Trend of ciprofloxacin resistance in Neisseria gonorrhoeae strains isolated in Italy and analysis of the molecular determinants

Diagn Microbiol Infect Dis. 2010 Aug;67(4):350-4. doi: 10.1016/j.diagmicrobio.2010.03.001.


A total of 599 Neisseria gonorrhoeae strains collected in Italy in 2 periods, 2003 to 2005 and 2007 to 2008, were screened for ciprofloxacin susceptibility by Etest. Ciprofloxacin-resistant strains (49.7%) were characterized by i) serovar determination, patterns of mutation in gyrA, and parC genes (38%, randomly selected) and ii) N. gonorrhoeae multiantigen sequence typing (56% of the strains isolated from patients who declared their sexual orientation). The percentage of ciprofloxacin-resistant strains increased from 42 (2003-2005) to 58 (2007-2008); in the second period, strains with MIC value >32 microg/mL have been observed. Mutations in gyrA and parC genes were identified in the majority of strains (88%). Ciprofloxacin-resistant isolates among men who have sex with men (MSM) increased from 24% in 2003 to 2005 to 47% in 2007 to 2008. However, sequence types exclusively found among MSM were mostly due to a single strain. This is the first study in Italy combining N. gonorrhoeae ciprofloxacin susceptibility testing with molecular analyses and comparing the results over time.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents / pharmacology*
  • Ciprofloxacin / pharmacology*
  • DNA Gyrase / genetics
  • DNA Topoisomerase IV / genetics
  • DNA, Bacterial / genetics
  • Drug Resistance, Bacterial*
  • Female
  • Genes, Bacterial
  • Gonorrhea / microbiology*
  • Homosexuality, Male
  • Humans
  • Italy
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Neisseria gonorrhoeae / drug effects*
  • Neisseria gonorrhoeae / isolation & purification
  • Sequence Analysis, DNA
  • Young Adult


  • Anti-Bacterial Agents
  • DNA, Bacterial
  • Ciprofloxacin
  • DNA Topoisomerase IV
  • DNA Gyrase