1
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Trembizki E, Anderson T, Whiley DM, Antonsson A. Investigating oral human papillomavirus co-infection with Neisseria gonorrhoeae and Chlamydia trachomatis. Epidemiol Infect 2024; 152:e8. [PMID: 38185832 PMCID: PMC10789976 DOI: 10.1017/s095026882300198x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/22/2023] [Accepted: 12/12/2023] [Indexed: 01/09/2024] Open
Abstract
Compared to cervical cancer, little is known about human papillomavirus (HPV)-driven oropharyngeal cancer and their cofactors. Here, we investigated potential associations between Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) with oral HPV and HPV persistence, which are known cofactors in cervical carcinogenesis, and also play a role in HPV-driven oropharyngeal cancer. Saliva samples (n = 547) from 312 people were tested for CT and NG and whom had previously been tested for oral HPV infection in a longitudinal study. Eight participants were positive for CT (2.6%) and one for NG (0.3%). Six of these nine participants were also positive for oral HPV in at least one of their samples. We found no significant associations between HPV, CT, or NG infection in the saliva samples analyzed. These preliminary data suggest CT and NG have little influence on oral HPV-positivity and persistence in a general population. However, larger studies focusing on 'at risk' population cohorts are necessary to assess potential associations between oral sexually transmissible infections and oral HPV infections, and their outcomes.
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Affiliation(s)
- Ella Trembizki
- The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Taylah Anderson
- The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - David M. Whiley
- The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Pathology Queensland Central Laboratory, Brisbane, QLD, Australia
| | - Annika Antonsson
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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2
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Tickner JA, Trembizki E, Whiley DM. Neisseria gonorrhoeae ciprofloxacin susceptibility testing and gyrA targets. Lancet Microbe 2023; 4:e574. [PMID: 37236216 DOI: 10.1016/s2666-5247(23)00149-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023]
Affiliation(s)
- Jacob A Tickner
- UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane 4029, QLD, Australia.
| | - Ella Trembizki
- UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane 4029, QLD, Australia
| | - David M Whiley
- UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane 4029, QLD, Australia; Pathology Queensland Central Laboratory, Queensland Health, Brisbane, QLD, Australia
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3
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McHugh L, Dyda A, Guglielmino C, Buckley C, Lau CL, Jennison AV, Regan DG, Wood J, Whiley D, Trembizki E. The changing epidemiology of Neisseria gonorrhoeae genogroups and antimicrobial resistance in Queensland, Australia, 2010-15: a case series analysis of unique Neisseria gonorrhoeae isolates. Sex Health 2023; 20:296-302. [PMID: 36972581 DOI: 10.1071/sh22118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 03/02/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Neisseria gonorrhoeae (NG) can lead to serious reproductive and sexual health outcomes, and the annual number of NG notifications in Australia increased steadily from 10329 in 2010 to 29549 by 2020. Australian populations most affected are urban men who have sex with men and First Nations peoples living in remote areas, and a resurgence in urban heterosexuals has been observed since 2012. METHODS A case series analysis of Queensland NG isolates (2010-15) exploring temporal trends and antimicrobial resistance by demographic and geographic distribution and genotype was performed. Proportions describe age, sex, strain, genogroup (NG multi-antigen sequence typing), region, swab site, antimicrobial sensitivity and isolate rates per 100000 population. Dominant genogroups were identified. RESULTS Among 3953 isolates, the median age was 25years (IQR 20-34years) and most (n =2871/3915, 73%) were men. Brisbane city (68.8) and Far North Queensland (54.1) excluding Cairns showed the highest rates. Forty-six genogroups were documented, seven (G2992, G6876, G1415, G4186, G5, G1407 and G6937) comprised half of all isolates. The predominant male genogroup was G2992 (16%), and G6876 (20%) for females; G5 was predominantly male from 2010 to 2011, but equal in both sexes from 2012 to 2015. CONCLUSION Considerable temporal, geographical and demographical diversity was observed in Queensland NG isolates, which has public health implications. Certain genogroups are more transient than others, and evidence suggests bridging from male-dominant networks to heterosexual networks. Molecular surveillance can enhance tracking the epidemiology and movement of NG in Australia, highlighting the necessity of genotyping to expose potentially prevalent strains circulating in undetected or underrepresented networks by current screening methods.
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Affiliation(s)
- Lisa McHugh
- University of Queensland, School of Public Health, Division of Medicine, Herston, Brisbane, Qld, Australia
| | - Amalie Dyda
- University of Queensland, School of Public Health, Division of Medicine, Herston, Brisbane, Qld, Australia
| | - Christine Guglielmino
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Brisbane, Qld, Australia
| | - Cameron Buckley
- The University of Queensland Centre for Clinical Health Research and Faculty of Medicine, Royal Brisbane and Women's Hospital Campus, Brisbane, Qld, Australia
| | - Colleen L Lau
- University of Queensland, School of Public Health, Division of Medicine, Herston, Brisbane, Qld, Australia; and Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Amy V Jennison
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Brisbane, Qld, Australia
| | - David G Regan
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - James Wood
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - David Whiley
- The University of Queensland Centre for Clinical Health Research and Faculty of Medicine, Royal Brisbane and Women's Hospital Campus, Brisbane, Qld, Australia; and Pathology Queensland, Herston, Brisbane, Qld, Australia
| | - Ella Trembizki
- The University of Queensland Centre for Clinical Health Research and Faculty of Medicine, Royal Brisbane and Women's Hospital Campus, Brisbane, Qld, Australia
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4
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Alharbi B, Jennison AV, Hicks V, Whiley DM, Sweeney E, Trembizki E. Decreased Neisseria gonorrhoeae genotypic diversity following COVID-19 restrictions in Queensland, Australia 2020. Epidemiol Infect 2023; 151:e67. [PMID: 37045547 PMCID: PMC10154642 DOI: 10.1017/s0950268823000523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
We investigated the potential effects of COVID-19 public health restrictions on the prevalence and distribution of Neisseria gonorrhoeae (NG) genotypes in our Queensland isolate population in the first half of the year 2020. A total of 763 NG isolates were genotyped to examine gonococcal strain distribution and prevalence for the first 6 months of 2020, with 1 January 2020 to 31 March 2020 classified as 'pre' COVID-19 restrictions (n = 463) and 1 April 2020 to 30 June 2020 classified as 'post' COVID-19 restrictions (n = 300). Genotypes most prevalent 'pre' restrictions remained proportionally high 'post' restrictions, with some significantly increasing 'post' restrictions. However, genotype diversity was significantly reduced 'post' restrictions. Overall, it seems public health restrictions (9-10 weeks) were not sufficient to affect rates of infection or reduce the prevalence of well-established genotypes in our population, potentially due to reduced access to services or health-seeking behaviours.
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5
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Alharbi B, Cozzolino D, Sikulu-Lord M, Whiley D, Trembizki E. Near-infrared spectroscopy as a feasible method for the differentiation of Neisseria gonorrhoeae from Neisseria commensals and antimicrobial resistant from susceptible gonococcal strains. J Microbiol Methods 2022; 201:106576. [PMID: 36096277 DOI: 10.1016/j.mimet.2022.106576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 12/27/2022]
Abstract
Rapid and cost-effective diagnosis of Neisseria gonorrhoeae (NG) are important measures for the control and management of gonococcal infection. Current diagnostic tools such as nucleic acid amplification tests and bacterial culture are not feasible in many resource-poor settings, and so syndromic patient management is commonplace. Alternative cost-effective diagnostic tools are therefore needed. Here, we sought to explore the utility and feasibility of Near Infrared Spectroscopy (NIRS) to (1) identify and differentiate NG from Neisseria commensals and (2) to differentiate fully susceptible NG from resistant NG. NIRS correctly classified NG from Neisseria commensals (R2= 0.89; SECV 0.164) and to a lesser capacity, susceptible NG from resistant (R2 = 0.60; SECV 0.32). To the best our knowledge, this is the first proof of concept study in the field. Further evaluations are now warranted to enhance capacity and accuracy of this diagnostic approach.
