Antimicrobial Resistance And Molecular Characteristics Among Neisseria gonorrhoeae Clinical Isolates In A Chinese Tertiary Hospital

The resistance of to antimicrobial agents has been increasing year by year due to the overuse of antibiotics. The primary aims of the present study were to investigate the molecular characteristics of the clinical isolates of and the resistance to azithromycin in a Chinese tertiary hospital. From January 2014 to May 2017, a total of 55 clinical isolates of were collected. Genes associated with azithromycin resistance (AZM-R), including mutations in 23S rRNA alleles, the promoter and coding regions, and and were evaluated by PCR and DNA sequencing. All clinical isolates were subjected to N. multiantigen sequence typing (NG-MAST), while the AZM-R isolates were further characterized by multilocus sequence typing (MLST). The AZM-R rate in this study was 23.64% (13/55), and a single (A)-nucleotide deletion mutation in the promoter region, a G45D mutation in the coding region, a point mutation in , and an A2047G mutation in 23S rRNA alleles were detected in 13, 4, 3 and 4 isolates, respectively; no mutations were found in . There was no significant difference in the coding region mutation rate between the azithromycin-sensitive and AZM-R groups ( > 0.05); however, there was a significant difference in the mutation rate of the promoter region ( < 0.05). Among the 55 isolates studied, 43 distinct NG-MAST were determined, while the AZM-R isolates were allocated into 10 distinct MLST/NG-MAST combinations. All three isolates with high-level AZM-R belonged to the sequence types (STs) NG-MAST ST1866 and MLST ST10899. clinical isolates from Wenzhou, eastern China, showed considerable genetic diversity. Measures should be implemented to monitor the spread of the NG-MAST ST1866 and MLST ST10899 clones, which exhibit high-level AZM-R in eastern China.