rss
Sex Transm Infect doi:10.1136/sti.2008.029694

Prediction of antibiotic resistance using Neisseria gonorrhoeae multi-antigen sequence typing.

  1. Helen M Palmer (helen.palmer{at}luht.scot.nhs.uk)
  1. Lothian University Health Trust, United Kingdom
    1. Hugh Young (hugh.young{at}luht.scot.nhs.uk)
    1. Lothian University Health Trust, United Kingdom
      1. Catriona Graham (c.graham{at}ed.ac.uk)
      1. Wellcome Trust Clinical Research, United Kingdom
        1. Jayshree Dave (jayshree.dave{at}luht.scot.nhs.uk)
        1. Lothian University Health Trust, United Kingdom
          • Published Online First 6 February 2008

          Abstract

          Objectives: To establish if antibiotic resistance in Neisseria gonorrhoeae is uniform within a given sequence type as determined by Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST).

          Methods: Antibiotic susceptibility testing and typing was performed on all N. gonorrhoeae isolated in Scotland over a two year period. Antibiotic susceptibility to seven antibiotics was determined using the agar dilution method and NG-MAST was performed.

          Results: Isolates from 1762 episodes of infection were tested, of which 8.0% were penicillinase-producing N. gonorrhoeae (PPNG), 8.4% were tetracycline resistant N. gonorrhoeae (TRNG), 2.7% had chromosomal penicillin resistance, 30.5% had chromosomal tetracycline resistance, 2.0% had decreased susceptibility to azithromycin; and 25.3% were ciprofloxacin resistant (including 1.7% with intermediate resistance). Resistance to spectinomycin or decreased susceptibility to ceftriaxone or cefixime was not observed. Of 405 sequence types (STs), 169 contained 2-85 isolates accounting for 1526 isolates. The overall concordance between ST and antibiotic susceptibility category was 98.1 %, 95% CI (97.8, 98.3). The concordance for penicillin (chromosomal and plasmid mediated resistance) was 97.1%, 95% CI (96.1, 97.8), for ciprofloxacin was 99.5%, 95% CI (99.1, 99.8), for azithromycin was 97.8%, 95% CI (96.9, 98.5) and for tetracycline (chromosomal and plasmid mediated resistance) was 92.0%, 95% CI (90.5, 93.3).

          Conclusions: Antibiotic resistance in Neisseria gonorrhoeae was usually uniform within a given sequence type. Therefore the ST of an isolate allows the presence of antibiotic resistance to be predicted with a high degree of accuracy. Further studies on the geographical variation and temporal stability of antibiotic susceptibility patterns within STs are required.

          This Article

          1. Abstract
          2. PDF
          3. All versions of this article:
            1. sti.2008.029694v1
            2. 84/4/280most recent

          Responses

          1. Submit a response
          2. No responses published

          Register for free content

          The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

          Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.