LAUSR

BACKGROUND Development and emergence of resistance in Neisseria gonorrhoeae (NG) to antimicrobials have become a major public health problem worldwide. The aim of our study was to analyze antimicrobial susceptibility and molecular characteristics of NG isolates in Shenzhen. METHODS A total of 1,282 NG isolates were consecutively collected between 2010 and 2017. The demographic information of patients was also collected. Minimum inhibitory concentrations of ceftriaxone, spectinomycin, ciprofloxacin, azithromycin and penicillin were determined using the agar dilution method. Isolates were genotyped using Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST). RESULTS Among the isolates, 97.4% were resistant to ciprofloxacin and 68.2% were resistant to penicillin. 5.0% showed decreased susceptibility to ceftriaxone (CROD), and 17.3% were resistant to azithromycin (AZM-R), in addition, 1.3% were simutaneously CROD and AZM-R. All isolates were susceptible to spectinomycin. Increasing MICs of ceftriaxone was found from 2010-2017. 427 sequence types (STs) and 68 genogroups were identified from 724 isolates. ST5061, ST3741 and ST1766 were observed across the study years. The predominant type were ST14638 (n = 3) among 32 CROD isolates. Prevalent STs were ST5061 (n = 6), ST1866 (n = 5), ST11133 (n = 5) among 96 AZM-R isolates. CONCLUSIONS High prevalence of isolates resistant to ciprofloxacin and penicillin were found in our study. Azithromycin, one antimicrobial of dual antimicrobial therapy recommended by WHO, showed high prevalence of resistance. The other one, ceftriaxone, can be used continuously in this region due to lower lever of resistance. However, the emergence of CROD and descending susceptibility to ceftriaxone indicate that continuous surveillance of antimicrobial resistance is essential.