Multidrug-resistant strains of Neisseria gonorrhoeae in Greece

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.