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Journal of Antimicrobial Chemotherapy 2004 54(2):451-455; doi:10.1093/jac/dkh345
JAC vol.54 no.2 © The British Society for Antimicrobial Chemotherapy 2004; all rights reserved.

Epidemiological characteristics and molecular basis of fluoroquinolone-resistant Neisseria gonorrhoeae strains isolated in Korea and nearby countries

Dongeun Yong1,3, Tae Sook Kim1, Jong Rak Choi1, Jong Hwa Yum2,3, Kyungwon Lee1,3,*, Yunsop Chong1,2, Hee-Bok Oh4, Tiffany Shultz5 and John W. Tapsall5

1 Department of Laboratory Medicine, 2 Research Institute of Bacterial Resistance and 3 Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul; 4 Department of Bacteriology, National Institute of Health, Seoul, Korea; 5 WHO Collaborating Centre for STD and HIV, Department of Microbiology, The Prince of Wales Hospital, Sydney, Australia

* Correspondence address. Department of Laboratory Medicine, Yonsei University College of Medicine, 134 Shinchondong, Seodaemunku, Seoul, 120-752, Korea. Tel: +82-2-361-5866; Fax: +82-2-313-0908; Email: leekcp{at}yumc.yonsei.ac.kr

Objectives: This study was performed to examine the cause of the increase in quinolone-resistant Neisseria gonorrhoeae (QRNG) observed in Korea.

Methods: The antimicrobial susceptibilities of 190 isolates of gonococci from Korea in 2000 were examined by NCCLS methods, and subsets of these isolates underwent mutation analysis of the quinolone resistance-determining regions (QRDRs) of gyrA and parC. Molecular epidemiological characterization of 25 Korean isolates and 54 isolates from overseas was performed by pulsed-field gel electrophoresis (PFGE) and the results compared.

Results: Most (172, 90.5%) of the 190 gonococci tested displayed reduced susceptibility to ciprofloxacin. All strains with high-level ciprofloxacin resistance (ciprofloxacin MIC ≥ 4 mg/L) contained a double amino acid alteration at the 91 and 95 positions in the QRDR of GyrA and a single alteration in ParC. PFGE types of high-level QRNG in Korea were mostly different from those of other nearby countries.

Conclusions: These results suggest that the observed increase in ciprofloxacin-resistant isolates is due to the mutation and spread of Korean multiclonal isolates rather than importation from overseas.

Keywords: N. gonorrhoeae , pulsed-field gel electrophoresis , ciprofloxacin , resistance , QRDRs


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