TABLE 2.
Genetic mechanisms of AMR for penicillin, tetracycline and ciprofloxacin, determined by Pathogenwatch, for 61 N. gonorrhoeae isolates collected from KwaZulu-Natal, South Africa, between 2013 and 2016
| Resistance genes/mutations identified by Pathogenwatcha | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Antibiotic | Gene | Mutation | Total isolates with this gene/ mutation | 2013 (n = 15) |
2014 (n = 24) |
2015 (n = 13) |
2016 (n = 9) |
||||||||
| No. S (%) | No. I (%) | No. R (%) | No. S (%) | No. I (%) | No. R (%) | No. S (%) | No. I (%) | No. R (%) | No. S (%) | No. I (%) | No. R (%) | ||||
| PEN | n = 12/15 (80) | n = 1/15 (7) | n = 2/15 (13) | n = 5/24 (21) | n = 10/24 (42) | n = 9/24 (37) | n = 3/13 (23) | n = 1/13 (8) | n = 9/13 (69) | 0 | n = 4/9 (44) | n = 5/9 (56) | |||
| blaTEM | 28 (46) | 1/12 (8) | 1/1 (100) | 2/2 (100) | 9/9 (100) | 1/1 (100) | 9/9 (100) | 5/5 (100) | |||||||
| penA | ins346D | 61 (100) | 12/12 (100) | 1/1 (100) | 2/2 (100) | 5/5 (100) | 10/10 (100) | 9/9 (100) | 3/3 (100) | 1/1 (100) | 9/9 (100) | 4/4 (100) | 5/5 (100) | ||
| ponA | L421P | 37 (61) | 4/12 (33) | 1/5 (20) | 8/10 (80) | 9/9 (100) | 1/3 (33) | 1/1 (100) | 9/9 (100) | 2 (50) | 2/5 (40) | ||||
| mtrR | G45D | 2 (3) | 1/1 (100) | 1/10 (10) | |||||||||||
| porB1 | G120K | 1 (2) | 1/9 (11) | ||||||||||||
| porB1 | A121N | 1 (2) | 1/9 (11) | ||||||||||||
| TET | n= 4 (27) | 0 | n= 11 (73) | n= 3 (12,5) | n= 3 (12,5) | n= 18 (75) | 0 | 0 | n= 13 (100) | 0 | n= 1 (11) | n = 8 (89) | |||
| rpsJ | V57M | 53 (87) | 2/4 (50) | 8/11 (73) | 2/3 (67) | 3/3 (100) | 17/18 (94) | 13/13 (100) | 1/1 (100) | 7/8 (88) | |||||
| tetM | 51 (84) | 11/11 (100) | 1/3 (33) | 18/18 (100) | 13/13 (100) | 8/8 (100) | |||||||||
| CIP | n= 12 (80) | 0 | n= 3 (20) | n= 13 (54) | 0 | n= 11 (46) | 0 | 0 | n= 13 (100) | n = 4 (44) | 0 | n = 5 (56) | |||
| gyrA | S91F | 34 (56) | 1/12 (8) | 3/3 (100) | 1/13 (8) | 11/11 (100) | 13/13 (100) | 5/5 (100) | |||||||
| D95G | 22 (36) | 1/12 (8) | 3/3 (100 | 1/13 (8) | 6/11 (55) | 7/13 (54) | 4/5 (80) | ||||||||
| D95A | 12 (20) | 1/13 (8) | 5/11 (45) | 6/13 (46) | 1/5 (20) | ||||||||||
| parC | D86N | 5 (8) | 1/3 (33) | 1/13 (8) | 1/11 (9) | 1/13 (8) | 1/5 (20) | ||||||||
| S87N | 12 (20) | 5/11 (45) | 6/13 (46) | 1/5 (20) | |||||||||||
| S87I | 1 (2) | 1/11 (9) | |||||||||||||
a
EUCAST MIC breakpoints (mg/liter): PEN (S ≤ 0.06, R > 1), TET (S ≤ 0.5, R > 1), CIP (S ≤ 0.03, R > 0.06).