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Cameron-McDermott SM, Barrow GJ, Webster AM, De La Haye CO, Wood DHE, Lewis VM, Nicholson A, Reynolds-Campbell GY, Thoms-Rodriguez CAA, Roye-Green KJ, Otto-Stewart N, Miller ZN, Tomlinson JA, Skyers N, Unemo M, Anzinger JJ. Antimicrobial susceptibility of Neisseria gonorrhoeae isolates and syndromic treatment of men with urethral discharge in Kingston, Jamaica, 2018-19. J Antimicrob Chemother 2021; 77:218-222. [PMID: 34557895 PMCID: PMC8730701 DOI: 10.1093/jac/dkab340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/20/2021] [Indexed: 01/16/2023] Open
Abstract
Objectives To quantitatively determine the antimicrobial susceptibility of clinical Neisseria gonorrhoeae isolates from men with urethral discharge in Jamaica and to describe the syndromic treatment therapies administered. Methods Urethral eSwabs (Copan) were collected from 175 men presenting with urethral discharge to the Comprehensive Health Centre STI Clinic, Kingston, Jamaica. Clinical information was collected and MICs of eight antimicrobials were determined for N. gonorrhoeae isolates (n = 96) using Etest and interpreted using CLSI criteria. Results The median age of the subjects was 28 years (range: 18–73 years) with a median of 2 sexual partners (range: 1–25) per male in the previous 3 months. All examined N. gonorrhoeae isolates were susceptible to ceftriaxone (96/96), azithromycin (91/91), cefixime (91/91) and spectinomycin (91/91). For ciprofloxacin and gentamicin, respectively, 98.9% (91/92) and 91.3% (84/92) of the isolates were susceptible and 1.1% (1/92) and 8.7% (8/92) showed intermediate susceptibility/resistance. For tetracycline and benzylpenicillin, respectively, 38.0% (35/92) and 22.0% (20/91) of the isolates were susceptible, 52.2% (48/92) and 74.7% (68/91) showed intermediate susceptibility/resistance and 9.8% (9/92) and 3.3% (3/91) were resistant. Syndromic treatment was administered as follows: 93.1% received 250 mg of ceftriaxone intramuscularly plus 100 mg of doxycycline orally q12h for 1–2 weeks and 6.9% received 500 mg of ciprofloxacin orally plus 100 mg of doxycycline orally q12h for 1 week. Conclusions Ceftriaxone (250 mg) remains appropriate for gonorrhoea treatment in the examined population of men in Kingston, Jamaica. Surveillance of N. gonorrhoeae AMR should be expanded in Jamaica and other Caribbean countries to guide evidence-based treatment guidelines.
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Affiliation(s)
- Suzette M Cameron-McDermott
- Department of Microbiology, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica
| | - Geoffrey J Barrow
- Department of Medicine, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica
| | | | | | | | - Violet M Lewis
- Comprehensive Health Centre STI Clinic, Kingston, Jamaica
| | - Alison Nicholson
- Department of Microbiology, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica
| | - Glendee Y Reynolds-Campbell
- Department of Microbiology, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica
| | | | - Karen J Roye-Green
- Department of Microbiology, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica
| | - Nakeisha Otto-Stewart
- Department of Microbiology, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica
| | - Zahra N Miller
- Epidemiology Unit, Ministry of Health and Wellness, Kingston, Jamaica
| | - Jennifer A Tomlinson
- HIV/STI/TB Unit, Ministry of Health and Wellness, Kingston, Jamaica.,Jamaica AIDS Support for Life, Kingston, Jamaica
| | - Nicola Skyers
- HIV/STI/TB Unit, Ministry of Health and Wellness, Kingston, Jamaica
| | - Magnus Unemo
- WHO Collaborating Centre for Gonorrhoea and Other STIs, Department of Laboratory Medicine, Örebro University and University Hospital, Örebro, Sweden
| | - Joshua J Anzinger
- Department of Microbiology, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica
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Smolarchuk C, Wensley A, Padfield S, Fifer H, Lee A, Hughes G. Persistence of an outbreak of gonorrhoea with high-level resistance to azithromycin in England, November 2014‒May 2018. ACTA ACUST UNITED AC 2019; 23. [PMID: 29897041 PMCID: PMC6152168 DOI: 10.2807/1560-7917.es.2018.23.23.1800287] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Between November 2014 and May 2018, 118 laboratory-confirmed cases of high-level azithromycin resistant Neisseria gonorrhoeae were identified in England. Cases emerged among heterosexuals in Leeds but spread across England and into sexual networks of men who have sex with men as the outbreak progressed. The few epidemiological links identified indicate substantial under-diagnosis of cases and this, along with the upturn in cases in 2017, highlights the difficulties in controlling the outbreak.
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Affiliation(s)
- Christa Smolarchuk
- These authors contributed equally to this work and share first authorship.,HIV & STI Department, Public Health England, Colindale, London, United Kingdom
| | - Adrian Wensley
- These authors contributed equally to this work and share first authorship.,Field Epidemiology Service, Public Health England, Leeds, United Kingdom
| | - Simon Padfield
- Field Epidemiology Service, Public Health England, Leeds, United Kingdom
| | - Helen Fifer
- Bacteriology Reference Department, National Infection Service, Public Health England, Colindale, London, United Kingdom
| | - Andrew Lee
- Public Health England, Yorkshire and Humber, Leeds
| | - Gwenda Hughes
- HIV & STI Department, Public Health England, Colindale, London, United Kingdom
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Shewell LK, Jen FEC, Jennings MP. Refinement of immunizing antigens to produce functional blocking antibodies against the AniA nitrite reductase of Neisseria gonorrhoeae. PLoS One 2017; 12:e0182555. [PMID: 28771632 PMCID: PMC5542605 DOI: 10.1371/journal.pone.0182555] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 07/20/2017] [Indexed: 01/16/2023] Open
Abstract
The emergence of multi-drug resistant Neisseria gonorrhoeae has generated an urgent need for novel therapies or a vaccine to prevent gonococcal disease. In this study we investigate the potential of targeting the surface exposed nitrite reductase, AniA, to block activity by producing functional blocking antibodies. AniA activity is essential for anaerobic growth and biofilm formation of N. gonorrhoeae and functional blocking antibodies may prevent colonisation and disease. Seven peptides covering regions adjacent to the active site were designed based on the AniA structure. Six of the seven peptide conjugates generated immune responses. Peptide 7, GALGQLKVEGAEN, was able to elicit antibodies capable of blocking AniA activity. Antiserum raised against the peptide 7 conjugate detected AniA in 20 N. gonorrhoeae clinical isolates. Recombinant AniA protein antigens were also assessed in this study and generated high-titre, functional blocking antibody responses. Peptide 7 conjugates or truncated recombinant AniA antigens have potential for inclusion in a vaccine against N. gonorrhoeae.
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Affiliation(s)
- Lucy K. Shewell
- Institute for Glycomics, Griffith University, Gold Coast, Queensland, Australia
| | - Freda E.-C Jen
- Institute for Glycomics, Griffith University, Gold Coast, Queensland, Australia
| | - Michael P. Jennings
- Institute for Glycomics, Griffith University, Gold Coast, Queensland, Australia
- * E-mail:
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