Typing of Neisseria gonorrhoeae isolates by phenotypic and genotypic techniques in New Delhi, India

Seema Sood; Neeraj Mahajan; Rajendra Singh; Sonu Kumari Agrawal; Trupti Shende; Arti Kapil; Hemanta K. Kar; Vinod K. Sharma

doi:10.4103/JLP.JLP_107_18

Journal of Laboratory Physicians, Table of Contents

CC BY-NC-ND 4.0 · J Lab Physicians 2019; 11(01): 045-050
DOI: 10.4103/JLP.JLP_107_18

Original Article

Typing of Neisseria gonorrhoeae isolates by phenotypic and genotypic techniques in New Delhi, India

Seema Sood

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India

,

Neeraj Mahajan

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India

,

Rajendra Singh

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India

,

Sonu Kumari Agrawal

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India

,

Trupti Shende

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India

,

Arti Kapil

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India

,

Hemanta K. Kar

Department of Dermatology, STDs and Leprosy, PGIMER and Dr. Ram Manohar Lohia Hospital, New Delhi, India

,

Vinod K. Sharma

Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India

› Author Affiliations

Abstract

PDF Download

Abstract

BACKGROUND: The objective of this study is to investigate gonococcal isolates using phenotypic and genotypic methods.

METHODOLOGY: Sixty gonococcal isolates obtained were examined. Strains were divided into 9 resistant phenotypes: Chromosomally mediated penicillin-resistant Neisseria gonorrhoeae (CMRNGP), penicillinase-producing NG (PPNG), chromosomally mediated tetracycline-resistant NG (CMRNG^T), TRNG, PPNG and TRNG, CMRNG^PT, quinolone resistant NG (QRNG), Azithro R, and decreased susceptibility (DS) to ceftriaxone. These isolates were also subjected to auxotyping and NG-multi-antigen sequence typing (MAST).

RESULTS: Of 60 isolates, 32 (53.33%) PPNG and only one was CMRNGP; 16 (26.66%) were CMRNG^T, while 18 (30%) were TRNG. Both PPNG and TRNG found in 13 (21.66%) and none were CMRNG^PT. QRNG was seen in 93.33%, 5% Azithromycin R, and 6.66% were DS to ceftriaxone. Based on auxotyping, 24 (40%) nonrequiring, 16 (26.66%) were proline requiring, 13 (21.66%) arginine requiring while 7 (11.66%) belonged to others. The most common ST was 6058 (32.5%). The discriminatory indices of antibiogram, auxotyping and NG-MAST were 0.77, 0.72, and 0.95, respectively.

CONCLUSIONS: NG-MAST is the method of choice for epidemiological studies.

Key words

Antibiogram - auxotyping - Neisseria gonorrhoeae multiantigen sequence typing - Neisseria gonorrhoeae

PDF (561 kb)