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Affiliation(s)
- Bushra Alharbi
- University of Queensland Clinical Research Centre, The University of Queensland, Brisbane, QLD, Australia; Faculty of Pharmacy, Taibah University, Madinah, Saudi Arabia
| | - Daniel Cozzolino
- Centre for Nutrition and Food Sciences, Queensland Alliance for Agriculture and Food Innovation (QAAFI), The University of Queensland, Brisbane, QLD, Australia
| | - Maggy Sikulu-Lord
- School of Biological Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - David Whiley
- University of Queensland Clinical Research Centre, The University of Queensland, Brisbane, QLD, Australia; Pathology Queensland Central Laboratory, Brisbane, QLD, Australia
| | - Ella Trembizki
- University of Queensland Clinical Research Centre, The University of Queensland, Brisbane, QLD, Australia.
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6
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Guglielmino CJD, Sandhu S, Lau CL, Buckely C, Trembizki E, Whiley DM, Jennison AV. Molecular characterisation of Neisseria gonorrhoeae associated with disseminated gonococcal infections in Queensland, Australia: a retrospective surveillance study. BMJ Open 2022; 12:e061040. [PMID: 35918119 PMCID: PMC9351343 DOI: 10.1136/bmjopen-2022-061040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Gonorrhoea caused by Neisseria gonorrhoeae is the second most notified sexually transmitted infection (STI) in Australia and the case numbers for this STI have been increasing globally. Progressive gonococcal infection may lead to disseminated gonococcal infection (DGI), which causes significant morbidity among patients. This study aims to examine the genetic diversity of N. gonorrhoeae isolates collected in Queensland from January 2010 to August 2015 and to determine factors associated with DGI in Queensland. DESIGN Retrospective surveillance study for epidemiological purposes. SETTING All gonorrhoeae isolates referred by private and public pathology laboratories to the state of Queensland, Australia Neisseria reference laboratory. METHODS Between January 2010 and August 2015, 3953 N. gonorrhoeae isolates from both metropolitan and regional Queensland infections were typed with NG-MAST (N. gonorrhoeae multiantigen sequence typing) to assess the genetic diversity between strains. Whole-genome sequencing (WGS) was used to investigate strain-related factors associated with DGI. RESULTS ST6876 was the most common NG-MAST type, detected in 7.6% of the isolates. DGI was significantly more likely in females <30 years (OR 13.02, p<0.0001) and in older males >30 years (OR 6.04, p<0.0001), with most cases originating from North Queensland (OR 8.5, p<0.0001). Strains harbouring PIA class of porB type were associated with DGI (OR 33.23, p<0.0001). CONCLUSION Genotyping techniques, such as NG-MAST and WGS, are proving instrumental in providing an insight into the population structure of N. gonorrhoeae, and genetic mechanisms of pathogenesis, such as for DGI.
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Affiliation(s)
- Christine J D Guglielmino
- Public Health Microbiology, Forensic and Scientific Services, Queensland Health, Archerfield, Queensland, Australia
| | - Sumeet Sandhu
- Public Health Microbiology, Forensic and Scientific Services, Queensland Health, Archerfield, Queensland, Australia
| | - Colleen L Lau
- Australian National University Research School of Population Health, Canberra, Australian Capital Territory, Australia
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Cameron Buckely
- The University of Queensland Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
- Pathology Queensland Central Laboratory, Queensland Health, Brisbane, Queensland, Australia
| | - Ella Trembizki
- The University of Queensland Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
| | - David M Whiley
- The University of Queensland Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
- Pathology Queensland Central Laboratory, Queensland Health, Brisbane, Queensland, Australia
| | - Amy V Jennison
- Public Health Microbiology, Forensic and Scientific Services, Queensland Health, Archerfield, Queensland, Australia
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7
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Furuya-Kanamori L, Mills DJ, Trembizki E, Robson JM, Jennison AV, Whiley DM, Lau CL. High rate of asymptomatic colonization with antimicrobial-resistant Escherichia coli in Australian returned travellers. J Travel Med 2022; 29:6365988. [PMID: 34494119 DOI: 10.1093/jtm/taab141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 08/27/2021] [Indexed: 11/12/2022]
Abstract
Global movement of people plays a key role in the spread of antimicrobial resistant (AMR) organisms. We found that 58% of Australian travellers returning from Asia were asymptomatic carriers of AMR Escherichia coli, including resistance to critically important antibiotics. Future studies are needed to identify interventions for travellers to reduce their risk of AMR acquisition.
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Trembizki E, Jennison AV, Buckley C, Bright A, Holds J, Ward A, Pitt J, Pendle S, Baird R, Freeman K, Robson J, Mhango L, Lowry K, Lahra M, Whiley D. Enhanced molecular surveillance in response to the detection of extensively resistant gonorrhoea in Australia. J Antimicrob Chemother 2021; 76:270-271. [PMID: 33020835 DOI: 10.1093/jac/dkaa402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ella Trembizki
- The University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia
| | - Amy V Jennison
- Public Health Microbiology, Forensic and Scientific Services, Health Support Queensland, Brisbane, Queensland, Australia
| | - Cameron Buckley
- The University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia
| | - Amy Bright
- Office of Health Protection, Australian Government Department of Health, ACT, Australia
| | - Judith Holds
- South Australia Pathology, Adelaide, South Australia, Australia
| | - Alison Ward
- Adelaide Sexual Health Centre, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - John Pitt
- Adelaide City General Practice, South Australia, Australia
| | - Stella Pendle
- Australian Clinical Labs, Bella Vista, New South Wales, Australia
| | - Rob Baird
- Royal Darwin Hospital, Darwin, Territory Pathology, Northern Territory, Australia
| | - Kevin Freeman
- Royal Darwin Hospital, Darwin, Territory Pathology, Northern Territory, Australia
| | - Jenny Robson
- Sullivan Nicolaides Pathology, Queensland, Australia
| | - Lebogang Mhango
- The University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia
| | - Kym Lowry
- The University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia
| | - Monica Lahra
- World Health Organization Collaborating Centre for STI and AMR, Sydney, New South Wales, Australia.,University of New South Wales, Sydney, Australia
| | - David Whiley
- The University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia.,Pathology Queensland Central Laboratory, Brisbane, Australia
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9
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Ayfan AKS, Macdonald J, Harris PNA, Heney C, Paterson DL, Trembizki E, Wang CYT, Whiley DM, Zowawi HM, Irwin AD. Rapid detection of NDM and VIM carbapenemase encoding genes by recombinase polymerase amplification and lateral flow-based detection. Eur J Clin Microbiol Infect Dis 2021; 40:2447-2453. [PMID: 33974185 DOI: 10.1007/s10096-021-04267-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 04/29/2021] [Indexed: 12/26/2022]
Abstract
Carbapenemase-producing organisms (CPOs) pose a serious clinical threat and rapid detection tools are essential to aid in patient management. We developed rapid and simple molecular tests to detect blaNDM-type and blaVIM-type carbapenemase genes using recombinase polymerase amplification (RPA) combined with a lateral flow detection. The tests could provide results in approximately 15 min when using DNA extracts, with limits of detection of 9.2 copies/μl for the blaNDM-type assay and 7.5 copies/μl for blaVIM-type assay, and successfully detected all isolates harbouring the carbapenemase encoding genes in a panel of 57 isolates. These RPA tests may be suitable for use in low-resource settings to tailor rapid implementation of infection control precautions and antibiotic stewardship.
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Affiliation(s)
- Abdulrahman K S Ayfan
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Royal Brisbane and Women's Hospital Campus, Brisbane, Australia
- Faculty of Science, Biochemistry Department, King Abdul-Aziz University (KAU), Jeddah, Saudi Arabia
| | - Joanne Macdonald
- School of Science and Engineering, Genecology Research Centre, University of Sunshine Coast (USC), Sunshine Coast, Australia
| | - Patrick N A Harris
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Royal Brisbane and Women's Hospital Campus, Brisbane, Australia
- Department of Microbiology, Pathology Queensland, Brisbane, Australia
| | - Claire Heney
- Department of Microbiology, Pathology Queensland, Brisbane, Australia
| | - David L Paterson
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Royal Brisbane and Women's Hospital Campus, Brisbane, Australia
| | - Ella Trembizki
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Royal Brisbane and Women's Hospital Campus, Brisbane, Australia
| | - Claire Y T Wang
- Infection Management and Prevention Service, Queensland Children's Hospital, Brisbane, Australia
| | - David M Whiley
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Royal Brisbane and Women's Hospital Campus, Brisbane, Australia
- Department of Microbiology, Pathology Queensland, Brisbane, Australia
| | - Hosam M Zowawi
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Royal Brisbane and Women's Hospital Campus, Brisbane, Australia
- College of Medicine, King Saud bin Abdul-Aziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre (KAIMRC), Riyadh, Saudi Arabia
| | - Adam D Irwin
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Royal Brisbane and Women's Hospital Campus, Brisbane, Australia.
