PMID- 27646968
OWN - NLM
STAT- MEDLINE
DCOM- 20170111
LR  - 20201209
IS  - 1476-0711 (Electronic)
IS  - 1476-0711 (Linking)
VI  - 15
IP  - 1
DP  - 2016 Sep 20
TI  - Emerging azithromycin-resistance among the Neisseria gonorrhoeae strains isolated 
      in Hungary.
PG  - 53
LID - 10.1186/s12941-016-0166-9 [doi]
LID - 53
AB  - BACKGROUND: In the 1990s, azithromycin became the drug of choice for many 
      infectious diseases but emerging resistance to the drug has only been reported in 
      the last decade. In the last 5 years, the National Neisseria gonorrhoeae 
      Reference Laboratory of Hungary (NNGRLH) has also observed an increased number of 
      N. gonorrhoeae strains resistant to azithromycin. The aim of this study was to 
      determine the most frequent sequence types (ST) of N. gonorrhoeae related to 
      elevated levels of azithromycin MIC (minimal inhibitory concentration). 
      Previously and currently isolated azithromycin-resistant strains have been 
      investigated for the existence of molecular relationship. METHODS: Maldi-Tof 
      technic was applied for the identification of the strains isolated from 
      outpatients attending the reference laboratory. Testing antibiotic susceptibility 
      of azithromycin, cefixime, ceftriaxone, tetracycline, spectinomycin and 
      ciprofloxacin was carried out for all the identified strains, using MIC strip 
      test Liofilchem((R)). N. gonorrhoeae multiantigen sequence typing (NG-MAST) was 
      performed exclusively on azithromycin-resistant isolates. A phylogenetic tree was 
      drawn using MEGA6 (Molecular Evolutionary Genetics Analysis Version 6.0) 
      Neighbour-Joining method. RESULTS: Out of 192 N. gonorrhoeae isolates, 30.0 % 
      (58/192) proved resistant to azithromycin (MIC > 0.5 mg/L). Of the 
      azithromycin-resistant isolates, ST1407, ST4995 and ST11064 were the most 
      prevalent. Based on the phylogenetic analysis, the latter two STs are closely 
      related. CONCLUSIONS: In contrast to West-European countries, in our region, 
      resistance to azithromycin has increased up to 30 % in the last 5 years, so the 
      recommendation of the European Guideline -500 mg of ceftriaxone combined with 2 g 
      of azithromycin as first choice therapy against N. gonorrhoeae- should be 
      seriously considered in case of Hungary.
FAU - Brunner, Alexandra
AU  - Brunner A
AD  - Department of Dermatology, Venerology and Dermatooncology, Semmelweis University, 
      41 Maria Street, Budapest, Hungary.
FAU - Nemes-Nikodem, Eva
AU  - Nemes-Nikodem E
AD  - Department of Laboratory Medicine, Semmelweis University, 41 Maria Street, 
      Budapest, Hungary.
FAU - Jeney, Csaba
AU  - Jeney C
AD  - Institute of Medical Microbiology, Semmelweis University, 4 Nagyvarad Square, 
      Budapest, Hungary.
FAU - Szabo, Dora
AU  - Szabo D
AD  - Institute of Medical Microbiology, Semmelweis University, 4 Nagyvarad Square, 
      Budapest, Hungary.
FAU - Marschalko, Marta
AU  - Marschalko M
AD  - Department of Dermatology, Venerology and Dermatooncology, Semmelweis University, 
      41 Maria Street, Budapest, Hungary.
FAU - Karpati, Sarolta
AU  - Karpati S
AD  - Department of Dermatology, Venerology and Dermatooncology, Semmelweis University, 
      41 Maria Street, Budapest, Hungary.
FAU - Ostorhazi, Eszter
AU  - Ostorhazi E
AD  - Institute of Medical Microbiology, Semmelweis University, 4 Nagyvarad Square, 
      Budapest, Hungary. ostorhazi.eszter@med.semmelweis-univ.hu.
LA  - eng
PT  - Journal Article
DEP - 20160920
PL  - England
TA  - Ann Clin Microbiol Antimicrob
JT  - Annals of clinical microbiology and antimicrobials
JID - 101152152
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Porins)
RN  - 0 (Transferrin-Binding Protein B)
RN  - 0 (porin protein, Neisseria)
RN  - 5E8K9I0O4U (Ciprofloxacin)
RN  - 75J73V1629 (Ceftriaxone)
RN  - 83905-01-5 (Azithromycin)
RN  - 93AKI1U6QF (Spectinomycin)
RN  - 97I1C92E55 (Cefixime)
RN  - F8VB5M810T (Tetracycline)
SB  - IM
MH  - Adult
MH  - Alleles
MH  - Anti-Bacterial Agents/*pharmacology
MH  - Azithromycin/*pharmacology
MH  - Bacterial Typing Techniques
MH  - Cefixime/pharmacology
MH  - Ceftriaxone/pharmacology
MH  - Ciprofloxacin/pharmacology
MH  - Drug Resistance, Bacterial/*genetics
MH  - Female
MH  - Gene Expression
MH  - Gonorrhea/drug therapy/*epidemiology/microbiology
MH  - Humans
MH  - Hungary/epidemiology
MH  - Male
MH  - Microbial Sensitivity Tests
MH  - Neisseria gonorrhoeae/classification/drug effects/*genetics/isolation & 
      purification
MH  - Phylogeny
MH  - Porins/genetics/metabolism
MH  - Prevalence
MH  - Spectinomycin/pharmacology
MH  - Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
MH  - Tetracycline/pharmacology
MH  - Transferrin-Binding Protein B/genetics/metabolism
PMC - PMC5029006
OTO - NOTNLM
OT  - Azithromycin-resistance
OT  - Neisseria gonorrhoeae
OT  - Phylogenetic tree
OT  - Sequence types
EDAT- 2016/09/21 06:00
MHDA- 2017/01/12 06:00
PMCR- 2016/09/20
CRDT- 2016/09/21 06:00
PHST- 2016/02/19 00:00 [received]
PHST- 2016/09/13 00:00 [accepted]
PHST- 2016/09/21 06:00 [entrez]
PHST- 2016/09/21 06:00 [pubmed]
PHST- 2017/01/12 06:00 [medline]
PHST- 2016/09/20 00:00 [pmc-release]
AID - 10.1186/s12941-016-0166-9 [pii]
AID - 166 [pii]
AID - 10.1186/s12941-016-0166-9 [doi]
PST - epublish
SO  - Ann Clin Microbiol Antimicrob. 2016 Sep 20;15(1):53. doi: 
      10.1186/s12941-016-0166-9.