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Multidrug-resistant strains of Neisseria gonorrhoeae in Greece

A Mavroidi1, L S Tzouvelekis, K P Kyriakis

  • 1National Reference Center for Neisseria gonorrhoeae, Department of Bacteriology, Hellenic Pasteur Institute, Athens, Greece.

Insights

Multidrug-resistant Neisseria gonorrhoeae (gonococci) of serovar Bropyst were identified in Greece. These resistant strains were linked to specific transmission networks, including homosexuals and refugees, with genetic mutations contributing to their resistance.

Area of Science:

  • Microbiology
  • Genetics
  • Epidemiology

Background:

  • Neisseria gonorrhoeae is a significant cause of sexually transmitted infections.
  • Emergence of antibiotic resistance in N. gonorrhoeae poses a global public health threat.
  • Serovar Bropyst strains have been previously associated with antimicrobial resistance.

Purpose of the Study:

  • To characterize multidrug-resistant N. gonorrhoeae serovar Bropyst isolates from Greece.
  • To investigate the genetic basis of antimicrobial resistance in these strains.
  • To determine the epidemiological links and transmission networks associated with these resistant isolates.

Main Methods:

  • Isolation and antimicrobial susceptibility testing of N. gonorrhoeae.
  • Conventional and molecular typing (e.g., genetic sequencing) of isolates.
  • Analysis of genetic mutations in key resistance-associated genes (penA, mtrR, porB).

Main Results:

  • Eighty-seven of 575 N. gonorrhoeae isolates (15.1%) belonged to serovar Bropyst and were resistant to penicillin, tetracycline, erythromycin, and chloramphenicol.
  • Three distinct clusters (A, B, C) were identified through typing.
  • Cluster A was associated with homosexual transmission networks, while clusters B and C were linked to refugees from Eastern Europe.
  • Mutations in penA, mtrR, and porB genes were identified in one isolate, potentially explaining its multidrug-resistant phenotype.

Conclusions:

  • Serovar Bropyst N. gonorrhoeae exhibiting multidrug resistance was prevalent in Greece between 1991-1998.
  • Specific transmission networks, including homosexual individuals and refugees, were associated with these resistant strains.
  • Genetic mutations in penA, mtrR, and porB genes are likely contributors to the observed multidrug-resistant phenotype, highlighting the need for ongoing surveillance.

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