LITERATURE UPDATE
This review provides a thorough analysis of the escalating problem of N. gonorrhoeae, including its pathogenesis, current treatment options, the emergence of drug- resistant mechanisms, and the potential for vaccine development. The authors aim to provide valuable insights for healthcare practitioners, policymakers, and researchers in their efforts to combat N. gonorrhoeae antibiotic resistance by elucidating the multifaceted aspects of this global challenge.
Sustained Transmission of Neisseria gonorrhoeae Strains with High-Level Azithromycin Resistance (MIC 256 μg/ mL) in Argentina, 2018 to 2022 Gianecini RA, Poklepovich T, Golparian D et al. Microbiol Spectr. 2023 Aug 17; 11 (4): e0097023. doi: 10.1128/ spectrum.00970-23.
Azithromycin combined with ceftriaxone is the recommended dual therapy for uncomplicated gonorrhoea in many countries. Nevertheless, the increasing prevalence of azithromycin resistance compromises the effectiveness of this treatment strategy. From 2018 to 2022, the authors collected 13 gonococcal isolates with high-level azithromycin resistance (MIC ≥256 μg/mL) across Argentina. Whole- genome sequencing revealed that these isolates were mainly represented by the internationally spreading Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST) genogroup G12302, containing the 23S rRNA A2059G mutation (in all four alleles) together with mosaic mtrD and mtrR promoter 2 loci. This information is important to develop targeted public health policies to control the spread of azithromycin- resistant N. gonorrhoeae in Argentina and internationally. In summary, azithromycin resistance
in N. gonorrhoeae has been increasing in numerous populations worldwide, which is of concern, as azithromycin is part of the recommended dual treatment in many countries. Here, the authors report 13 N. gonorrhoeae isolates with high-level azithromycin resistance (MIC ≥256 μg/mL). This study observed that high-level azithromycin-resistant gonococcal strains have shown sustained transmission in Argentina and are related to the successful international clone NG-MAST G12302. Genomic surveillance together with real-time tracing and data-sharing networks will be crucial in controlling the spread of azithromycin resistance in gonococcus.
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Neisseria gonorrhoeae colonies growing on selective NYC agar medium.
Antibiotic resistance in Neisseria gonorrhoeae: broad-spectrum drug target identification using subtractive genomics Omeershffudin UNM, Kumar S. Genomics Inform. 2023 Mar; 21 (1): e5. doi: 10.5808/gi.22066.
Neisseria gonorrhoeae is a Gram- negative aerobic diplococcus bacterium that primarily causes sexually transmitted infections through direct human sexual contact. It is a major public health threat due to its impact on reproductive health, the widespread presence of antimicrobial resistance, and the lack of a vaccine. In this study, the authors used a
bioinformatics approach and performed subtractive genomic methods to identify potential drug targets against the core proteome of N. gonorrhoeae (12 strains). In total, 12,300 protein sequences were retrieved, and paralogous proteins were removed using CD-HIT. The remaining sequences were analysed for non- homology against the human proteome and gut microbiota, and screened for broad-spectrum analysis, drug ability, and anti-target analysis. The proteins were also characterised for unique interactions between the host and pathogen through metabolic pathway analysis.
Based on the subtractive genomic
approach and subcellular localisation, the authors identified one cytoplasmic protein, 2Fe-2S iron-sulphur cluster binding domain-containing protein (NGFG RS03485), as a potential drug target. This protein could be further exploited for drug development to create new medications and therapeutic agents for the treatment of N. gonorrhoeae infections.
Seven Years of Culture Collection of Neisseria gonorrhoeae: Antimicrobial Resistance and Molecular Epidemiology Carannante A, Vacca P, Fontana S et al. Microb Drug Resist. 2023 Mar; 29 (3): 85–95. doi: 10.1089/mdr.2021.0483.
The emergence of Neisseria gonorrhoeae isolates displaying resistance to antimicrobials, in particular to ceftriaxone monotherapy or ceftriaxone plus azithromycin, represents a global public health concern. This study aimed to analyse the trend of antimicrobial resistance in a seven-year isolate collection retrospective analysis in Italy. Molecular typing on a subsample of gonococci was also included. A total of 1810 culture-positive gonorrhoea cases, collected from 2013 to 2019, were investigated by antimicrobial susceptibility, using gradient diffusion method, and by the N. gonorrhoeae
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