. gonorrhoeae strains, which are unique for this geographic region (dominating sequence types No. 343, 5042, 1523, 1152, 387, 6238, 5825 and 6234 as well as single sequence types), are registered in the territory of the Arkhangelsk region. The authors demonstrated the possibility to use molecular methods (PCR and sequence analysis) for individual identification of infection sources and sexual partners of patients suffering from the gonococcal infection and for the purposes of epidemiological monitoring. The authors established associations between the fact that the N. gonorrhoeae strains obtained from patients suffering from the gonococcal infection in the Arkhangelsk region belong to sequence types No. 343, 285, 2625 and 6237, and their multi-resistance, which demands a thorough examination to determine the treatment tactics for such patients. Taking into consideration the results of these studies, the authors prepared recommendations on how to control the propagation of the gonococcal infection in the territory of the Arkhangelsk region.