- Infection Management and Prevention Service, Queensland Children's Hospital, Brisbane, Australia.
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10
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Mhango LP, Trembizki E, Thng C, Whiley DM, Sweeney EL. Exploring the implications for coincidental treatment of Mycoplasma genitalium infection in Neisseria gonorrhoeae-positive patients. JAC Antimicrob Resist 2021; 3:dlab033. [PMID: 34223105 PMCID: PMC8210116 DOI: 10.1093/jacamr/dlab033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Lebogang P Mhango
- The University of Queensland Centre for Clinical Research (UQ-CCR), Queensland, Australia
| | - Ella Trembizki
- The University of Queensland Centre for Clinical Research (UQ-CCR), Queensland, Australia
| | - Caroline Thng
- Gold Coast Sexual Health & HIV Service, Queensland, Australia
| | - David M Whiley
- The University of Queensland Centre for Clinical Research (UQ-CCR), Queensland, Australia.,Pathology Queensland Central Laboratory, Queensland, Australia
| | - Emma L Sweeney
- The University of Queensland Centre for Clinical Research (UQ-CCR), Queensland, Australia
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11
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Hanrahan JK, Hogan TR, Buckley C, Trembizki E, Mitchell H, Lau CL, Whiley DM, Lahra MM. Emergence and spread of ciprofloxacin-resistant Neisseria gonorrhoeae in New South Wales, Australia: lessons from history. J Antimicrob Chemother 2020; 74:2214-2219. [PMID: 31170281 DOI: 10.1093/jac/dkz182] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/10/2019] [Accepted: 04/05/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Our aim was to investigate the emergence and spread of ciprofloxacin resistance in clinical Neisseria gonorrhoeae isolates in New South Wales, Australia, from the first reported case in 1991 until ciprofloxacin resistance was sustained at or above the WHO threshold for treatment change of 5% (1999), to inform future strategies for controlling gonococcal antimicrobial resistance. METHODS The index isolate and all subsequent clinical isolates of ciprofloxacin-resistant N. gonorrhoeae in New South Wales from 1991 to 1999 were genotyped using a previously described method on the Agena MassARRAY iPLEX platform. Region of acquisition data, where available, were used to determine whether cases were travel associated. RESULTS In New South Wales, of the 325 ciprofloxacin-resistant N. gonorrhoeae isolates reported from 1991 to 1999, 98% (320/325) were able to be recovered and 100% (320/320) were genotyped. There were 66 different genotypes, comprising 1-99 isolates each. Notably no single clone was found to account for ciprofloxacin resistance being sustained in the population, with considerable variability in genotype prevalence observed throughout the study period. A total of 65% (209/320) of genotyped isolates had information regarding the likely place of acquisition; of these, 44% (93/209) were associated with overseas travel or sexual contact with an overseas visitor. The first ciprofloxacin-resistant N. gonorrhoeae in New South Wales was associated with travel to Thailand. Index cases of each resistant genotype were significantly more likely to have been acquired overseas (51.5%), predominantly in Asia (45%, 30/66). CONCLUSIONS The continued importation of multiple genotypes, rather than the expansion of a single genotype, led to ciprofloxacin-resistant N. gonorrhoeae being established in New South Wales.
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Affiliation(s)
- Jane K Hanrahan
- WHO Collaborating Centre for Sexually Transmitted Infections and Antimicrobial Resistance, NSWHP Microbiology, Prince of Wales Hospital, Sydney, New South Wales 2031, Australia.,School of Biotechnology and Biomolecular Science, The University of New South Wales, Sydney, New South Wales 2052
| | - Tiffany R Hogan
- WHO Collaborating Centre for Sexually Transmitted Infections and Antimicrobial Resistance, NSWHP Microbiology, Prince of Wales Hospital, Sydney, New South Wales 2031, Australia
| | - Cameron Buckley
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Herston, Queensland 4029, Australia
| | - Ella Trembizki
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Herston, Queensland 4029, Australia
| | - Hazel Mitchell
- School of Biotechnology and Biomolecular Science, The University of New South Wales, Sydney, New South Wales 2052
| | - Colleen L Lau
- Research School of Population Health, The Australian National University, Canberra, ACT 2600, Australia
| | - David M Whiley
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Herston, Queensland 4029, Australia.,Pathology Queensland, Microbiology Department, Herston, Queensland 4029, Australia
| | - Monica M Lahra
- WHO Collaborating Centre for Sexually Transmitted Infections and Antimicrobial Resistance, NSWHP Microbiology, Prince of Wales Hospital, Sydney, New South Wales 2031, Australia.,School of Biotechnology and Biomolecular Science, The University of New South Wales, Sydney, New South Wales 2052
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12
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Ebeyan S, Windsor M, Bordin A, Mhango L, Erskine S, Trembizki E, Mokany E, Tan LY, Whiley D. Evaluation of the ResistancePlus GC (beta) assay: a commercial diagnostic test for the direct detection of ciprofloxacin susceptibility or resistance in Neisseria gonorrhoeae. J Antimicrob Chemother 2020; 74:1820-1824. [PMID: 30897201 DOI: 10.1093/jac/dkz108] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 02/04/2019] [Accepted: 02/22/2019] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES To evaluate the performance of the ResistancePlus GC (beta) assay for the simultaneous detection of Neisseria gonorrhoeae and gyrA S91 markers of resistance (S91F) and susceptibility (WT) to ciprofloxacin, from both clinical specimens and isolates. METHODS Performance was assessed on several sample banks, including N. gonorrhoeae isolates (n = 822), non-gonococcal isolates (n = 110), N. gonorrhoeae-positive clinical specimens (n = 402) and N. gonorrhoeae-negative specimens (n = 290). Results were compared with previous testing data, including S91 genotyping and phenotypic resistance profiles. RESULTS Overall, the assay demonstrated 100% sensitivity for N. gonorrhoeae detection in clinical isolates. For gyrA S91 mutation detection in clinical isolates, the assay showed 100% sensitivity/specificity compared with the genotype, and >99%/>97% sensitivity/specificity when compared with phenotype. For positive clinical specimens, the assay demonstrated >96% sensitivity for N. gonorrhoeae detection and 100% sensitivity/specificity for gyrA S91 mutation detection. The assay demonstrated >99% specificity for N. gonorrhoeae detection against non-gonococcal isolates and 100% specificity for negative clinical specimens. CONCLUSIONS The ResistancePlus GC (beta) assay is suitable for the detection of N. gonorrhoeae and gyrA markers associated with resistance/susceptibility to ciprofloxacin directly in clinical samples. This assay could be implemented for the individualized treatment of gonorrhoea infections as well as to enhance current antimicrobial resistance surveillance methods.
