Azithromycin Susceptibility Testing and Molecular Investigation of <i>Neisseria gonorrhoeae</i> Isolates Collected in Russia, 2020-2021

• Main Authors: Ilya Kandinov (Author), Boris Shaskolskiy (Author), Dmitry Kravtsov (Author), Alexandra Vinokurova (Author), Sofya Gorshkova (Author), Alexey Kubanov (Author), Victoria Solomka (Author), Julia Shagabieva (Author), Dmitry Deryabin (Author), Ekaterina Dementieva (Author), Dmitry Gryadunov (Author)
• Format: Book
• Published: MDPI AG, 2023-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

The aim of this work was to study the resistance to macrolides (azithromycin) in the modern Russian population of <i>N. gonorrhoeae</i> with the analysis of genetic resistance determinants. Azithromycin is not used to treat gonococcal infection in Russia. However, among 162 isolates collected in 2020-2021, 22 isolates (13.6%) were phenotypically resistant to azithromycin. Mutations in 23S rRNA genes were found only in two isolates; <i>erm</i> and <i>mefA</i> genes were absent. Azithromycin resistance was shown to be predominantly associated with mutations in the <i>mtrR</i> and <i>mtrD</i> genes of the MtrCDE efflux pump and their mosaic alleles which may have formed due to a horizontal transfer from <i>N. meningitidis</i>. A total of 30 types of <i>mtrR</i> alleles and 10 types of <i>mtrD</i> alleles were identified including mosaic variants. Matching between the <i>mtrR</i> and <i>mtrD</i> alleles was revealed to indicate the cooperative molecular evolution of these genes. A link between the <i>mtrR</i> and <i>mtrD</i> alleles and NG-MAST types was found only for NG-MAST 228 and 807, typical of <i>N. gonorrhoeae</i> in Russia. The high level of resistance to azithromycin in Russia may be related to the spread of multiple transferable resistance to antimicrobials regardless of their use in the treatment of gonococcal infection.

Item Description

10.3390/antibiotics12010170
2079-6382