Typing and antimicrobial susceptibility of 134 Neisseria gonorrhoeae strains from Southern Spain

espanolIntroduccion. Las ultimas guias recomiendan la introduccion de tratamiento antimicrobiano doble para evitar fallos de tratamiento. En esta publicacion, se evaluo la sensibilidad a algunos antibioticos, y se realizo el tipado de las cepas de Neisseria gonorrhoeae. Material y metodos. La determinacion de sensibilidad fue realizada segun las recomendaciones tanto del CLSI como del (EUCAST). Un total de 134 cepas fueron tipadas mediante la tecnica de NG-MAST. Resultados. Se encontraron 72 tipos diferentes de N. gonorrhoeae, siendo los mas frecuentes el ST 1407, 14958, 7192, 13251 y 5405. Aplicando los criterios del CLSI/EUCAST, un tipo ST 9807 fue no sensible a ceftriaxona y cefixima (CMI 0,5 mg/L), y un tipo ST 12800 fue no sensible solo a cefixima (CMI 0,25 mg/L). Al aplicar solamente los puntos de corte de EUCAST, tres cepas fueron tambien resistentes a cefixima (CMI 0,25 mg/L) y tres lo fueron tambien a ceftriaxona (CMI 0,19, 0,16 y 0,25 mg/L, respectivamente). La mayoria de cepas fueron resistentes a ciprofloxacino (68,6%), y todas las cepas de N. gonorrhoeae fueron sensibles a espectinomicina; el 9,7% de aislamientos fueron resistentes a azitromicina. Conclusiones. El tipado molecular puede ser una herramienta util para predecir resistencia a antimicrobianos. En esta area se encontraron altas tasas de resistencia a penicilina, tetraciclina y ciprofloxacino. Se recomienda encarecidamente realizar estudio de sensibilidad a antibioticos en todos los casos de gonorrea e identificar fallos de tratamiento para verificar la aparicion de resistencias. EnglishIntroduction. Last guidelines have recommended the introduction of dual antimicrobial therapy in order to avoid treatment failure. In the present report, the susceptibility to some antibiotics was evaluated, and the typing of Neisseria gonorrhoeae strains was performed. Material and methods. Gonococcal isolates were tested for susceptibility according to the recommendations of both CLSI and EUCAST. A total of 134 isolates were typed by the NG-MAST technique. Results. Seventy-two different N. gonorrhoeae types were found, and the most frequent types obtained were ST 1407, ST 14958, ST 7192, ST 13251 and ST 5405. If CLSI/EUCAST criteria were applied, a ST 9807 type was found nonsusceptible to ceftriaxone and cefixime (MIC 0.5 mg/L), and a ST 12800 type was found nonsusceptible only to cefixime (MIC 0.25 mg/L). When only EUCAST breakpoints were taken into account, three strains were also resistant to cefixime (MIC 0.25 mg/L) and three isolates were resistant to ceftriaxone (MIC 0.19, 0.16 and 0.25 mg/L, respectively). The majority of strains were resistant to ciprofloxacin (68.6%), and all N. gonorrhoeae strains were susceptible to spectinomycin; 9.7% of isolates were resistant to azithromycin. Conclusions. Molecular typing may be a useful tool to predict antimicrobial resistance. High rates of resistance to penicillin, tetracycline and ciprofloxacin were found in this area. It is highly recommended to carry out antimicrobial susceptibility in all gonorrhoea cases and to identify treatment failures to verify emerging resistance.