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Case Reports
. 2020 May;47(5):326-328.
doi: 10.1097/OLQ.0000000000001149.

First Case of High-Level Azithromycin-Resistant Neisseria gonorrhoeae in North Carolina

Elizabeth L Palavecino  1 , Abdullah Kilic  1 , Matthew W Schmerer  2 , Oana Dobre-Buonya, Cindy Toler  3 , Candice J McNeil
Affiliations
Case Reports

First Case of High-Level Azithromycin-Resistant Neisseria gonorrhoeae in North Carolina

Elizabeth L Palavecino et al. Sex Transm Dis. 2020 May.

Abstract

We report on the first high-level azithromycin-resistant Neisseria gonorrhoeae isolate (minimum inhibitory concentration, ≥256 μg/mL) in North Carolina isolated from a pharyngeal swab of a 33-year-old HIV-negative man who has sex with men. In addition, the isolate was found to be susceptible to cefixime, ceftriaxone, and penicillin and resistant to tetracycline. By whole-genome sequencing, the strain was assigned as MLST ST9363, NG-MAST ST5035, and a novel NG-STAR sequence type, ST1993.

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Conflict of interest statement

All authors report no conflicts of interest relevant to this article. The work performed at the Guilford County Health Department was supported by funding from the US CDC’s Epidemiology and Laboratory Capacity for the Prevention and Control of Infectious Diseases Cooperative Agreement (CK19-1904) under the SURRG project. This work was also supported in part by funds made available by the CDC Advanced Molecular Detection and Combating Antibiotic Resistant Bacteria programs (M.W.S.). The findings and conclusions of this article are those of the authors and do not necessarily represent the views of the CDC.

Figures

Figure 1.
Figure 1.
porB gene single-nucleotide polymorphism phylogenetic tree of the high-level azithromycin-resistant NC-1263 strain and a panel of previously reported high-level azithromycin-resistant N. gonorrhoeae isolates in the United States. Scale bar indicates nucleotide substitutions per site. POR110 was used as a reference. The tree was constructed using fasttree with slow nearest-neighbor interchanges and MLACC = 3 (to make the maximum-likelihood nearest-neighbor interchanges more exhaustive). NG-MAST indicates N. gonorrhoeae multiantigen sequence typing.
See this image and copyright information in PMC

References

    1. CDC. Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2018. Available at: https://www.cdc.gov/std/stats18/default.htm. Accessed October 27, 2019.
    1. Unemo M, Shafer WM. Antimicrobial resistance in Neisseria gonorrhoeae in the 21st century: Past, evolution, and future. Clin Microbiol Rev 2014; 27:587–613. - PMC - PubMed
    1. Galarza PG, Alcala B, Salcedo C, et al. Emergence of high level azithromycin-resistant Neisseria gonorrhoeae strain isolated in Argentina. Sex Transm Dis 2009; 36:787–788. - PubMed
    1. Demczuk W, Martin I, Peterson S, et al. Genomic epidemiology and molecular resistance mechanisms of azithromycin-resistant Neisseria gonorrhoeae in Canada from 1997 to 2014. J Clin Microbiol 2016; 54:1304–1313. - PMC - PubMed
    1. CLSI. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing, 29th ed. CLSI Supplement M100. Wayne, PA: CLSI, 2019.

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