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Affiliation(s)
| | | | - Amanda Bordin
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Herston, Queensland, Australia
| | - Lebogang Mhango
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Herston, Queensland, Australia
| | | | - Ella Trembizki
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Herston, Queensland, Australia
| | - Elisa Mokany
- SpeeDx Pty Ltd, Sydney, New South Wales, Australia
| | - Lit Yeen Tan
- SpeeDx Pty Ltd, Sydney, New South Wales, Australia
| | - David Whiley
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Herston, Queensland, Australia.,Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia
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13
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Sweeney EL, Trembizki E, Bletchly C, Bradshaw CS, Menon A, Francis F, Langton-Lockton J, Nimmo GR, Whiley DM. Levels of Mycoplasma genitalium Antimicrobial Resistance Differ by Both Region and Gender in the State of Queensland, Australia: Implications for Treatment Guidelines. J Clin Microbiol 2019; 57:e01555-18. [PMID: 30602443 PMCID: PMC6425175 DOI: 10.1128/jcm.01555-18] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 12/15/2018] [Indexed: 11/20/2022] Open
Abstract
Mycoplasma genitalium is frequently associated with urogenital and rectal infections, with the number of cases of macrolide-resistant and quinolone-resistant M. genitalium infection continuing to increase. In this study, we examined the levels of resistance to these two common antibiotic treatments in geographically distinct locations in Queensland, Australia. Samples were screened for macrolide resistance-associated mutations using a commercially available kit (ResistancePlus MG; SpeeDx), and quinolone resistance-associated mutations were identified by PCR and DNA sequencing. Comparisons between antibiotic resistance mutations and location/gender were performed. The levels of M. genitalium macrolide resistance were high across both locations (62%). Quinolone resistance mutations were found in ∼10% of all samples, with a number of samples harboring mutations conferring resistance to both macrolides and quinolones. Quinolone resistance was higher in southeast Queensland than in north Queensland, and this was consistent in both males and females (P = 0.007). The M. genitalium isolates in rectal swab samples from males harbored high levels of macrolide (75.9%) and quinolone (19%) resistance, with 15.5% harboring resistance to both classes of antibiotics. Overall, the lowest observed level of resistance was to quinolones in females from north Queensland (1.6%). These data highlight the high levels of antibiotic resistance in M. genitalium isolates within Queensland and the challenges faced by sexually transmitted infection clinicians in managing these infections. The data do, however, show that the levels of antibiotic resistance may differ between populations within the same state, which has implications for clinical management and treatment guidelines. These findings also support the need for ongoing antibiotic resistance surveillance and tailored treatment.
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Affiliation(s)
- E L Sweeney
- The University of Queensland Centre for Clinical Research (UQ-CCR), The University of Queensland, Brisbane, Queensland, Australia
| | - E Trembizki
- The University of Queensland Centre for Clinical Research (UQ-CCR), The University of Queensland, Brisbane, Queensland, Australia
| | - C Bletchly
- Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia
| | - C S Bradshaw
- Melbourne Sexual Health Centre, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - A Menon
- Townsville Sexual Health Service, Townsville, Queensland, Australia
| | - F Francis
- Pathology Queensland Townsville Laboratory, Townsville, Queensland, Australia
| | | | - G R Nimmo
- Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia
| | - D M Whiley
- The University of Queensland Centre for Clinical Research (UQ-CCR), The University of Queensland, Brisbane, Queensland, Australia
- Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia
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14
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Trembizki E, Guy R, Donovan B, Kaldor JM, Lahra MM, Whiley DM. Further evidence to support the individualised treatment of gonorrhoea with ciprofloxacin. Lancet Infect Dis 2018; 16:1005-1006. [PMID: 27684341 DOI: 10.1016/s1473-3099(16)30271-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 07/18/2016] [Accepted: 07/18/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Ella Trembizki
- UQ Centre for Clinical Research, University of Queensland, Brisbane, QLD 4029, Australia.
| | - Rebecca Guy
- Kirby Institute, UNSW Australia, Sydney, NSW, Australia
| | - Basil Donovan
- Kirby Institute, UNSW Australia, Sydney, NSW, Australia
| | - John M Kaldor
- Kirby Institute, UNSW Australia, Sydney, NSW, Australia
| | - Monica M Lahra
- WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, NSW, Australia; School of Medical Sciences, Faculty of Medicine, UNSW Australia, Sydney, NSW, Australia
| | - David M Whiley
- UQ Centre for Clinical Research, University of Queensland, Brisbane, QLD 4029, Australia; Pathology Queensland Central Laboratory, Brisbane, QLD, Australia
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15
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Whiley DM, Trembizki E, Buckley C, Freeman K, Baird RW, Beaman M, Chen M, Donovan B, Kundu RL, Fairley CK, Guy R, Hogan T, Kaldor JM, Karimi M, Limnios A, Regan DG, Ryder N, Su JY, Ward J, Lahra MM. Molecular Antimicrobial Resistance Surveillance for Neisseria gonorrhoeae, Northern Territory, Australia. Emerg Infect Dis 2018; 23:1478-1485. [PMID: 28820128 PMCID: PMC5572890 DOI: 10.3201/eid2309.170427] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Neisseria gonorrhoeae antimicrobial resistance (AMR) is a globally recognized health threat; new strategies are needed to enhance AMR surveillance. The Northern Territory of Australia is unique in that 2 different first-line therapies, based primarily on geographic location, are used for gonorrhea treatment. We tested 1,629 N. gonorrhoeae nucleic acid amplification test–positive clinical samples, collected from regions where ceftriaxone plus azithromycin or amoxicillin plus azithromycin are recommended first-line treatments, by using 8 N. gonorrhoeae AMR PCR assays. We compared results with those from routine culture-based surveillance data. PCR data confirmed an absence of ceftriaxone resistance and a low level of azithromycin resistance (0.2%), and that penicillin resistance was <5% in amoxicillin plus azithromycin regions. Rates of ciprofloxacin resistance and penicillinase-producing N. gonorrhoeae were lower when molecular methods were used. Molecular methods to detect N. gonorrhoeae AMR can increase the evidence base for treatment guidelines, particularly in settings where culture-based surveillance is limited.
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16
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Zowawi HM, Syrmis MW, Kidd TJ, Balkhy HH, Walsh TR, Al Johani SM, Al Jindan RY, Alfaresi M, Ibrahim E, Al-Jardani A, Al Salman J, Dashti AA, Sidjabat HE, Baz O, Trembizki E, Whiley DM, Paterson DL. Identification of carbapenem-resistant Pseudomonas aeruginosa in selected hospitals of the Gulf Cooperation Council States: dominance of high-risk clones in the region. J Med Microbiol 2018; 67:846-853. [PMID: 29664716 DOI: 10.1099/jmm.0.000730] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE The molecular epidemiology and resistance mechanisms of carbapenem-resistant Pseudomonas aeruginosa (CRPA) were determined in hospitals in the countries of the Gulf Cooperation Council (GCC), namely, Saudi Arabia, the United Arab Emirates, Oman, Qatar, Bahrain and Kuwait. METHODOLOGY Isolates were screened for common carbapenem-resistance genes by PCR. Relatedness between isolates was assessed using previously described genotyping methods: an informative-single nucleotide polymorphism MassARRAY iPLEX assay (iPLEX20SNP) and the enterobacterial repetitive intergenic consensus (ERIC)-PCR assay, with selected isolates being subjected to multilocus sequence typing (MLST). Ninety-five non-repetitive isolates that were found to be resistant to carbapenems were subjected to further investigation.Results/Key findings. The most prevalent carbapenemase-encoding gene, blaVIM-type, was found in 37/95 (39 %) isolates, while only 1 isolate (from UAE) was found to have blaIMP-type. None of the CRPA were found to have blaNDM-type or blaKPC-type. We found a total of 14 sequence type (ST) clusters, with 4 of these clusters being observed in more than 1 country. Several clusters belonged to the previously recognized internationally disseminated high-risk clones ST357, ST235, ST111, ST233 and ST654. We also found the less predominant ST316, ST308 and ST823 clones, and novel MLST types (ST2010, ST2011, ST2012 and ST2013), in our collection. CONCLUSION Overall our data show that 'high-risk' CRPA clones are now detected in the region and highlight the need for strategies to limit further spread of such organisms, including enhanced surveillance, infection control precautions and further promotion of antibiotic stewardship programmes.
