Genomic surveillance of Neisseria gonorrhoeae to investigate the distribution and evolution of antimicrobial-resistance determinants and lineages

• DOI: 10.1099/mgen.0.000205
• Publication Date: 2018-07-31T13:12:45Z
• Authors: Koji Yahara; Shu-ichi Nakayama; Ken Shimuta; Ken-ichi Lee; Masatomo Morita; Takuya Kawahata; Toshiro Kuroki; Yuko Watanabe; Hitomi Ohya; Mitsuru Yasuda; Takashi Deguchi; Xavier Didelot; Makoto Ohnishi
• Keywords: Lineage (genetic); Neisseria gonorrhoeae; Cefixime; Multilocus sequence typing

The first extensively drug resistant (XDR) Neisseria gonorrhoeae strain with high resistance to the extended-spectrum cephalosporin ceftriaxone was identified in 2009 Japan, but no other this antimicrobial-resistance profile has been reported since. However, surveillance date based on phenotypic methods and sequence typing, not genome sequencing. Therefore, little is known about local population structure at genomic level, how determinants lineages are distributed evolve. We analysed whole-genome data antimicrobial-susceptibility testing results of 204 strains sampled a region where XDR ceftriaxone-resistant N. isolated, complemented 67 additional genomes from time frames locations within Japan. Strains were found, we discovered type (ST)7363 sub-lineage susceptible cefixime which mosaic penA allele responsible for reduced susceptibility had reverted by recombination. Approximately 85 % isolates showed fluoroquinolones (ciprofloxacin) explained linked amino acid substitutions positions 91 95 GyrA 99 sensitivity 100 specificity. 10 macrolides (azithromycin), genetic less clear. Furthermore, revealed different evolutionary paths two major lineages: single acquisition X ST7363-associated lineage, followed multiple independent acquisitions XXXIV ST1901-associated lineage. Our study provides detailed picture distribution disentangles evolution spreading worldwide.