Устойчивый к Ceftriaxone штам Neisseria gonorrhoeae впервые диагностирован в Северной Америке.
Первый случай устойчивой к Ceftriaxone (цефтриаксону) гонореи (Neisseria gonorrhoeae) выявлен у женщины в Канаде.
Устойчивость к противомикробным препаратам все более ограничивает возможности лечения гонореи. CDC (Centers for Disease Control and Prevention) рекомендует в этом случае лечение комбинацией антибиотиков ceftriaxone and azithromycin (цефтриаксона и азитромицина). До октября 2017 года только пять случаев Ceftriaxone - резистентной гонореи было зарегистрировано в мире, большинство из них в Азии и ни одного в Северной Америке.
Источники: Emerg Infect Dis. 2018 Apr;24(4). doi: 10.3201/eid2404.171873.
Emerg Infect Dis. 2018 Feb;24(2). doi: 10.3201/eid2402.171756. Epub 2018 Feb 17.
Cooperative Recognition of Internationally Disseminated Ceftriaxone-Resistant Neisseria gonorrhoeae Strain.
Lahra MM et al
Ceftriaxone remains a first-line treatment for patients infected by Neisseria gonorrhoeae in most settings. We investigated the possible spread of a ceftriaxone-resistant FC428 N. gonorrhoeae clone in Japan after recent isolation of similar strains in Denmark (GK124) and Canada (47707). We report 2 instances of the FC428 clone in Australia in heterosexual men traveling from Asia. Our bioinformatic analyses included core single-nucleotide variation phylogeny and in silico molecular typing; phylogenetic analysis showed close genetic relatedness among all 5 isolates. Results showed multilocus sequence type 1903; N. gonorrhoeae sequence typing for antimicrobial resistance (NG-STAR) 233; and harboring of mosaic penA allele encoding alterations A311V and T483S (penA-60.001), associated with ceftriaxone resistance. Our results provide further evidence of international transmission of ceftriaxone-resistant N. gonorrhoeae. We recommend increasing awareness of international spread of this drug-resistant strain, strengthening surveillance to include identifying treatment failures and contacts, and strengthening international sharing of data.
Ceftriaxone-Resistant Neisseria gonorrhoeae, Canada, 2017.
Lefebvre B et al
We identified a ceftriaxone-resistant Neisseria gonorrhoeae isolate in a patient in Canada. This isolate carried the penA-60 allele, which differs substantially from its closest relative, mosaic penA XXVII (80% nucleotide identity). Epidemiologic and genomic data suggest spread from Asia. Antimicrobial susceptibility surveillance helps prevent spread of highly resistant N. gonorrhoeae strains.