Antimicrobial susceptibility testing and molecular characterization of Neisseria gonorrhoeae in Tehran, Iran

Background and Aim : Antimicrobial resistance (AMR) surveillance in Neisseria gonorrhoeae and associated molecular epidemiological studies are crucial to ascertain the spread of antibiotic-resistant gonococci at national and international levels. AMR data are essential for developing or refining the local treatment guidelines. The current study was carried out to determine antimicrobial susceptibility and molecular epidemiology of N. gonorrhoeae isolates in Tehran, Iran.Methods : In ۲۰۱۸ – ۲۰, ۵۰۰ urogenital swab specimens were collected. Specimen swabs were cultured and examined for the presence of N. gonorrhoeae isolates by biochemical tests. MIC Test Strip determined the MICs of ceftriaxone, azithromycin, and ciprofloxacin. Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST) was also performed. Results : A total of ۳۸ N. gonorrhoeae isolates (from ۳۷ females and ۱ male) were obtained during the study period. The proportions of resistant N. gonorrhoeae isolates were as follows: ceftriaxone (MIC ≥ ۰.۱۲۵ mg/L) ۱۰.۵% (۴/۳۸), azithromycin (MIC > ۱ mg/L) ۳۴% (۱۳/۳۸) and ciprofloxacin (MIC ≥ ۱ mg/L) ۳۱.۵% (۱۲/۳۸). In total, ۲۵ different NG-MAST STs were identified. The STs comprised ۱ to ۴ isolates each, and the predominant ST was ST۲۶۶ (n=۴). Conclusion : This is the first multi-center surveillance study on antibiotic susceptibility and molecular epidemiology of N. gonorrhoeae in Iran. Our study demonstrates a diverse gonococcal population with high rates of resistance to azithromycin and evidence of resistance to ceftriaxone. The results have potential implications for antibiotic choice for the treatment of gonorrhea and highlight the need to broaden gonococcal AMR monitoring in Iran to prevent the transmission of resistant strains.

کلیدواژه ها:

Neisseria gonorrhoeae ، Gonorrhoea ، Antimicrobial resistance ، NG-MAST ، Ceftriaxone ، Ciprofloxacin