Emergence and Characterization of a Ceftriaxone-Resistant Neisseria gonorrhoeae FC428 Clone Evolving Moderate-Level Resistance to Azithromycin in Shenzhen, China

Lulu Zhang; Chi Zhang; Yaling Zeng; Yamei Li; Shuhong Huang; Feng Wang; Junping Peng

doi:10.2147/IDR.S336212

Emergence and Characterization of a Ceftriaxone-Resistant Neisseria gonorrhoeae FC428 Clone Evolving Moderate-Level Resistance to Azithromycin in Shenzhen, China

Infect Drug Resist. 2021 Oct 19:14:4271-4276. doi: 10.2147/IDR.S336212. eCollection 2021.

Authors

Lulu Zhang^#^{1

2}, Chi Zhang^#^{1

2}, Yaling Zeng^#³, Yamei Li^{1

2}, Shuhong Huang³, Feng Wang³, Junping Peng^{1

2}

Affiliations

¹ NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.
² Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
³ Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, People's Republic of China.

^# Contributed equally.

Abstract

We here described a ceftriaxone-resistant Neisseria gonorrhoeae FC428 clone (YL201) with moderate-level resistance to azithromycin in Shenzhen, South China in 2020. The NG-STAR type of YL201 is ST2238, containing a mosaic penA-60.001 allele, which is a typical characteristic of FC428 clone. YL201 harbours four copies of the 23S rRNA C2611T mutation, conferring moderate-level resistance to azithromycin. The MLST type is ST1600, identical with two N. gonorrhoeae FC428 clones identified in Hangzhou. Genome-wide phylogeny analysis demonstrates that YL201 is clustered with other FC428 clones from Hangzhou (South-east China) and Chengdu (South-west China). Isolates within this cluster have relatively higher MIC for ceftriaxone and display closely related MLST STs (ST1600 and ST7363) but are different from the ST of typical FC428 clone (ST1903). As ST1600 and ST7363 are common STs in Shenzhen, the further spread of FC428 clones may increase the severity of gonococcal resistance. In summary, identifying a multidrug-resistant (MDR) N. gonorrhoeae isolate in Shenzhen showed FC428 clones have undergone further transmission in China and presented more extensive and concerning antimicrobial resistance (AMR) characteristics during the spread.

Keywords: Neisseria gonorrhoeae; antimicrobial resistance; azithromycin; ceftriaxone; phylogeny.

Grants and funding

This study was supported by CAMS Innovation Fund for Medical Sciences (CIFMS) (2016-I2M-3-021); the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (2020-PT310-004); the National Science and Technology Infrastructure of China (Project No. National Pathogen Resource Center-NPRC-32); and the Sanming Project of Medicine in Shenzhen (SZSM201611077).