References

References
1 Van Looveren M, Ison CA, Ieven M, Vandamme P, Martin IM, Vermeulen K, et al. Evaluation of the discriminatory power of typing methods for Neisseria gonorrhoeae. J Clin Microbiol 1999;37:2183-8.
2 Moodley P, Martin IM, Ison CA, Sturm AW. Typing of Neisseria gonorrhoeae reveals rapid reinfection in rural South Africa. J Clin Microbiol 2002;40:4567-70.
3 Palomares JC, Lozano MC, Perea EJ. Antibiotic resistance, plasmid profile, auxotypes and serovars of Neisseria gonorrhoeae strains isolated in Sevilla (Spain). Genitourin Med 1990;66:87-90.
4 Pierce RL, Thomas JC, Sparling PF, Fisher W, Davis RH, Alcorn T, et al. An epidemiological evaluation of the use of microbiological tools for identifying gonorrhoea infection networks. Int J STD AIDS 1999;10:316-23.
5 Divekar AA, Gogate AS, Shivkar LK. Association between auxotypes, serogroups, and antibiotic susceptibilities of Neisseria gonorrhoeae isolated from women in Mumbai (Formerly Bombay), India. Sex Transm Dis 1999;26:358-63.
6 Agarwal SK, Deb M, Prakash K, Sharma AK. Auxotyping of Neisseria gonorrhoeae as an additional epidemiological marker. Indian J Med Res 1992;95:227-9.
7 La Scolea LJ Jr., Young FE. Development of a defined minimal medium for the growth of Neisseria gonorrhoeae. Appl Microbiol 1974;28:70-6.
8 Bell SM, Pham JN, Carter IW, Hanrahan JK. Antibiotic Susceptibility Testing by the CDS Method. A Manual for Medical and Veterinary Laboratories. 6^th ed. Randwick, Australia: The Prince of Wales Hospital, South Eastern Area Laboratory Services; 2011. p. 62.
9 Martin IM, Ison CA, Aanensen DM, Fenton KA, Spratt BG. Rapid sequence-based identification of gonococcal transmission clusters in a large metropolitan area. J Infect Dis 2004;189:1497-505.
10 Hunter PR, Gaston MA. Numerical index of the discriminatory ability of typing systems: An application of Simpson’s index of diversity. J Clin Microbiol 1988;26:2465-6.
11 Khaki P, Bhalla P, Sharma P, Chawla R, Bhalla K. Epidemilogical analysis of Neisseria gonorrhoeae isolates by antimicrobial susceptibility testing, auxotyping and serotyping. Indian J Med Microbiol 2007;25:225-9.
12 Bala M, Kakran M, Singh V, Sood S, Ramesh V, Members of WHO GASP SEAR Network, et al. Monitoring antimicrobial resistance in Neisseria gonorrhoeae in selected countries of the WHO South-East Asia region between 2009 and 2012: A retrospective analysis. Sex Transm Infect 2013;89 Suppl 4:iv28-35.
13 Rawat D, Nair D. Extended-spectrum β-lactamases in gram negative bacteria. J Glob Infect Dis 2010;2:263-74.
14 Ohnishi M, Ono E, Shimuta K, Watanabe H, Okamura N. Identification of TEM-135 beta-lactamase in penicillinase-producing Neisseria gonorrhoeae strains in Japan. Antimicrob Agents Chemother 2010;54:3021-3.
15 Kirkcaldy RD, Harvey A, Papp JR, Del Rio C, Soge OO, Holmes KK, et al. Neisseria gonorrhoeae antimicrobial susceptibility surveillance – The gonococcal isolate surveillance project, 27 sites, United States, 2014. MMWR Surveill Summ 2016;65:1-9.
16 Lahra MM, Enriquez RP; National Neisseria Network. Australian gonococcal surveillance programme, 1 July to 30 September 2015. Commun Dis Intell Q Rep 2016;40:E179-81.
17 Trecker MA, Waldner C, Jolly A, Liao M, Gu W, Dillon JA, et al. Behavioral and socioeconomic risk factors associated with probable resistance to ceftriaxone and resistance to penicillin and tetracycline in Neisseria gonorrhoeae in Shanghai. PLoS One 2014;9:e89458.
18 Shimuta K, Unemo M, Nakayama S, Morita-Ishihara T, Dorin M, Kawahata T, et al. Antimicrobial resistance and molecular typing of Neisseria gonorrhoeae isolates in Kyoto and Osaka, Japan, 2010 to 2012: Intensified surveillance after identification of the first strain (H041) with high-level ceftriaxone resistance. Antimicrob Agents Chemother 2013;57:5225-32.
19 Bala M, Ray K, Gupta SM, Muralidhar S, Jain RK. Changing trends of antimicrobial susceptibility patterns of Neisseria gonorrhoeae in India and the emergence of ceftriaxone less susceptible N. gonorrhoeae strains. J Antimicrob Chemother 2007;60:582-6.
20 Tapsall JW. Annual report of the Australian gonococcal surveillance programme, 2005. Commun Dis Intell 2006;30:205-10.
21 Akasaka S, Muratani T, Yamada Y, Inatomi H, Takahashi K, Matsumoto T, et al. Emergence of cephem- and aztreonam-high-resistant Neisseria gonorrhoeae that does not produce beta-lactamase. J Infect Chemother 2001;7:49-50.
22 Muratani T, Akasaka S, Kobayashi T, Yamada Y, Inatomi H, Takahashi K, et al. Outbreak of cefozopran (penicillin, oral cephems, and aztreonam)-resistant Neisseria gonorrhoeae in Japan. Antimicrob Agents Chemother 2001;45:3603-6.
23 Ito M, Deguchi T, Mizutani KS, Yasuda M, Yokoi S, Ito S, et al. Emergence and spread of Neisseria gonorrhoeae clinical isolates harboring mosaic-like structure of penicillin-binding protein 2 in central Japan. Antimicrob Agents Chemother 2005;49:137-43.
24 Bala M, Ray K, Salhan S. First case of spectinomycin resistant Neisseria gonorrhoeae isolate in New Delhi, India. Sex Transm Infect 2005;81:186-7.
25 Kulkarni S, Bala M, Risbud A. Antimicrobial susceptibility testing, auxotyping, and serotyping of Neisseria gonorrhoeae strains isolated in India. Sex Transm Dis 2012;39:188-90.
26 Mahajan N, Sood S, Singh R, Kapil A, Das BK, Sreenivas V, et al. Antimicrobial resistance and Neisseria gonorrhoeae multiantigen sequence typing profile of Neisseria gonorrhoeae in New Delhi, India. Sex Transm Dis 2016;43:506-16.
27 Ota KV, Ng LK, Melano RG, Martin IE, Brown EM, Richardson SE, et al. Identification of sexual networks through molecular typing of quinolone-resistant Neisseria gonorrhoeae in Ontario, Canada. Sex Transm Dis 2011;38:811-4.
28 Tapsall JW, Ray S, Limnios A. Characteristics and population dynamics of mosaic penA allele-containing Neisseria gonorrhoeae isolates collected in Sydney, Australia, in 2007-2008. Antimicrob Agents Chemother 2010;54:554-6.