The mechanisms of drug resistance in Multidrug-resistant Neisseria gonorrhoeae

BACKGROUND AND OBJECTIVESGonorrhea is the second prevalent sexually transmitted infection (STI) around the world which caused by Neisseria gonorrhoeae (N. gonorrhoeae). Recent reports exhibit the high-resistance of this bacterium against the main antibiotics: Penicillin, cefixime, ceftriaxone, tetracycline, azithromycin and ciprofloxacin with the globally increase in the prevalence of ۳.۸% within last decade. In this review, we will discuss the main mechanisms of drug resistance in multidrug-resistant Neisseria gonorrhoeae (MDR-NG) that are those strains with resistance to the mentioned antibiotics.MATERIALS AND METHODSGoogle scholar, Pubmed, Scopus and Springer link were explored according to the given keywords by Medical Subject Headings (MeSH): “Neisseria gonorrhoeae”, “drug resistance”, “penicillin”, “cefixime”, “ceftriaxone”, “tetracycline”, “azithromycin” and “ciprofloxacin”. The results were limited to the last decade from ۲۰۱۳ to ۲۰۲۳., and lastly, related original papers were collected.RESULTS AND DISCUSSIONFindings illustrate that chromosomal expression of mtrCDE, synthesis of penicillin-binding proteins (PBPs), substitutions in PenA, PorB۱b and PonA in penicillin and oxyimino-cephalosporin Resistance, plasmid-mediated expression of tetM and chromosomal Single Nucleotide Polymorphisms (SNPs) in mtrR, porB and rpsJ genes in tetracycline resistance, SNPs in ۲۳S rRNA (C۲۶۱۱T and A۲۰۵۹G), mtrR mutations, expression of ermBCF genes and existence of MacAB and mef-encoded efflux pumps in azithromycin resistance and lastly, gyrA SNPs (S۹۱F, D۹۵N, D۹۵G etc.) and ParC SNPs (D۸۶N, S۸۸P, and E۹۱K) in ciprofloxacin resistance, are the main cause of increased Minimum Inhibitory Concentrations (MICs) and the drug resistance in MDR-NG.CONCLUSIONDue to the expansion of the resistance of N. gonorrhoeae, as one of the most prevalent pathogens to the most effective treatments, it is necessary to discovery some novel antibacterial agents or vaccine candidates in order to control the future possible crisis.

کلیدواژه ها:

Neisseria gonorrhoeae ، Multidrug resistance ، Beta-Lactams ، Tetracycline ، Macrolides ، Fluoroquinolones