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JAC Advance Access originally published online on January 27, 2008
Journal of Antimicrobial Chemotherapy 2008 61(3):478-487; doi:10.1093/jac/dkm544
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Original research

Clusters of circulating Neisseria gonorrhoeae strains and association with antimicrobial resistance in Shanghai

Mingmin Liao1,2, Kelli Bell1, Wei-Ming Gu3, Yang Yang3, Nelson F. Eng1, Wenkai Fu1, Lei Wu3, Chu-Guang Zhang3, Yue Chen4, Ann M. Jolly4 and Jo-Anne R. Dillon1,2,*

1 Vaccine and Infectious Disease Organization, University of Saskatchewan, 120 Veterinary Road, Saskatoon, Saskatchewan, Canada S7N 5E3 2 Department of Microbiology, University of Saskatchewan, 107 Wiggins Road, Saskatoon, Saskatchewan, Canada S7N 5E5 3 Shanghai Skin Disease and STD Hospital, 196 Wu Yi Road, Shanghai 200050, China 4 Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, Canada K1H 8M5

Received 14 August 2007; returned 12 December 2007; revised 19 October 2007; accepted 18 December 2007

* Correspondence address. College of Arts and Science, University of Saskatchewan, Room 226, Arts Building, 9 Campus Drive, Saskatoon, Saskatchewan, Canada S7N 5A5. Tel: +1-306-966-4232; Fax: +1-306-966-8839; E-mail: j.dillon{at}usask.ca

Objectives: (i) To distinguish Neisseria gonorrhoeae isolates in Shanghai by porB typing; (ii) to ascertain the congruence of porB DNA sequence typing with cases linked epidemiologically; (iii) to determine the association of specific PorB mutations with antimicrobial resistance to penicillin or tetracycline.

Methods: porB DNA sequences of 174 N. gonorrhoeae isolates, collected from 143 male patients and 31 female sexual partners in Shanghai were determined. Phylogenetic analysis was used to determine sequence associations and concordance with epidemiologically linked cases. PorB protein sequences were compared with the wild-type sequence to identify mutations associated with antimicrobial resistance to penicillin and tetracycline.

Results: porB1a genotypes comprised 27.0% of the isolates and included 15 distinct DNA sequences, while 73.0% of the isolates carried porB1b genotypes with 63 distinct DNA sequences. porB DNA sequence typing was congruent with patient-reported sexual contacts. In addition, porB DNA sequence analysis revealed a number of strains with identical DNA sequences not identified through traditional epidemiological methods. The porB1b isolates had a significantly higher percentage of chromosomally mediated resistance to tetracycline and higher MIC50s to penicillin and ciprofloxacin. G120K/A121D mutations were observed in 71.1% of PIB isolates and were associated with resistance to penicillin and/or tetracycline. The majority of the PIA isolates (82.1%) also carried G120D/A121G double mutations. The index of discrimination for porB DNA sequence analysis was 95%.

Conclusions: The porB1b genotype was found to be predominant in Shanghai. porB DNA sequence typing was sufficiently discriminatory for differentiating N. gonorrhoeae isolates and was congruent with epidemiological linkages. Novel porB sequences of N. gonorrhoeae and novel mutations of PorB proteins were identified.

Keywords: N. gonorrhoeae , molecular epidemiology , molecular typing , sexually transmitted diseases


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