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首页> 外文期刊>BMC Infectious Diseases >Antimicrobial resistance and Neisseria gonorrhoeae multiantigen sequence typing (NG-MAST) genotypes in N. gonorrhoeae during 2012–2014 in Karachi, Pakistan
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Antimicrobial resistance and Neisseria gonorrhoeae multiantigen sequence typing (NG-MAST) genotypes in N. gonorrhoeae during 2012–2014 in Karachi, Pakistan

机译：巴基斯坦卡拉奇市2012年至2014年淋病奈瑟菌的抗菌素耐药性和淋病奈瑟菌多抗原序列分型（NG-MAST）基因型。

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Background Globally, increasing antimicrobial resistance (AMR) in Neisseria gonorrhoea has led to decreased treatment options for gonorrhoea. Continuous monitoring of resistance is crucial to determine evolving resistance trends in Neisseria gonorrhoea and to suggest treatment recommendations. Quality assured gonococcal AMR data from Pakistan are mainly lacking. This study was performed to determine prevalence and trends of gonococcal AMR and molecular epidemiology of local strains during 2012–2014 in Karachi, Pakistan. Methods Gonococcal isolates ( n?= 100) were obtained from urogenital specimens submitted to the Aga Khan University Laboratory, Karachi, Pakistan. Antimicrobial susceptibility was determined using Etest and molecular epidemiology was assessed by N. gonorrhoeae multiantigen sequence typing (NG-MAST). Quality control was performed using N. gonorrhoeae WHO reference strains C, F, G, K, L, M, N, O, and P, and ATCC 49226. Results Susceptibility to spectinomycin, ceftriaxone and cefixime was 100?% and to azithromycin was 99?%. All isolates had low ceftriaxone MICs, i.e., ≤0.032?mg/L. Resistance to ciprofloxacin, tetracycline and penicillin G were 86?%, 51?% and 43?%, respectively. NG-MAST analysis identified 74 different sequence types (STs). Conclusions A highly diversified gonococcal population, 74 NG-MAST STs (62 novel STs) with an increased resistance to penicillin G, ciprofloxacin and tetracycline circulated in Karachi, Pakistan. Fortunately, no resistance to ceftriaxone was detected. Accordingly, ceftriaxone can continuously be recommended as the treatment of choice. However it is recommended to increase the dose of ceftriaxone from 125?mg intramuscularly to 250?mg intramuscularly due to ceftriaxone MIC creep and emerging resistance reported in the region. Furthermore, due to the high level of resistance to ciprofloxacin (86?%) it is essential to exclude ciprofloxacin from the recommended first-line therapy. It is imperative to significantly broaden the gonococcal AMR monitoring with participation from other laboratories and cities in Pakistan.
机译：背景技术在全球范围内，淋病奈瑟氏球菌的抗药性增加（AMR）导致淋病的治疗选择减少。持续监测耐药性对于确定淋病奈瑟菌不断演变的耐药趋势并提出治疗建议至关重要。巴基斯坦缺乏质量保证的淋球菌AMR数据。这项研究是为了确定2012-2014年巴基斯坦卡拉奇地区淋球菌AMR的流行和趋势以及当地菌株的分子流行病学。方法从提交给巴基斯坦卡拉奇阿加汗大学实验室的泌尿生殖道标本中分离出淋球菌（n = 100）。使用Etest测定抗菌药的敏感性，并通过淋病奈瑟氏球菌多抗原序列分型（NG-MAST）评估分子流行病学。使用淋病奈瑟氏球菌WHO参考菌株C，F，G，K，L，M，N，O和P以及ATCC 49226进行质量控制。结果对壮观霉素，头孢曲松和头孢克肟的敏感性为100％，对阿奇霉素的敏感性为99％。所有分离株的头孢曲松MIC均较低，即≤0.032？mg / L。对环丙沙星，四环素和青霉素G的抗性分别为86％，51％和43％。 NG-MAST分析确定了74种不同的序列类型（ST）。结论高度多样性的淋球菌种群，在巴基斯坦卡拉奇流通的74个NG-MAST ST（62个新型ST），对青霉素G，环丙沙星和四环素的耐药性增加。幸运的是，未检测到对头孢曲松的耐药性。因此，头孢曲松可以连续被推荐作为治疗选择。但是，由于该地区报道的头孢曲松酮MIC蠕变和新出现的耐药性，建议将头孢曲松的剂量从肌内注射125mg增至肌内250mg。此外，由于对环丙沙星的耐药性很高（86％），因此必须从推荐的一线治疗中排除环丙沙星。在巴基斯坦其他实验室和城市的参与下，必须大大扩展淋球菌AMR监测。

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