JAC Advance Access originally published online on March 24, 2009
Journal of Antimicrobial Chemotherapy 2009 63(6):1142-1151; doi:10.1093/jac/dkp098
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Original research |
Phenotypic and genetic characterization of the 2008 WHO Neisseria gonorrhoeae reference strain panel intended for global quality assurance and quality control of gonococcal antimicrobial resistance surveillance for public health purposes
1 National Reference Laboratory for Pathogenic Neisseria, Department of Clinical Microbiology, Örebro University Hospital, Örebro, Sweden 2 WHO Collaborating Centre for STD, Microbiology Department, The Prince of Wales Hospital, Randwick, Sydney, Australia
Received 22 December 2008; returned 11 February 2009; revised 24 February 2009; accepted 26 February 2009
* Corresponding author. Department of Clinical Microbiology, Örebro University Hospital, SE-701 85 Örebro, Sweden. Tel: +46-19-6021520; Fax: +46-19-127416; E-mail: magnus.unemo{at}orebroll.se
Objectives: Emergence and spread of antimicrobial resistance (AMR) in Neisseria gonorrhoeae remain a major global problem and expanded, but valid, AMR surveillance is crucial for public health purposes. The World Health Organization (WHO) Collaborating Centre in Sydney, Australia, continually evaluates N. gonorrhoeae strains used in quality control and assurance aspects of the national, WHO regional and international programmes for AMR surveillance it conducts. Here we phenotypically and genetically characterized the 2008 WHO N. gonorrhoeae reference panel, widely used under existing WHO AMR surveillance protocols.
Materials and methods: The eight N. gonorrhoeae WHO reference strains were phenotypically characterized by antibiogram, auxotype, serovar and prolyliminopeptidase screening; and genetically with regard to resistance plasmid types, polymorphisms in divergent genetic resistance-mediating loci (n = 9), porB sequencing and N. gonorrhoeae multi-antigen sequence typing.
Results: The 2008 WHO reference strains represented all the important susceptible and resistant phenotypes, including corresponding resistance genotypes, and the range of resistances currently seen for relevant antimicrobials. Several pertinent additional phenotypic and genotypic markers, for example, epidemiological markers, were also determined.
Conclusions: The 2008 WHO N. gonorrhoeae reference strain panel was extensively characterized, which is crucial for the expansion of gonococcal AMR surveillance nationally and internationally. The panel is available through WHO sources for quality assurance and quality control aspects of current phenotypic testing protocols, to allow valid comparison of AMR data derived by divergent methods, and also for the control of present and future molecular assays for AMR detection. Additional WHO reference strains can be included as required by the emergence of additional resistant phenotypes and/or genotypes.
Keywords: antimicrobial resistance testing and surveillance , 2008 World Health Organization reference strains , genotypic characterization , quality assurance and quality control
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