头孢曲松耐药淋病奈瑟菌株FC428的流行、耐药机制及应对策略

doi:10.35541/cjd.20200528

Abstract

Abstract: 【Abstract】 Antimicrobial resistance of Neisseria gonorrhoeae has become a big challenge in the control and prevention of sexually transmitted diseases. Recently, a ceftriaxone-resistant Neisseria gonorrhoeae strain FC428 has spread across the world including China, which has worsened the antimicrobial resistance problem. This strain is highly resistant to ceftriaxone due to a novel mosaic penA gene. In order to better understand the characteristics of FC428 and control its further spread, this review summarizes its origin, spread, main molecular characteristics, resistance mechanisms, detection methods, and strategies for clinical treatment and antimicrobial resistance surveillance.

Key words: Neisseria gonorrhoeae, Ceftriaxone, Drug resistance, bacterial, Disease transmission, infectious, Infection control, FC428

Chen Shaochun, Liu Jingwei, Zhou Ke, Yin Yueping. Ceftriaxone-resistant Neisseria gonorrhoeae strain FC428: prevalence, resistance mechanisms and control strategies[J]. Chinese Journal of Dermatology, 2022, 55(12): 1122-1126.doi:10.35541/cjd.20200528

References ［39］

［1］	Rowley J, Vander Hoorn S, Korenromp E, et al. Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016［J］. Bull World Health Organ, 2019,97（8）:548⁃562P. doi: 10.2471/BLT.18.228486.
［2］	Yue XL, Gong XD, Li J, et al. Gonorrhea in China, 2018［J/OL］. Int J Dermatol Venereol, 2019,2（2）:65⁃69［2020⁃06⁃24］. https://journals.lww.com/ijdv/Fulltext/2019/06000/Gonorrhea_in_China,_2018.1.aspx. doi: 10.1097/JD9.0000000000000008.
［3］	Nakayama S, Shimuta K, Furubayashi K, et al. New ceftriaxone⁃ and multidrug⁃resistant Neisseria gonorrhoeae strain with a novel mosaic pena gene isolated in Japan［J］. Antimicrob Agents Chemother, 2016,60（7）:4339⁃4341. doi: 10.1128/AAC. 00504⁃16.
［4］	Ohnishi M, Golparian D, Shimuta K, et al. Is Neisseria gonorrhoeae initiating a future era of untreatable gonorrhea?: detailed characterization of the first strain with high⁃level resistance to ceftriaxone［J］. Antimicrob Agents Chemother, 2011,55（7）:3538⁃3545. doi: 10.1128/AAC.00325⁃11.
［5］	Deguchi T, Yasuda M, Hatazaki K, et al. New clinical strain of Neisseria gonorrhoeae with decreased susceptibility to ceftriaxone, Japan［J］. Emerg Infect Dis, 2016,22（1）:142⁃144. doi: 10.3201/eid2201.150868.
［6］	Unemo M, Golparian D, Nicholas R, et al. High⁃level cefixime⁃ and ceftriaxone⁃resistant Neisseria gonorrhoeae in France: novel penA mosaic allele in a successful international clone causes treatment failure［J］. Antimicrob Agents Chemother, 2012,56（3）:1273⁃1280. doi: 10.1128/AAC.05760⁃11.
［7］	Lahra MM, Ryder N, Whiley DM. A new multidrug⁃resistant strain of Neisseria gonorrhoeae in Australia［J］. N Engl J Med, 2014,371（19）:1850⁃1851. doi: 10.1056/NEJMc1408109.
［8］	Cherdtrakulkiat T, Wongsurawat T, Jenjaroenpun P, et al. Complete genome sequences of three Neisseria gonorrhoeae isolates from Thailand with multidrug resistance and multilocus sequence type 1903［J］. Microbiol Resour Announc, 2020,9（19）. doi: 10.1128/MRA.00198⁃20.
［9］	Chen SC, Han Y, Yuan LF, et al. Identification of internationally disseminated ceftriaxone⁃resistant Neisseria gonorrhoeae strain FC428, China［J］. Emerg Infect Dis, 2019,25（7）:1427⁃1429. doi: 10.3201/eid2507.190172.
［10］	Lahra MM, Martin I, Demczuk W, et al. Cooperative recognition of internationally disseminated ceftriaxone⁃resistant Neisseria gonorrhoeae strain［J］. Emerg Infect Dis, 2018,24（4）:735⁃740. doi: 10.3201/eid2404.171873.
［11］	Lefebvre B, Martin I, Demczuk W, et al. Ceftriaxone⁃resistant Neisseria gonorrhoeae, Canada, 2017. Emerg Infect Dis, 2018,24（2）:381⁃383. doi: 10.3201/eid2402.171756.