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Affiliation(s)
- Hosam M Zowawi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,WHO Collaborating Centre for Infection Prevention and Control, and GCC Center for Infection Control, Riyadh, Saudi Arabia
| | | | - Timothy J Kidd
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4072, Australia.,Centre for Experimental Medicine, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Hanan H Balkhy
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,WHO Collaborating Centre for Infection Prevention and Control, and GCC Center for Infection Control, Riyadh, Saudi Arabia
| | - Timothy R Walsh
- The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia.,Department of Medical Microbiology and Infectious Diseases, School of Medicine, Cardiff University, Heath Park, Cardiff, UK
| | - Sameera M Al Johani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Microbiology, Department of Pathology and Lab Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Reem Y Al Jindan
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mubarak Alfaresi
- Pathology and Laboratory Medicine Department at Sheikh Khalifa General Hospital, Umm Al Quwain, UAE.,College of Medicine, University of Sharjah, UAE
| | - Emad Ibrahim
- Clinical Microbiology Department, Hamad Medical Corporation, Doha, Qatar
| | - Amina Al-Jardani
- Medical Microbiology Department, The Royal Hospital, Muscat, Oman
| | - Jameela Al Salman
- Samlaniya Medical Complex, Infectious Diseases Unit, Manama, Bahrain
| | - Ali A Dashti
- Medical Laboratory Department, Faculty of Allied Health Sciences, Health Science Center, Kuwait University, Kuwait City, Kuwait
| | - Hanna E Sidjabat
- The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia
| | - Omar Baz
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Ella Trembizki
- The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia
| | - David M Whiley
- The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia.,Pathology Queensland, Brisbane, Queensland 4029, Australia
| | - David L Paterson
- The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia
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17
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Lahra MM, Trembizki E, Buckley C, Donovan B, Chen M, Guy R, Kundu RL, Regan DG, Whiley DM. Changes in the rates of Neisseria gonorrhoeae antimicrobial resistance are primarily driven by dynamic fluctuations in common gonococcal genotypes. J Antimicrob Chemother 2017; 72:705-711. [PMID: 27999043 DOI: 10.1093/jac/dkw452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 09/19/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives To examine how gonococcal genotypes and associated changes over time influence rates of Neisseria gonorrhoeae antimicrobial resistance. Methods All available N. gonorrhoeae isolates collected in New South Wales, Australia in the first half of both 2012 and 2014 were genotyped using the Agena MassARRAY iPLEX platform. Genotypic data were compared with phenotypic antimicrobial resistance profiles over time. We focused on penicillin and ciprofloxacin as significant increases in resistance to both antibiotics were observed over this time period. Results Genotyping data were obtained for 760 and 782 isolates in 2012 and 2014, respectively. A total of 162 distinct genotypes were identified in the study, including 36 (22.2%) genotypes present in both years ( persisting genotypes), 54 (33.3%) observed in 2012 only and 72 (44.4%) observed in 2014 only (s ingle-year genotypes). Overall, persisting genotypes comprised 15 of the 20 most common genotypes, 8 of which showed a significant change in proportion from 2012 to 2014. Persisting genotypes also comprised the majority (>70%) of ciprofloxacin- and penicillin-resistant isolates in both years. Significant fluctuations in the most common persisting genotypes accounted for the majority of observed increases in both ciprofloxacin and penicillin resistance. Single-year genotypes contributed to ∼20% of ciprofloxacin and penicillin resistance in each year. Conclusions The results show that the gonococcal genotypes persisting in the study population fluctuated significantly within a 3 year period, with numerous other genotypes appearing or disappearing. It is the net effect of these changes that determines N. gonorrhoeae antimicrobial resistance levels within the population.
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Affiliation(s)
- Monica M Lahra
- WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Randwick, New South Wales 2031, Australia.,School of Medical Sciences, Faculty of Medicine, UNSW Australia, Sydney, New South Wales 2052, Australia
| | - Ella Trembizki
- The University of Queensland, UQ Centre for Clinical Research (UQCCR), Herston, Queensland 4029, Australia
| | - Cameron Buckley
- The University of Queensland, UQ Centre for Clinical Research (UQCCR), Herston, Queensland 4029, Australia
| | - Basil Donovan
- Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia.,Sydney Sexual Health Centre, Sydney Hospital, Sydney, New South Wales 2000, Australia
| | - Marcus Chen
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria 3053, Australia.,Central Clinical School Monash University, Melbourne, Victoria, Australia
| | - Rebecca Guy
- Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia
| | - Ratan L Kundu
- WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Randwick, New South Wales 2031, Australia
| | - David G Regan
- Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia
| | - David M Whiley
- School of Medical Sciences, Faculty of Medicine, UNSW Australia, Sydney, New South Wales 2052, Australia.,Pathology Queensland Central Laboratory, Brisbane, Queensland 4029, Australia
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18
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Abstract
The macrolide azithromycin is recommended for treatment of Mycoplasma genitalium infection; however, M. genitalium strains possessing macrolide resistance-mediating mutations (MRMMs) are increasingly being reported. Here, we used the SpeeDx ResistancePlus MG kit, which provides simultaneous detection of M. genitalium and MRMMs, to assess MRMM carriage among M. genitalium infections in Queensland, Australia. Performance characteristics of the ResistancePlus MG kit for M. genitalium detection were compared to in-house PCR. Available M. genitalium PCR-positive (n=67) and negative (n=281) samples from the years 2011 to 2017 were tested using the SpeeDx ResistancePlus MG kit. In total, 63.6 % M. genitalium-positive samples were indicated to harbour MRMMs. The ResistancePlus MG method provided sensitivity and specificity of 97 and 99.6 % respectively compared to in-house PCR for M. genitalium detection. Such high levels of macrolide-resistant M. genitalium raise further concerns over future use of azithromycin for treatment of M. genitalium infection.
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Affiliation(s)
- Ella Trembizki
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland 4029, Australia
| | - Cameron Buckley
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland 4029, Australia
| | - Cheryl Bletchly
- Pathology Queensland Central Laboratory, Brisbane, Queensland 4029, Australia
| | - Graeme R. Nimmo
- Pathology Queensland Central Laboratory, Brisbane, Queensland 4029, Australia
| | - David M. Whiley
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland 4029, Australia
- Pathology Queensland Central Laboratory, Brisbane, Queensland 4029, Australia
- *Correspondence: David M. Whiley,
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19
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Goire N, Kundu R, Trembizki E, Buckley C, Hogan TR, Lewis DA, Branley JM, Whiley DM, Lahra MM. Mixed gonococcal infections in a high-risk population, Sydney, Australia 2015: implications for antimicrobial resistance surveillance? J Antimicrob Chemother 2016; 72:407-409. [PMID: 27707989 DOI: 10.1093/jac/dkw406] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 08/24/2016] [Accepted: 08/26/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Previous studies have shown that mixed-strain gonococcal infections can occur. However, it remains unclear whether such infections impact upon the reliability of Neisseria gonorrhoeae antimicrobial resistance (AMR) surveillance. In this study, we aimed to resolve this question by intensively sampling isolates from gonorrhoea-positive specimens in a high-risk population in Sydney, Australia. METHODS A total of 615 N. gonorrhoeae isolates, originating from 63 clinical samples (31 rectal swabs and 32 throat swabs), were characterized. All isolates were subject to N. gonorrhoeae identification, antimicrobial susceptibility testing and genotyping by SNP-based MLST. RESULTS Only 2 of the 63 (3.2%) samples provided evidence of mixed-strain infections. These comprised two rectal swabs that harboured isolates of different SNP-based MLST genotypes; however, the AMR susceptibility profiles of the different genotypes from these samples were indistinguishable. Within-sample differences in the AMR susceptibility profiles were observed for a further seven samples; however, the differences were not considered significant; MIC values were typically within a 2-fold difference or were close to test breakpoints. CONCLUSIONS Results of this study provide further evidence that mixed-strain gonococcal infections do occur, although at low prevalence. Our data indicate that at a population level such infections are unlikely to impact significantly upon N. gonorrhoeae AMR surveillance.
