Objective: We investigated the initial outbreak of QRNG in southern California with analysis of transmission using strain typing.
Methods: Surveillance for QRNG was conducted in 2000-2002 in southern California including epidemiology and strain typing by a combination of antibiogram, auxotype, serovar, Lip type, and amino acid alteration patterns in the quinolone-resistance determining region of GyrA and ParC. Combining epidemiological data with strain typing, we describe the emergence of QRNG outbreak strains using risk factor analysis and transmission networks.
Results: Two outbreak strains accounted for 82% of isolates. Both strains required proline, were Lip type 17c, had amino acid alterations 91 > Phe in GyrA and 87 > Arg in ParC, but they differed by their serovar, IB-3C8 versus IB-2H7, 2G2. Outbreak strains were positively associated with men who have sex with men (MSM), adjusted odds ratio (AOR) 23.9; 95% confidence interval (CI) 2.2-261 and negatively associated with travel history: AOR 0.05, (95% CI 0.0-0.6). Network analysis demonstrated that 17 cases were connected by sexual contacts and/or public venues including bars, bathhouses/sex clubs, and Internet sites.
Conclusions: QRNG may have become established among Californian MSM through an identified transmission network of southern Californian bars, bathhouses and Internet sites.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.