［12］	Terkelsen D, Tolstrup J, Johnsen CH, et al. Multidrug⁃resistant Neisseria gonorrhoeae infection with ceftriaxone resistance and intermediate resistance to azithromycin, Denmark, 2017［J］. Euro Surveill，2017，22（42）:17⁃00659. doi: 10.2807/1560⁃7917.ES.2017.22.42.17⁃00659.
［13］	Golparian D, Rose L, Lynam A, et al. Multidrug⁃resistant Neisseria gonorrhoeae isolate, belonging to the internationally spreading Japanese FC428 clone, with ceftriaxone resistance and intermediate resistance to azithromycin, Ireland, August 2018［J］. Euro Surveill, 2018,23（47）:1800617. doi: 10.2807/1560⁃7917.ES.2018.23.47.1800617.
［14］	Eyre DW, Town K, Street T, et al. Detection in the United Kingdom of the Neisseria gonorrhoeae FC428 clone, with ceftriaxone resistance and intermediate resistance to azithromycin, October to December 2018. Euro Surveill, 2019, 24（10）:1900147. doi: 10.2807/1560⁃7917.ES.2019.24.10.1900 147.
［15］	Ko K, Chio M, Goh SS, et al. First case of ceftriaxone⁃resistant multidrug⁃resistant Neisseria gonorrhoeae in Singapore［J］. Antimicrob Agents Chemother, 2019,63（5）:e02624⁃18. doi: 10. 1128/AAC.02624⁃18.
［16］	Poncin T, Merimeche M, Braille A, et al. Two cases of multidrug⁃resistant Neisseria gonorrhoeae related to travel in south⁃eastern Asia, France, June 2019［J］. Euro Surveill, 2019,24（36）:1900528. doi: 10.2807/1560⁃7917.ES.2019.24.36.1900528.
［17］	Lee K, Nakayama SI, Osawa K, et al. Clonal expansion and spread of the ceftriaxone⁃resistant Neisseria gonorrhoeae strain FC428, identified in Japan in 2015, and closely related isolates［J］. J Antimicrob Chemother, 2019,74（7）:1812⁃1819. doi: 10. 1093/jac/dkz129.
［18］	Berenger BM, Demczuk W, Gratrix J, et al. Genetic characterization and enhanced surveillance of ceftriaxone⁃resistant Neisseria gonorrhoeae Strain, Alberta, Canada, 2018. Emerg Infect Dis, 2019,25（9）:1660⁃1667. doi: 10.3201/eid2509. 190407.
［19］	Chen SC, Yuan LF, Zhu XY, et al. Sustained transmission of the ceftriaxone⁃resistant Neisseria gonorrhoeae FC428 clone in China［J］. J Antimicrob Chemother, 2020,75（9）:2499⁃2502. doi: 10.1093/jac/dkaa196.
［20］	Yang Y, Yang Y, Martin I, et al. NG⁃STAR genotypes are associated with MDR in Neisseria gonorrhoeae isolates collected in 2017 in Shanghai［J］. J Antimicrob Chemother, 2020,75（3）:566⁃570. doi: 10.1093/jac/dkz471.
［21］	Yang F, Zhang H, Chen Y, et al. Detection and analysis of two cases of the internationally spreading ceftriaxone⁃resistant Neisseria gonorrhoeae FC428 clone in China［J］. J Antimicrob Chemother, 2019,74（12）:3635⁃3636. doi: 10.1093/jac/dkz384.
［22］	Wang H, Wang Y, Yong G, et al. Emergence and genomic characterization of the ceftriaxone⁃resistant Neisseria gonorrhoeae FC428 clone in Chengdu, China［J］. J Antimicrob Chemother, 2020,75（9）:2495⁃2498. doi: 10.1093/jac/dkaa123.
［23］	Yuan Q, Li Y, Xiu L, et al. Identification of multidrug⁃resistant Neisseria gonorrhoeae isolates with combined resistance to both ceftriaxone and azithromycin, China, 2017-2018［J］. Emerg Microbes Infect, 2019, 8（1）:1546⁃1549. doi: 10.1080/22221751. 2019.1681242.
［24］	Jolley KA, Maiden MC. BIGSdb: Scalable analysis of bacterial genome variation at the population level［J］. BMC Bioinformatics, 2010,11:595. doi: 10.1186/1471⁃2105⁃11⁃595.
［25］	Martin IM, Ison CA, Aanensen DM, et al. Rapid sequence⁃based identification of gonococcal transmission clusters in a large metropolitan area［J］. J Infect Dis, 2004,189（8）:1497⁃1505. doi: 10.1086/383047.
［26］	Demczuk W, Sidhu S, Unemo M, et al. Neisseria gonorrhoeae sequence typing for antimicrobial resistance, a novel antimicrobial resistance multilocus typing scheme for tracking global dissemination of N. gonorrhoeae strains［J］. J Clin Microbiol, 2017,55（5）:1454⁃1468. doi: 10.1128/JCM.001 00⁃17.