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Affiliation(s)
- Namraj Goire
- WHO Collaborating Centre for Sexually Transmitted Diseases, Sydney, Department of Microbiology, South Eastern Area Laboratory Services, Prince of Wales Hospital, Randwick, New South Wales 2031, Australia .,Sydney Medical School Nepean, The University of Sydney, Nepean Hospital, Penrith, New South Wales 2747, Australia
| | - Ratan Kundu
- WHO Collaborating Centre for Sexually Transmitted Diseases, Sydney, Department of Microbiology, South Eastern Area Laboratory Services, Prince of Wales Hospital, Randwick, New South Wales 2031, Australia
| | - Ella Trembizki
- The University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital Campus, Herston, Queensland 4029, Australia
| | - Cameron Buckley
- The University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital Campus, Herston, Queensland 4029, Australia
| | - Tiffany R Hogan
- WHO Collaborating Centre for Sexually Transmitted Diseases, Sydney, Department of Microbiology, South Eastern Area Laboratory Services, Prince of Wales Hospital, Randwick, New South Wales 2031, Australia
| | - David A Lewis
- Western Sydney Sexual Health Centre, Parramatta, New South Wales 2150, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity & Sydney Medical School-Westmead, University of Sydney, New South Wales 2006, Australia
| | - James M Branley
- Sydney Medical School Nepean, The University of Sydney, Nepean Hospital, Penrith, New South Wales 2747, Australia
| | - David M Whiley
- The University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital Campus, Herston, Queensland 4029, Australia.,Pathology Queensland Central Laboratory, Brisbane, Queensland 4029, Australia
| | - Monica M Lahra
- WHO Collaborating Centre for Sexually Transmitted Diseases, Sydney, Department of Microbiology, South Eastern Area Laboratory Services, Prince of Wales Hospital, Randwick, New South Wales 2031, Australia.,School of Medical Sciences, Faculty of Medicine, The University of New South Wales, Kensington, New South Wales 2033, Australia
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20
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Trembizki E, Wand H, Donovan B, Chen M, Fairley CK, Freeman K, Guy R, Kaldor JM, Lahra MM, Lawrence A, Lau C, Pearson J, Regan DG, Ryder N, Smith H, Stevens K, Su JY, Ward J, Whiley DM. The Molecular Epidemiology and Antimicrobial Resistance of Neisseria gonorrhoeae in Australia: A Nationwide Cross-Sectional Study, 2012. Clin Infect Dis 2016; 63:1591-1598. [PMID: 27682063 DOI: 10.1093/cid/ciw648] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 09/12/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) by Neisseria gonorrhoeae is considered a serious global threat. METHODS In this nationwide study, we used MassARRAY iPLEX genotyping technology to examine the epidemiology of N. gonorrhoeae and associated AMR in the Australian population. All available N. gonorrhoeae isolates (n = 2452) received from Australian reference laboratories from January to June 2012 were included in the study. Genotypic data were combined with phenotypic AMR information to define strain types. RESULTS A total of 270 distinct strain types were observed. The 40 most common strain types accounted for over 80% of isolates, and the 10 most common strain types accounted for almost half of all isolates. The high male to female ratios (>94% male) suggested that at least 22 of the top 40 strain types were primarily circulating within networks of men who have sex with men (MSM). Particular strain types were also concentrated among females: two strain types accounted for 37.5% of all isolates from females. Isolates harbouring the mosaic penicillin binding protein 2 (PBP2)-considered a key mechanism for cephalosporin resistance-comprised 8.9% of all N. gonorrhoeae isolates and were primarily observed in males (95%). CONCLUSIONS This large scale epidemiological investigation demonstrated that N. gonorrhoeae infections are dominated by relatively few strain types. The commonest strain types were concentrated in MSM in urban areas and Indigenous heterosexuals in remote areas, and we were able to confirm a resurgent epidemic in heterosexual networks in urban areas. The prevalence of mosaic PBP2 harboring N. gonorrhoeae strains highlight the ability for new N. gonorrhoeae strains to spread and become established across populations.
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Affiliation(s)
- Ella Trembizki
- UQ Centre for Clinical Research, The University of Queensland, Brisbane
| | | | - Basil Donovan
- Kirby Institute, UNSW Australia, Sydney.,Sydney Sexual Health Centre, Sydney Hospital, New South Wales
| | - Marcus Chen
- Melbourne Sexual Health Centre, Alfred Health, Carlton.,Central Clinical School Monash University, Melbourne, Victoria
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Carlton.,Central Clinical School Monash University, Melbourne, Victoria
| | - Kevin Freeman
- Microbiology Laboratory, Pathology Department, Royal Darwin Hospital, Northern Territory
| | | | | | - Monica M Lahra
- WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales
| | - Andrew Lawrence
- Microbiology and Infectious Diseases Department, Women's and Children's Hospital, North Adelaide, South Australia
| | - Colleen Lau
- Department of Global Health, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory
| | - Julie Pearson
- PathWest Laboratory Medicine-WA, Royal Perth Hospital, Western Australia
| | | | - Nathan Ryder
- Kirby Institute, UNSW Australia, Sydney.,HNE Sexual Health, Hunter New England Local Health District, New South Wales
| | - Helen Smith
- Public Health Microbiology, Communicable Disease, Queensland Health Forensic and Scientific Services, Archerfield
| | - Kerrie Stevens
- Microbiological Diagnostic Unit, Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Victoria
| | - Jiunn-Yih Su
- Sexual Health and Blood Borne Virus Unit, Centre for Disease Control, Darwin, Northern Territory
| | - James Ward
- South Australian Health and Medical Research Institute, Adelaide, South Australia
| | - David M Whiley
- UQ Centre for Clinical Research, The University of Queensland, Brisbane.,Pathology Queensland Central Laboratory, Herston, Australia
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21
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Buckley C, Trembizki E, Donovan B, Chen M, Freeman K, Guy R, Lahra MM, Kundu RL, Regan DG, Smith HV, Whiley DM. Real-time PCR detection of Neisseria gonorrhoeae susceptibility to penicillin. J Antimicrob Chemother 2016; 71:3090-3095. [PMID: 27494921 DOI: 10.1093/jac/dkw291] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 06/16/2016] [Accepted: 06/17/2016] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES The objective of this study was to develop a real-time PCR assay targeting the gonococcal porB gene (PorB-PCR) for predicting susceptibility of Neisseria gonorrhoeae to penicillin. This complements a previously described PCR assay for detecting penicillinase-producing N. gonorrhoeae (PPNG) developed by our laboratory (PPNG-PCR). METHODS The PorB-PCR assay was designed using six probes to characterize various combinations of amino acids at positions 101 and 102 of the PorB1b class protein, including the WT G101/A102 and mutant G101K/A102D, G101K/A102N and G101K/A102G sequences, as well as the PorB1a sequence. The ability of these sequences to predict penicillin susceptibility was initially assessed using 2307 N. gonorrhoeae isolates from throughout Australia for which phenotypic susceptibility data were available. The assay was then applied to N. gonorrhoeae-positive clinical specimens (n = 70). Specificity was assessed by testing commensal Neisseria strains (n = 75) and N. gonorrhoeae-negative clinical specimens (n = 171). RESULTS Testing of the 2307 N. gonorrhoeae isolates using PorB-PCR to detect G101/A102 and PorB1a sequences identified a total of 78.4% (61.2% and 17.2%, respectively) of penicillin-susceptible isolates with specificities of 97.4% and 99.3% and positive predictive values of 98.8% and 98.9%, where PPNG strains were simultaneously identified and excluded. Similar performance data were obtained when the PorB-PCR assay was applied to the N. gonorrhoeae-positive clinical specimens. No false-positive results were observed for the N. gonorrhoeae-negative samples and no cross-reactions were observed with the non-gonococcal species. CONCLUSIONS When used in parallel with the previously described PPNG-PCR, the PorB-PCR approach has the potential to facilitate individualized treatment of gonorrhoea using penicillin.
