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. 2021 Oct 19:14:4271-4276.
doi: 10.2147/IDR.S336212. eCollection 2021.

Emergence and Characterization of a Ceftriaxone-Resistant Neisseria gonorrhoeae FC428 Clone Evolving Moderate-Level Resistance to Azithromycin in Shenzhen, China

Lulu Zhang #  1   2 , Chi Zhang #  1   2 , Yaling Zeng #  3 , Yamei Li  1   2 , Shuhong Huang  3 , Feng Wang  3 , Junping Peng  1   2
Affiliations

Emergence and Characterization of a Ceftriaxone-Resistant Neisseria gonorrhoeae FC428 Clone Evolving Moderate-Level Resistance to Azithromycin in Shenzhen, China

Lulu Zhang et al. Infect Drug Resist. .

Abstract

We here described a ceftriaxone-resistant Neisseria gonorrhoeae FC428 clone (YL201) with moderate-level resistance to azithromycin in Shenzhen, South China in 2020. The NG-STAR type of YL201 is ST2238, containing a mosaic penA-60.001 allele, which is a typical characteristic of FC428 clone. YL201 harbours four copies of the 23S rRNA C2611T mutation, conferring moderate-level resistance to azithromycin. The MLST type is ST1600, identical with two N. gonorrhoeae FC428 clones identified in Hangzhou. Genome-wide phylogeny analysis demonstrates that YL201 is clustered with other FC428 clones from Hangzhou (South-east China) and Chengdu (South-west China). Isolates within this cluster have relatively higher MIC for ceftriaxone and display closely related MLST STs (ST1600 and ST7363) but are different from the ST of typical FC428 clone (ST1903). As ST1600 and ST7363 are common STs in Shenzhen, the further spread of FC428 clones may increase the severity of gonococcal resistance. In summary, identifying a multidrug-resistant (MDR) N. gonorrhoeae isolate in Shenzhen showed FC428 clones have undergone further transmission in China and presented more extensive and concerning antimicrobial resistance (AMR) characteristics during the spread.

Keywords: Neisseria gonorrhoeae; antimicrobial resistance; azithromycin; ceftriaxone; phylogeny.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Maximum-likelihood tree based on 13,236 SNPs extracted from whole-genome sequences. FA1090 was placed as the outgroup. STs, antimicrobial resistance determinants and antimicrobial susceptibility are also shown. For YL201 and A2543, they contain four copies of the 23S rRNA C2611T and A2059G mutation respectively. Isolate YL201 described in this study is shown in red. The color coding of AMR phenotype and AMR-related alleles are indicated in the columns on the bottom left.
Figure 2
Figure 2
Comparison of YL201 and other 14 strains genomes in the phylogenetic tree. FA1090 (GenBank: AE004969.1) genome was used as the reference. The outermost ring indicates YL201. BLASTn matches with less than 30% identity appear as blank spaces (gaps) in each ring.
See this image and copyright information in PMC

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