The influence of target population on nonculture-based detection of markers of Neisseria gonorrhoeae antimicrobial resistance

Goire, Namraj, Freeman, Kevin, Lambert, Stephen B., Nimmo, Graeme R., Limnios, Athena E., Lahra, Monica M., Nissen, Michael D., Sloots, Theo P. and Whiley, David M. (2012) The influence of target population on nonculture-based detection of markers of Neisseria gonorrhoeae antimicrobial resistance. Sexual Health, 9 5: 422-429. doi:10.1071/SH12026


Author Goire, Namraj
Freeman, Kevin
Lambert, Stephen B.
Nimmo, Graeme R.
Limnios, Athena E.
Lahra, Monica M.
Nissen, Michael D.
Sloots, Theo P.
Whiley, David M.
Total Author Count Override 9
Title The influence of target population on nonculture-based detection of markers of Neisseria gonorrhoeae antimicrobial resistance
Formatted title
The influence of target population on nonculture-based detection of markers of Neisseria gonorrhoeae antimicrobial resistance
Journal name Sexual Health   Check publisher's open access policy
ISSN 1448-5028
1449-8987
Publication date 2012-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1071/SH12026
Volume 9
Issue 5
Start page 422
End page 429
Total pages 8
Place of publication Collingwood, VIC, Australia
Publisher C S I R O Publishing
Collection year 2013
Language eng
Formatted abstract
Background
With treatment options for gonorrhoea (Neisseria gonorrhoeae) diminishing, strengthening antimicrobial resistance (AMR) surveillance is paramount.

Methods:
In this study, we investigated polymerase chain reaction (PCR) based methods, in parallel with N. gonorrhoeae multi-antigen sequence typing (NG-MAST), for direct detection of four N. gonorrhoeae chromosomal mechanisms associated with emerging resistance to extended spectrum cephalosporins using noncultured samples: an adenine deletion in the mtrR promoter, a mosaic penicillin-binding protein (PBP) 2, an A501V PBP2 mutation, and alterations at positions 120 and 121 of the porB protein. The PCR assays were validated using a panel of characterised N. gonorrhoeae isolates (n=107) and commensal Neisseria (n=100) species. These PCR assays with NG-MAST were then applied to noncultured clinical specimens from distinct populations in Australia with differing levels of N. gonorrhoeae AMR: the Northern Territory (NT), where resistance has a low population prevalence, and Queensland (Qld), with higher AMR prevalence.

Results:
The real-time PCR assays proved highly sensitive and specific. When applied to the noncultured samples, only 1 out of 50 (2%) samples from NT harboured a resistant mechanism, whereas the Qld samples (n=129) collected over different periods showed progressive acquisition of resistant mechanisms, and these were associated with specific NG-MAST types, including Type 225.

Conclusions:
The results suggest that our PCR-based methods could be used to rapidly pinpoint incursion of resistant strains into previously unaffected populations. Likewise, our results show that for molecular AMR surveillance, the population being investigated is as important as the genetic mechanisms being targeted.
Keyword Australia
Cephalosporin
Gonorrhoea
Penicillin
Polymerase chain reaction
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online: 5 October 2012.

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2013 Collection
School of Medicine Publications
Clinical Medical Virology Centre Publications
 
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