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Affiliation(s)
- Cameron Buckley
- The University of Queensland, UQ Centre for Clinical Research (UQCCR), Herston, Queensland 4029, Australia
| | - Ella Trembizki
- The University of Queensland, UQ Centre for Clinical Research (UQCCR), Herston, Queensland 4029, Australia
| | - Basil Donovan
- Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia
| | - Marcus Chen
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria 3053, Australia.,Central Clinical School, Monash University, Melbourne, Victoria 3181, Australia
| | - Kevin Freeman
- Microbiology Laboratory, Pathology Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Rebecca Guy
- Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia
| | - Monica M Lahra
- WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales 2031, Australia
| | - Ratan L Kundu
- WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales 2031, Australia
| | - David G Regan
- Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia
| | - Helen V Smith
- Public Health Microbiology, Communicable Disease, Queensland Health Forensic and Scientific Services, Archerfield, Queensland, Australia
| | - David M Whiley
- The University of Queensland, UQ Centre for Clinical Research (UQCCR), Herston, Queensland 4029, Australia.,Pathology Queensland, Microbiology Department, Herston, Queensland, Australia
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22
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Buckley C, Trembizki E, Donovan B, Chen M, Freeman K, Guy R, Kundu R, Lahra MM, Regan DG, Smith H, Whiley DM. A real-time PCR assay for direct characterization of the Neisseria gonorrhoeae GyrA 91 locus associated with ciprofloxacin susceptibility. J Antimicrob Chemother 2015; 71:353-6. [PMID: 26538505 DOI: 10.1093/jac/dkv366] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 10/08/2015] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES The objective of this study was to develop a real-time PCR method for specific detection of the gonococcal GyrA amino acid 91 locus directly in clinical samples so as to predict Neisseria gonorrhoeae ciprofloxacin susceptibility. METHODS The real-time PCR assay, GyrA91-PCR, was designed using two probes, one for detection of the WT S91 sequence and the other for detection of the S91F alteration. The performance of the assay was initially assessed using characterized N. gonorrhoeae isolates (n = 70), a panel of commensal Neisseria and Moraxella species (n = 55 isolates) and clinical samples providing negative results by a commercial N. gonorrhoeae nucleic acid amplification test (NAAT) method (n = 171). The GyrA91-PCR was then applied directly to N. gonorrhoeae NAAT-positive clinical samples (n = 210) from the year 2014 for which corresponding N. gonorrhoeae isolates with susceptibility results were also available. RESULTS The GyrA91-PCR accurately characterized the GyrA 91 locus of all 70 N. gonorrhoeae isolates (sensitivity = 100%, 95% CI = 94.9%-100%), whereas all non-gonococcal isolates and N. gonorrhoeae NAAT-negative clinical samples gave negative results by the GyrA91-PCR (specificity = 100%, 95% CI = 98.4%-100%). When applied to the 210 N. gonorrhoeae NAAT-positive clinical samples, the GyrA91-PCR successfully characterized 195 samples (92.9%, 95% CI = 88.5%-95.9%). When compared with the corresponding bacterial culture results, positivity by the GyrA91-PCR WT probe correctly predicted N. gonorrhoeae susceptibility to ciprofloxacin in 161 of 162 (99.4%, 95% CI = 96.6%-99.9%) samples. CONCLUSIONS The use of a PCR assay for detection of mutation in gyrA applied directly to clinical samples can predict ciprofloxacin susceptibility in N. gonorrhoeae.
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Affiliation(s)
- Cameron Buckley
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, Brisbane, Queensland 4029, Australia University of Queensland Child Health Research Centre, Brisbane, Queensland 4029, Australia
| | - Ella Trembizki
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, Brisbane, Queensland 4029, Australia University of Queensland Child Health Research Centre, Brisbane, Queensland 4029, Australia
| | - Basil Donovan
- Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia
| | - Marcus Chen
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Melbourne, Victoria 3053, Australia Central Clinical School, Monash University, Melbourne, Victoria 3181, Australia
| | - Kevin Freeman
- Microbiology Laboratory, Pathology Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Rebecca Guy
- Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia
| | - Ratan Kundu
- WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales 2031, Australia
| | - Monica M Lahra
- WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales 2031, Australia
| | - David G Regan
- Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia
| | - Helen Smith
- Public Health Microbiology, Communicable Disease, Queensland Health Forensic and Scientific Services, Archerfield, Brisbane, Queensland, Australia
| | - David M Whiley
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, Brisbane, Queensland 4029, Australia University of Queensland Child Health Research Centre, Brisbane, Queensland 4029, Australia UQ Centre for Clinical Research (UQCCR), The University of Queensland, Brisbane, Queensland 4029, Australia
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Trembizki E, Buckley C, Donovan B, Chen M, Guy R, Kaldor J, Lahra MM, Regan DG, Smith H, Ward J, Whiley DM. Direct real-time PCR-based detection of Neisseria gonorrhoeae 23S rRNA mutations associated with azithromycin resistance. J Antimicrob Chemother 2015; 70:3244-9. [PMID: 26338048 DOI: 10.1093/jac/dkv274] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 08/10/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Surveillance for Neisseria gonorrhoeae azithromycin resistance is of growing importance given increasing use of ceftriaxone and azithromycin dual therapy for gonorrhoea treatment. In this study, we developed two real-time PCR methods for direct detection of two key N. gonorrhoeae 23S rRNA mutations associated with azithromycin resistance. METHODS The real-time PCR assays, 2611-PCR and 2059-PCR, targeted the gonococcal 23S rRNA C2611T and A2059G mutations, respectively. A major design challenge was that gonococcal 23S rRNA sequences have high sequence homology with those of commensal Neisseria species. To limit the potential for cross-reaction, 'non-template' bases were utilized in primer sequences. The performance of the methods was initially assessed using a panel of gonococcal (n = 70) and non-gonococcal (n = 28) Neisseria species. Analytical specificity was further assessed by testing N. gonorrhoeae nucleic acid amplification test (NAAT)-negative clinical samples (n = 90), before being applied to N. gonorrhoeae NAAT-positive clinical samples (n = 306). RESULTS Cross-reactions with commensal Neisseria strains remained evident for both assays; however, cycle threshold (Ct) values were significantly delayed, indicating reduced sensitivity for non-gonococcal species. For the N. gonorrhoeae NAAT-negative clinical samples, 7/21 pharyngeal samples provided evidence of cross-reaction (Ct values >40 cycles); however, the remaining urogenital and rectal swab samples were negative. In total, the gonococcal 2611 and 2059 23S rRNA nucleotides were both successfully characterized in 266/306 (87%) of the N. gonorrhoeae NAAT-positive clinical specimens. CONCLUSIONS Real-time PCR detection of gonococcal 23S rRNA mutations directly from clinical samples is feasible and may enhance culture- and non-culture-based N. gonorrhoeae resistance surveillance.
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Affiliation(s)
- Ella Trembizki
- Queensland Paediatric Infectious Diseases (QPID) Laboratory, Queensland Children's Medical Research Institute, Brisbane, Queensland 4029, Australia UQ Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland 4029, Australia
| | - Cameron Buckley
- Queensland Paediatric Infectious Diseases (QPID) Laboratory, Queensland Children's Medical Research Institute, Brisbane, Queensland 4029, Australia UQ Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland 4029, Australia
| | - Basil Donovan
- Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia Sydney Sexual Health Centre, Sydney Hospital, Sydney, New South Wales 2000, Australia
| | - Marcus Chen
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria 3053, Australia Central Clinical School, Monash University, Melbourne, Victoria 3800, Australia
| | - Rebecca Guy
- Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia
| | - John Kaldor
- Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia
| | - Monica M Lahra
- WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales 2031, Australia
| | - David G Regan
- Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia
| | - Helen Smith
- Public Health Microbiology, Public and Environmental Health, Queensland Health Forensic and Scientific Services, Archerfield, Queensland 4107, Australia
| | - James Ward
- South Australian Health and Medical Research Institute, Adelaide, South Australia 5000, Australia
| | - David M Whiley
- Queensland Paediatric Infectious Diseases (QPID) Laboratory, Queensland Children's Medical Research Institute, Brisbane, Queensland 4029, Australia UQ Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland 4029, Australia
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Trembizki E, Regan DG, Donovan B, Chen MY, Guy RJ, Lahra MM, Whiley D. 001.5 An australia-wide molecular study of neisseria gonorrhoeaeidentifies frequent occurrence of a key cephalosporin resistance mechanism. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.83] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Trembizki E, Doyle C, Buckley C, Jennison A, Smith H, Bates J, Sloots T, Nissen M, Lahra MM, Whiley D. Estimating the prevalence of mixed-type gonococcal infections in Queensland, Australia. Sex Health 2015; 12:439-44. [PMID: 26145099 DOI: 10.1071/sh15009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 05/07/2015] [Indexed: 11/23/2022]
Abstract
UNLABELLED Background Mixed gonococcal infections within the one anatomical site have been recognised but questions remain over how often they occur. In this study, the aim was to estimate the prevalence of mixed gonococcal infections using novel real-time polymerase chain reaction (PCR) methods that were developed and validated, targeting the gonococcal porB gene. METHODS Neisseria gonorrhoeae strains were categorised into three different porB groups, based on sequence data derived from N. gonorrhoeae multi-antigen sequence typing (NG-MAST) analyses of local isolates. Specific PCR methods for each group were then developed and these PCR methods were used to test clinical samples (n=350) that were positive for gonorrhoea as determined by nucleic acid amplification test (NAAT) diagnostic screening. RESULTS Initial validation using isolates showed the group PCR methods proved 100% sensitive and 100% specific for their respective porB groups. When applied to the clinical specimens, 298/350 (85%) provided positive results by the group PCR methods. Of these, four specimens showed evidence of mixed infections, supported by subsequent DNA sequencing of the PCR products. CONCLUSIONS The data provide further evidence of mixed gonococcal infections at the same anatomical site, but show that such infections may be relatively infrequent (1.3%; 95% confidence interval 0.01-2.6%) in a general screening population.
