Antimicrobial resistance (AMR) and molecular characterization of Neisseria gonorrhoeae in Ghana, 2012-2015

Autoři: Naiki Attram aff001;  Bright Agbodzi aff001;  Helena Dela aff001;  Eric Behene aff001;  Edward O. Nyarko aff003;  Nicholas N. A. Kyei aff003;  John A. Larbi aff004;  Bernard W. L. Lawson aff004;  Kennedy K. Addo aff002;  Mercy J. Newman aff005;  Christopher A. Duplessis aff001;  Nehkonti Adams aff001;  Magnus Unemo aff006;  Andrew G. Letizia aff001
Působiště autorů: US Naval Medical Research Unit Number Three, Ghana Laboratory, Legon, Ghana aff001;  Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana aff002;  Department of Public Health, Military Hospital, Accra, Ghana aff003;  Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana aff004;  Department of Medical Microbiology, School of Biomedical and Allied Health Science, College of Health Sciences, University of Ghana, Accra, Ghana aff005;  WHO Collaborating Centre for Gonorrhoea and other STIs, National Reference Laboratory for STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden aff006
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article


Neisseria gonorrhoeae antimicrobial resistance (AMR) surveillance is essential for tracking the emergence and spread of AMR strains in local, national and international populations. This is crucial for developing or refining treatment guidelines. N. gonorrhoeae multiantigen sequence typing (NG-MAST) is beneficial for describing the molecular epidemiology of gonococci at national and international levels. Elucidation of AMR determinants to β-lactam drugs, is a means of monitoring the development of resistance. In Ghana, little is known about the current gonococcal AMR prevalence and no characterization of gonococcal isolates has been previously performed. In this study, gonococcal isolates (n = 44) collected from five health facilities in Ghana from 2012 to 2015, were examined using AMR testing, NG-MAST and sequencing of penA. High rates of resistance were identified to tetracycline (100%), benzylpenicillin (90.9%), and ciprofloxacin (81.8%). One isolate had a high cefixime MIC (0.75 μg/ml). Twenty-eight NG-MAST sequence types (STs) were identified, seventeen of which were novel. The isolate with the high cefixime MIC contained a mosaic penA-34 allele and belonged to NG-MAST ST1407, an internationally spreading multidrug-resistant clone that has accounted for most cefixime resistance in many countries. In conclusion, AMR testing, NG-MAST, and sequencing of the AMR determinant penA, revealed high rates of resistance to tetracycline, benzylpenicillin, and ciprofloxacin; as well as a highly diverse population of N. gonorrhoeae in Ghana. It is imperative to continue with enhanced AMR surveillance and to understand the molecular epidemiology of gonococcal strains circulating in Ghana and other African countries.

Klíčová slova:

Antimicrobial resistance – Bacterial disk diffusion – Ghana – Penicillin – Sequence alignment – Tetracyclines – Etest


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