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Molecular Characterization of Markers Associated With Antimicrobial Resistance in Neisseria gonorrhoeae Identified From Residual Clinical Samples

Melendez, Johan, H., MS, PhD*†; Hardick, Justin, MS*; Barnes, Mathilda, MS*; Barnes, Perry, MSPM*; Geddes, Christopher, D., PhD; Gaydos, Charlotte, A., MS, DrPH*

Sexually Transmitted Diseases: May 2018 - Volume 45 - Issue 5 - p 312–315
doi: 10.1097/OLQ.0000000000000755
Original Studies

Background The emergence and spread of antimicrobial-resistant (AMR) Neisseria gonorrhoeae (NG) is a major public health concern. In the era of nucleic acid amplifications tests, rapid and accurate molecular approaches are needed to help increase surveillance, guide antimicrobial stewardship, and prevent outbreaks.

Methods Residual urethral swabs, collected prospectively in the Baltimore City Health Department during a 6-month period, were analyzed by real-time polymerase chain reaction assays for NG DNA and AMR determinants to fluoroquinolones, penicillin, and extended-spectrum cephalosporins.

Results N. gonorrhoeae DNA was detected in 34.8% (73/210) of samples, including 67.3% (68/101) of the swabs that had been previously identified as NG positive by culture. Markers associated with decreased susceptibility to fluoroquinolones were detected in 22.4% of the polymerase chain reaction NG-positive samples. The rate of penicillinase-producing NG was very low (1.6%), and no markers associated with decreased susceptibility to extended-spectrum cephalosporins were detected in this cohort of men using the AMR assays herein described.

Conclusions Detection of molecular markers associated with AMR in NG can be performed directly from residual clinical samples, although the recovery rate of adequate DNA for molecular testing from these samples can be suboptimal. A high number of samples with mutations associated with decreased susceptibility to fluoroquinolones were identified.

Residual urethral samples can be used for the molecular detection of markers associated with antimicrobial resistance in Neisseria gonorrhoeae.

From the *Johns Hopkins Medical Institutions; and †Institute of Fluorescence, Department of Chemistry and Biochemistry, University of Maryland Baltimore County, Baltimore, MD

This work was funded by the National Institutes of Health: U54EB007958, U01-068613, and T32GM066706.

Conflict of Interest: None declared.

Correspondence: Johan H. Melendez, PhD, Division of Infectious Diseases, Johns Hopkins University, 833 North Wolfe St, 530 Rangos Bldg, Baltimore, MD 21205. E-mail:

Received for publication July 11, 2017, and accepted October 21, 2017.

© Copyright 2018 American Sexually Transmitted Diseases Association