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Affiliation(s)
- Ella Trembizki
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Health Services, Block 28, Royal Children's Hospital, Herston Road, Herston, Qld 4029, Australia
| | - Christine Doyle
- Public Health Microbiology, Queensland Health Forensic and Scientific Services, Archerfield, Qld 4108, Australia
| | - Cameron Buckley
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Health Services, Block 28, Royal Children's Hospital, Herston Road, Herston, Qld 4029, Australia
| | - Amy Jennison
- Public Health Microbiology, Queensland Health Forensic and Scientific Services, Archerfield, Qld 4108, Australia
| | - Helen Smith
- Public Health Microbiology, Queensland Health Forensic and Scientific Services, Archerfield, Qld 4108, Australia
| | - John Bates
- Public Health Microbiology, Queensland Health Forensic and Scientific Services, Archerfield, Qld 4108, Australia
| | - Theo Sloots
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Health Services, Block 28, Royal Children's Hospital, Herston Road, Herston, Qld 4029, Australia
| | - Michael Nissen
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Health Services, Block 28, Royal Children's Hospital, Herston Road, Herston, Qld 4029, Australia
| | - Monica M Lahra
- WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, NSW 2031, Australia
| | - David Whiley
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Health Services, Block 28, Royal Children's Hospital, Herston Road, Herston, Qld 4029, Australia
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Trembizki E, Doyle C, Jennison A, Smith H, Bates J, Lahra M, Whiley D. A Neisseria gonorrhoeae strain with a meningococcal mtrR sequence. J Med Microbiol 2014; 63:1113-1115. [DOI: 10.1099/jmm.0.074286-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Ella Trembizki
- Queensland Children’s Medical Research Institute, The University of Queensland, Queensland, Australia
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children’s Health Services, Queensland, Australia
| | - Christine Doyle
- Public Health Microbiology, Queensland Health Forensic and Scientific Services, Archerfield, Queensland, Australia
| | - Amy Jennison
- Public Health Microbiology, Queensland Health Forensic and Scientific Services, Archerfield, Queensland, Australia
| | - Helen Smith
- Public Health Microbiology, Queensland Health Forensic and Scientific Services, Archerfield, Queensland, Australia
| | - John Bates
- Public Health Microbiology, Queensland Health Forensic and Scientific Services, Archerfield, Queensland, Australia
| | - Monica Lahra
- WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - David Whiley
- Queensland Children’s Medical Research Institute, The University of Queensland, Queensland, Australia
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children’s Health Services, Queensland, Australia
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Trembizki E, Smith H, Lahra MM, Chen M, Donovan B, Fairley CK, Guy R, Kaldor J, Regan D, Ward J, Nissen MD, Sloots TP, Whiley DM. High-throughput informative single nucleotide polymorphism-based typing of Neisseria gonorrhoeae using the Sequenom MassARRAY iPLEX platform. J Antimicrob Chemother 2014; 69:1526-32. [DOI: 10.1093/jac/dkt544] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Trembizki E, Lahra M, Stevens K, Freeman K, Hogan T, Hogg G, Lawrence A, Limnios A, Pearson J, Smith H, Nissen M, Sloots T, Whiley D. A national quality assurance survey of Neisseria gonorrhoeae testing. J Med Microbiol 2014; 63:45-49. [DOI: 10.1099/jmm.0.065094-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The aims of this study were to (1) conduct a national survey of Neisseria gonorrhoeae identification by National Neisseria Network (NNN) reference laboratories contributing data to the Australian Gonococcal Surveillance Programme and (2) determine the prevalence in Australia of strains of N. gonorrhoeae lacking gene sequences commonly targeted by in-house PCR assays for confirmation of gonococcal nucleic acid amplification tests. Gonococcal clinical isolates referred to NNN laboratories for the first half of 2012 were screened using in-house real-time PCR assays targeting multicopy opa, porA pseudogene and cppB genes. There were 2455 clinical gonococcal isolates received in the study period; 98.6 % (2420/2455) of isolates harboured all three gene targets, 0.12 % (3/2455) were porA-negative, 0.04 % (1/2455) opa-negative and 1.14 % (28/2455) cppB-negative by PCR. Notably, no isolates were simultaneously negative for two targets. However, three isolates failed to be amplified by all three PCR methods, one isolate of which was shown to be a commensal Neisseria strain by 16S rRNA sequencing. Using PCR as the reference standard the results showed that (1) identification of N. gonorrhoeae isolates by NNN laboratories was highly specific (99.96 %) and (2) strains of N. gonorrhoeae lacking gene sequences commonly targeted by in-house PCR assays are present but not widespread throughout Australia at this point in time.
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Affiliation(s)
- Ella Trembizki
- Queensland Children’s Medical Research Institute, University of Queensland, Queensland, Australia
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children’s Health Services, Queensland, Australia
| | - Monica Lahra
- WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Kerrie Stevens
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, University of Melbourne, Parkville, Victoria, Australia
| | - Kevin Freeman
- Microbiology Laboratory, Pathology Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Tiffany Hogan
- WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Geoff Hogg
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, University of Melbourne, Parkville, Victoria, Australia
| | - Andrew Lawrence
- Microbiology and Infectious Diseases Department, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Athena Limnios
- WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Julie Pearson
- PathWest Laboratory Medicine-WA, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Helen Smith
- Public Health Microbiology, Communicable Disease, Queensland Health Forensic and Scientific Services, Archerfield, Queensland, Australia
| | - Michael Nissen
- Microbiology Division, Pathology Queensland Central, Royal Brisbane and Women’s Hospital Campus, Queensland, Australia
- Queensland Children’s Medical Research Institute, University of Queensland, Queensland, Australia
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children’s Health Services, Queensland, Australia
| | - Theo Sloots
- Microbiology Division, Pathology Queensland Central, Royal Brisbane and Women’s Hospital Campus, Queensland, Australia
- Queensland Children’s Medical Research Institute, University of Queensland, Queensland, Australia
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children’s Health Services, Queensland, Australia
| | - David Whiley
- Queensland Children’s Medical Research Institute, University of Queensland, Queensland, Australia
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children’s Health Services, Queensland, Australia
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Trembizki E, Chen M, Donovan B, Fairley C, Guy RJ, Kaldor JM, Lahra MM, Regan DG, Ward J, Whiley D. P1.021 A National Study Utilising the Sequenom Massarray iPLEX Platform For High Throughput MLST-Based Typing and Characterisation of Resistance Mechanisms in Neisseria Gonorrhoeae. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Trembizki E, Lahra MM, Stevens S, Freeman K, Hogg G, Lawrence A, Pearson J, Smith H, Sloots T, Whiley D. P2.032 A National Quality Assurance Survey: Low Neisseria Gonorrhoeae Misidentification Rates in Australia, 2012. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Whiley D, Chen M, Donovan B, Fairley C, Guy R, Kaldor J, Regan D, Trembizki E, Ward J, Lahra M. S09.1 Molecular Detection of Antimicrobial Resistance in STI Pathogens. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Whiley D, Trembizki E, Syrmis M, Nakos J, Bletchly C, Nissen M, Nimmo G, Sloots TP. High-throughput molecular typing of microbes using the Sequenom Massarray platform. Microbiol Aust 2013. [DOI: 10.1071/ma13058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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