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Molecular characterization of ciprofloxacin resistance of gonococcal strains in Spain
B Alcalá1, L Arreaza, C Salcedo
1Servicio de Bacteriología, Laboratorio de Referencia de Neisserias, Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28220 Majadahonda, Madrid, Spain.
Background:
Over the past several years, the emergence of gonococcal isolates with intermediate or full resistance to fluoroquinolones has become a significant concern in several countries, including Spain.
Goal:
The goal was to determine the occurrence of ciprofloxacin resistance among Neisseria gonorrhoeae strains in Spain during 2000 to 2001 and determine the frequency and patterns of mutations at gyrA, gyrB, and parC genes in these isolates.
Study Design:
Eleven ciprofloxacin-resistant strains (with MICs ranging from 1 to 64 micrograms/mL) and two intermediate isolates (with MICs of 0.12 and 0.5 microgram/mL) were found. Mutations were identified by polymerase chain reaction and direct sequencing of the amplified products.
Results And Conclusions:
Alterations at Ser-91 and Asp-95 in GyrA were detected in all strains except one, an isolate for which the MIC was 0.12 microgram/mL. Alterations in ParC were more variable, and there was no clear correlation between the number of parC mutations and the level of resistance. No alterations at gyrB gene associated with ciprofloxacin resistance were found. The resistance was distributed among different types of strains, suggesting that the increase in the incidence of ciprofloxacin-resistant strains in Spain was not exclusively due to the appearance of a single-strain outbreak.
Insights
Ciprofloxacin resistance in Neisseria gonorrhoeae is increasing in Spain. Mutations in the gyrA gene are common in resistant strains, but gyrB mutations are not associated with resistance.
Area of Science:
- Microbiology
- Genetics
- Public Health
Background:
- Emergence of fluoroquinolone-resistant Neisseria gonorrhoeae is a global health concern.
- Spain has observed an increase in gonococcal isolates resistant to fluoroquinolones.
Purpose of the Study:
- To investigate the prevalence of ciprofloxacin resistance in Neisseria gonorrhoeae in Spain from 2000-2001.
- To analyze mutations in gyrA, gyrB, and parC genes in these resistant strains.
Main Methods:
- Identification of ciprofloxacin-resistant and intermediate Neisseria gonorrhoeae strains.
- Polymerase chain reaction and direct sequencing to detect mutations in gyrA, gyrB, and parC genes.
Main Results:
- Eleven resistant and two intermediate Neisseria gonorrhoeae strains were identified.
- Mutations at Ser-91 and Asp-95 in GyrA were prevalent in resistant strains.
- No significant correlation was found between parC mutations and resistance levels; gyrB mutations were absent.
Conclusions:
- GyrA mutations are key drivers of ciprofloxacin resistance in Neisseria gonorrhoeae in Spain.
- The spread of resistance is likely multifactorial, not due to a single strain.
- Monitoring genetic alterations is crucial for understanding antimicrobial resistance trends.
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