Llanes R1 *, Gutiérrez O1 , Feliciano O1 , Sánchez J2 , De Baetselier I3 , Cuylaerts V3 , Vuylsteke B4 and Crucitti T5
1Department of Bacteriology-Mycology, National Reference Laboratory of Neisseria & Helicobacter, Institute of Tropical Medicine Pedro Kourí (IPK), Cuba 2 Program for Control of Sexually Transmitted Infections, Ministry of Public Health, Cuba 3 Department of Clinical Sciences, Clinical Reference Laboratory, Institute of Tropical Medicine Antwerp, Belgium 4 Department of Public Health, Sexual and Reproductive Health, Institute of Tropical Medicine Antwerp, Belgium 5 Experimental Bacteriology Unit, Institut Pasteur de Madagascar, Antananarivo, MadagascarFulltext PDF
Background: There are a growing incidence of urogenital and anorectal infections caused by Neisseria meningitidis and commensal Neisseria species. Prevalence of Antimicrobial Resistance (AMR) of commensal Neisseria is steadily increasing. Aims: To confirm the identification of presumptive N. gonorrhoeae isolates and other Neisseria species from patients with genital or extragenital symptoms in Cuba, during the period 2014-2021. We also assessed the antibiotic susceptibility of commensal Neisseria spp. and N. meningitidis isolates. Methods: during the study period, 520 Neisseria spp isolates from patients with suspicion of gonorrhea were received at the Neisseria-Helicobacter reference laboratory for definitive identification and the study of the AMR. The identification of gonococci included Gram staining, oxidase and catalase tests, glucose utilization on CTA medium and a PCR amplifying a fragment of the OPA gene. Further identification comprised colistin susceptibility, growth on Mueller-Hinton agar at 22ºC, automated Vitek 2 system and an in-house PCR that amplifies a 127 bp fragment of the N. meningitidis sodC gene. The antibiotic susceptibilities to penicillin, ceftriaxone, ciprofloxacin, azithromycin, rifampicin, tetracycline and gentamicin were determined by the E-test method (for meningococci) and by agar dilution for commensal Neisseria. Results: the 48.5% of the Neisseria spp isolates (252/520) were viable; of them 241 were N. gonorrhoeae. Of the 11 non-gonorrhoeae isolates, six and three isolates were identified as N. cinerea and N. meningitidis, respectively and two Neisseria spp could not be identified at species level. The AMR profiles in six isolates of N. cinerea revealed that all isolates except one were at least resistant to one antibiotic, with the exception of gentamicin, and four isolates exhibited combined resistance to two or more antibiotics. This behavior is quite different to the AMR observed in N. meningitidis isolates in which, only one isolate showed intermediate susceptibility to penicillin. Conclusion: It represents one of the largest studies that report of N. cinerea from patients with genital symptomatology, combined with multiple resistance to several antibiotics, and the demonstration of high resistance to azithromycin/ceftriaxone. This behavior is troublesome as these organisms constitutes a reservoir of AMR and may transfer mutations encoding resistance to Neisseria gonorrhoeae and N. meningitidis. Further investigations are required to know about the role of MALDI-TOF or genomic tools in identification of non-pathogenic Neisseria at the reference laboratory and if enhanced antibiotic stewardship activities could reduce the MIC of these organisms.
Neisseria Cinerea; Prevalence of Antimicrobial Resistance (AMR); Antibiotic susceptibility in N. meningitidis
Llanes R, Gutiérrez O, Feliciano O, Sánchez J, De Baetselier I, Cuylaerts V, et al. Identification and Antibiotic Susceptibility of Neisseria cinerea and Neisseria meningitidis in Patients with Suspect of Gonorrhea in Cuba, 2014- 2021. Am J Clin Microbiol Antimicrob. 2023; 6(1): 1063..