ArticlePloS one2022
Whole-genome sequence analysis of high-level penicillin-resistant strains and antimicrobial susceptibility of Neisseria gonorrhoeae clinical isolates from Thailand.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Temporal and geographic trends in extended-spectrum cephalosporins resistance among Neisseria gonorrhoeae isolates worldwide: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Molecular epidemiology and pharmacokinetic-pharmacodynamic analysis of Neisseria gonorrhoeae strains in Northern Spain.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Emerging epidemic of the Africa-type plasmid in penicillinase-producingEmerging microbes & infections · 2025Article
- Global genomic and antimicrobial resistance profiling of Neisseria gonorrhoeae: Insights from whole genome sequencing and minimum inhibitory concentration analysis.PLoS neglected tropical diseases · 2025Article
- Tetracycline-resistantJAC-antimicrobial resistance · 2025Review
- Sexually transmitted pathogens in asymptomatic women at Rethabile clinic, Limpopo, South Africa.Southern African journal of infectious diseases · 2024Article
- Penicillin-Binding Protein Occupancy Dataset for 18 β-Lactams and 4 β-Lactamase Inhibitors in Neisseria gonorrhoeae.Microbiology spectrum · 2023Article
- Evidence of horizontal gene transfer withinMicrobial genomics · 2023Article
- Evaluation ofInfection and drug resistance · 2023Article
- Prevalence, Antibiotic Resistance and Associated Factors ofInfection and drug resistance · 2023Article
- Increase in Multidrug ResistantInfection and drug resistance · 2023Article
- Availability of Laboratory Diagnosis of Gonorrhoea and Its Meaning in Case Reporting in Shandong Province, China.Clinical, cosmetic and investigational dermatology · 2023Article
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Authors and funding
5 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe increasing rate of antimicrobial-resistant Neisseria gonorrhoeae poses a considerable public health threat due to the difficulty in treating gonococcal infections. This study examined antimicrobial resistance (AMR) to drugs recommended for gonorrhea treatment between 2015 and 2017, and the AMR determinants and genetic compositions of plasmids in 3 gonococcal strains with high-level penicillin resistance.
methodsWe collected 117 N. gonorrhoeae isolates from patients with gonococcal infections who attended Siriraj Hospital, Bangkok, Thailand, between 2015 and 2017. Minimum inhibitory concentrations (MICs) of penicillin, tetracycline, ciprofloxacin, azithromycin, spectinomycin, cefixime, and ceftriaxone were determined by the agar dilution method. PCR amplification and sequencing of 23S rRNA and mtrR (a negative regulator of MtrCDE efflux pump) were performed. Whole genomes of 3 PPNG strains with high-level penicillin resistance (MIC ≥ 128 μg/ml) were sequenced using Illumina and Nanopore sequencing platforms.
resultsThe proportions of N. gonorrhoeae isolates with resistance were 84.6% for penicillin, 91.5% for tetracycline, and 96.6% for ciprofloxacin. All isolates were susceptible to spectinomycin, azithromycin, cefixime, and ceftriaxone. An adenine deletion within a 13 bp inverted repeat sequence in the mtrR promoter and an H105Y mutation in the mtrR coding region were found in the N. gonorrhoeae isolate with the highest azithromycin MIC value (1 μg/ml). Three high-level penicillin-resistant isolates contained nonmosaic type II penA and had mutations in penB and the mtrR coding region. All isolates with high-level penicillin resistance carried the conjugative plasmids with or without the Dutch type tetM determinant, the beta-lactamase plasmid (Rio/Toronto), and the cryptic plasmid.
conclusionsThe gonococcal population in Thailand showed high susceptibility to ceftriaxone and azithromycin, current dual therapy recommended for gonorrhea treatment. As elevated MIC of azithromycin has been observed in 1 strain of N. gonorrhoeae, expanded and enhanced surveillance of antimicrobial susceptibility and study of genetic resistance determinants are essential to improve treatment guidelines.
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