Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections

The aim of this study was to apply molecular epidemiology, antimicrobial surveillance, and PK/PD analysis to guide the antimicrobial treatment of gonococci infections in a region of the north of Spain. Antibiotic susceptibility testing was performed on all isolates (2017 to 2019, n = 202). A subset...

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Autores: Alonso Monsalve, Rodrigo, Rodríguez Achaerandio, Ainara, Aguirre Quiñonero, Amaia, Artetxe, Aitor, Martínez Ballesteros, Ilargi, Rodríguez Gascón, Alicia, Garaizar Candina, Javier, Canut Blasco, Andrés
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad del País Vasco
Repositorio:Addi. Archivo Digital para la Docencia y la Investigación
OAI Identifier:oai:addi.ehu.eus:10810/53647
Acceso en línea:http://hdl.handle.net/10810/53647
Access Level:acceso abierto
Palabra clave:N. gonorrhoeae
antibiotic resistance
cephalosporins
azithromycin
pharmacokinetic/pharmacodynamic (PK/PD) analysis
whole-genome sequencing (WGS)
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spelling Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae InfectionsAlonso Monsalve, RodrigoRodríguez Achaerandio, AinaraAguirre Quiñonero, AmaiaArtetxe, AitorMartínez Ballesteros, IlargiRodríguez Gascón, AliciaGaraizar Candina, JavierCanut Blasco, AndrésN. gonorrhoeaeantibiotic resistancecephalosporinsazithromycinpharmacokinetic/pharmacodynamic (PK/PD) analysiswhole-genome sequencing (WGS)The aim of this study was to apply molecular epidemiology, antimicrobial surveillance, and PK/PD analysis to guide the antimicrobial treatment of gonococci infections in a region of the north of Spain. Antibiotic susceptibility testing was performed on all isolates (2017 to 2019, n = 202). A subset of 35 isolates intermediate or resistant to at least two antimicrobials were selected to search for resistance genes and genotyping through WGS. By Monte Carlo simulation, we estimated the probability of target attainment (PTA) and the cumulative fraction of response (CFR) of the antimicrobials used to treat gonorrhea, both indicative of the probability of treatment success. In total, 2.0%, 6.4%, 5.4%, and 48.2% of the isolates were resistant to ceftriaxone, cefixime, azithromycin, and ciprofloxacin, respectively. Twenty sequence types were identified. Detected mutations were related to antibiotic resistance. PK/PD analysis showed high probability of treatment success of the cephalosporins. In conclusion, multiple populations of N. gonorrhoeae were identified. We can confirm that ceftriaxone (even at the lowest dose: 250 mg) and oral cefixime are good candidates to treat gonorrhea. For patients allergic to cephalosporins, ciprofloxacin should be only used if the MIC is known and ≤0.125 mg/L; this antimicrobial is not recommended for empirical treatment.This research was funded by the University of the Basque Country UPV/EHU (GIU20/048; PA20/03), Spain.MDPI2021202120212021info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10810/53647reponame:Addi. Archivo Digital para la Docencia y la Investigacióninstname:Universidad del País VascoIngléshttps://www.mdpi.com/1999-4923/13/10/1699/htminfo:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by/3.0/es/2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).oai:addi.ehu.eus:10810/536472026-06-18T09:23:17Z
dc.title.none.fl_str_mv Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections
title Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections
spellingShingle Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections
Alonso Monsalve, Rodrigo
N. gonorrhoeae
antibiotic resistance
cephalosporins
azithromycin
pharmacokinetic/pharmacodynamic (PK/PD) analysis
whole-genome sequencing (WGS)
title_short Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections
title_full Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections
title_fullStr Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections
title_full_unstemmed Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections
title_sort Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections
dc.creator.none.fl_str_mv Alonso Monsalve, Rodrigo
Rodríguez Achaerandio, Ainara
Aguirre Quiñonero, Amaia
Artetxe, Aitor
Martínez Ballesteros, Ilargi
Rodríguez Gascón, Alicia
Garaizar Candina, Javier
Canut Blasco, Andrés
author Alonso Monsalve, Rodrigo
author_facet Alonso Monsalve, Rodrigo
Rodríguez Achaerandio, Ainara
Aguirre Quiñonero, Amaia
Artetxe, Aitor
Martínez Ballesteros, Ilargi
Rodríguez Gascón, Alicia
Garaizar Candina, Javier
Canut Blasco, Andrés
author_role author
author2 Rodríguez Achaerandio, Ainara
Aguirre Quiñonero, Amaia
Artetxe, Aitor
Martínez Ballesteros, Ilargi
Rodríguez Gascón, Alicia
Garaizar Candina, Javier
Canut Blasco, Andrés
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv N. gonorrhoeae
antibiotic resistance
cephalosporins
azithromycin
pharmacokinetic/pharmacodynamic (PK/PD) analysis
whole-genome sequencing (WGS)
topic N. gonorrhoeae
antibiotic resistance
cephalosporins
azithromycin
pharmacokinetic/pharmacodynamic (PK/PD) analysis
whole-genome sequencing (WGS)
description The aim of this study was to apply molecular epidemiology, antimicrobial surveillance, and PK/PD analysis to guide the antimicrobial treatment of gonococci infections in a region of the north of Spain. Antibiotic susceptibility testing was performed on all isolates (2017 to 2019, n = 202). A subset of 35 isolates intermediate or resistant to at least two antimicrobials were selected to search for resistance genes and genotyping through WGS. By Monte Carlo simulation, we estimated the probability of target attainment (PTA) and the cumulative fraction of response (CFR) of the antimicrobials used to treat gonorrhea, both indicative of the probability of treatment success. In total, 2.0%, 6.4%, 5.4%, and 48.2% of the isolates were resistant to ceftriaxone, cefixime, azithromycin, and ciprofloxacin, respectively. Twenty sequence types were identified. Detected mutations were related to antibiotic resistance. PK/PD analysis showed high probability of treatment success of the cephalosporins. In conclusion, multiple populations of N. gonorrhoeae were identified. We can confirm that ceftriaxone (even at the lowest dose: 250 mg) and oral cefixime are good candidates to treat gonorrhea. For patients allergic to cephalosporins, ciprofloxacin should be only used if the MIC is known and ≤0.125 mg/L; this antimicrobial is not recommended for empirical treatment.
publishDate 2021
dc.date.none.fl_str_mv 2021
2021
2021
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/10810/53647
url http://hdl.handle.net/10810/53647
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv https://www.mdpi.com/1999-4923/13/10/1699/htm
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/3.0/es/
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Addi. Archivo Digital para la Docencia y la Investigación
instname:Universidad del País Vasco
instname_str Universidad del País Vasco
reponame_str Addi. Archivo Digital para la Docencia y la Investigación
collection Addi. Archivo Digital para la Docencia y la Investigación
repository.name.fl_str_mv
repository.mail.fl_str_mv
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