［27］	Tomberg J, Unemo M, Ohnishi M, et al. Identification of amino acids conferring high⁃level resistance to expanded⁃spectrum cephalosporins in the penA gene from Neisseria gonorrhoeae strain H041［J］. Antimicrob Agents Chemother, 2013,57（7）:3029⁃3036. doi: 10.1128/AAC.00093⁃13.
［28］	Zhou K, Chen SC, Yang F, et al. Impact of the gonococcal FC428 penA allele 60.001 on ceftriaxone resistance and biological fitness［J］. Emerg Microbes Infect, 2020,9（1）:1219⁃1229. doi: 10.1080/22221751.2020.1773325.
［29］	Shimuta K, Igawa G, Yasuda M, et al. A real⁃time PCR assay for detecting a penA mutation associated with ceftriaxone resistance in Neisseria gonorrhoeae［J］. J Glob Antimicrob Resist, 2019,19:46⁃49. doi: 10.1016/j.jgar.2019.02.011.
［30］	Whiley DM, Mhango L, Jennison AV, et al. Direct detection of penA gene associated with ceftriaxone⁃resistant Neisseria gonorrhoeae FC428 strain by using PCR［J］. Emerg Infect Dis, 2018,24（8）:1573⁃1575. doi: 10.3201/eid2408.180295.
［31］	Xiu L, Zhang C, Li Y, et al. High⁃resolution melting analysis for rapid detection of the internationally spreading ceftriaxone⁃resistant Neisseria gonorrhoeae FC428 clone［J］. J Antimicrob Chemother, 2020,75（1）:106⁃109. doi: 10.1093/jac/dkz395.
［32］	Shimuta K, Nakayama SI, Takahashi H, et al. A loop⁃mediated isothermal amplification assay targeting Neisseria gonorrhoeae penA⁃60.001［J］. Antimicrob Agents Chemother, 2019,64（1）:e01663⁃19. doi: 10.1128/AAC.01663⁃19.
［33］	Li Y, Xiu L, Liu J, et al. A multiplex assay for characterization of antimicrobial resistance in Neisseria gonorrhoeae using multi⁃PCR coupled with mass spectrometry［J］. J Antimicrob Chemother, 2020,75（10）:2817⁃2825. doi: 10.1093/jac/dkaa269.
［34］	Xiu L, Yuan Q, Li Y, et al. Emergence of ceftriaxone⁃resistant Neisseria gonorrhoeae strains harbouring a novel mosaic penA gene in China［J］. J Antimicrob Chemother, 2020,75（4）:907⁃910. doi: 10.1093/jac/dkz530.
［35］	中国疾病预防控制中心性病控制中心, 中华医学会皮肤性病学分会性病学组, 中国医师协会皮肤科医师分会性病亚专业委员会. 梅毒、淋病和生殖道沙眼衣原体感染诊疗指南（2020年）［J］. 中华皮肤科杂志, 2020,53（3）:168⁃179. doi: 10.35541/cjd.20190808.
［36］	Chen SC, Hu LH, Zhu XY, et al. Gonococcal urethritis caused by a multidrug resistant Neisseria gonorrhoeae strain with high⁃level resistance to spectinomycin in China［J］. Emerg Microbes Infect, 2020,9（1）:517⁃519. doi: 10.1080/22221751.2020.1732 836.
［37］	Chisholm SA, Mouton JW, Lewis DA, et al. Cephalosporin MIC creep among gonococci: time for a pharmacodynamic rethink?［J］. J Antimicrob Chemother, 2010,65（10）:2141⁃2148. doi: 10. 1093/jac/dkq289.
［38］	Unemo M. Current and future antimicrobial treatment of gonorrhoea ⁃ the rapidly evolving Neisseria gonorrhoeae continues to challenge［J］. BMC Infect Dis, 2015,15:364. doi: 10.1186/s12879⁃015⁃1029⁃2.
［39］	Yin YP, Han Y, Dai XQ, et al. Susceptibility of Neisseria gonorrhoeae to azithromycin and ceftriaxone in China: a retrospective study of national surveillance data from 2013 to 2016［J/OL］. PLoS Med, 2018,15（2）:e1002499［2020⁃06⁃24］. https://journals.plos.org/plosmedicine/article?id=10.1371/journal. pmed.1002499. doi: 10.1371/journal. pmed.1002499.

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[3]	chuan Xiaohong Su. Resistance of Neisseria gonorrhoeae to azithromycin: an update [J]. Chinese Journal of Dermatology, 2018, 51(5): 394-396.
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[5]	. Penicillinase-producing Neisseria gonorrhoeae and its blaTEM-135 gene variants at several gonococcal antimicrobial surveillance sites in China: an epidemiological study [J]. Chinese Journal of Dermatology, 2015, 48(5): 312-316.
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Ceftriaxone-resistant Neisseria gonorrhoeae strain FC428: prevalence, resistance mechanisms and control strategies

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