Journal
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
Volume 63, Issue 6, Pages 1200-1204Publisher
OXFORD UNIV PRESS
DOI: 10.1093/jac/dkp118
Keywords
antimicrobial susceptibility; gonorrhoea; macrolides
Funding
- 'V and VI Programma Nazionale di Ricerca sull' AIDS-intramurale' Fasc. [20F/F, 20G1]
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The aim of this study was to characterize 22 azithromycin-resistant Neisseria gonorrhoeae isolates, collected in Italy from January 2007 through June 2008, during a study of the prevalence of antibiotic resistance. MICs of azithromycin, ciprofloxacin, ceftriaxone, penicillin and tetracycline were determined by the Etest method. Azithromycin-resistant strains (MIC >= 1 mg/L) were genetically analysed by N. gonorrhoeae multi-antigen sequence typing (NG-MAST) and PFGE. A total of 22 azithromycin-resistant isolates were found among the 219 collected. Five of the 22 isolates showed high-level azithromycin resistance (MICs of 128 or 256 mg/L). Sixteen of the 22 were isolated from men who have sex with men. Among the 14 sequence types (STs) found by NG-MAST, 5 STs, containing clusters of two, three or four strains, were homogeneous with respect to epidemiology and/or antibiotic susceptibility. PFGE divided the 22 strains into two main groups that were possibly related. This is the first report of gonococci with high-level resistance to azithromycin circulating in Italy. Correlation between NG-MAST results and epidemiological data for some of the analysed strains and patients could be established. This study represents a reference point for future surveillance in Italy and suggests the need to add azithromycin to the antibiotic susceptibility panel for gonococci.
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