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Antimicrobial Agents and Chemotherapy, September 2007, p. 3111-3116, Vol. 51, No. 9
0066-4804/07/$08.00+0     doi:10.1128/AAC.00306-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Diversity of penA Alterations and Subtypes in Neisseria gonorrhoeae Strains from Sydney, Australia, That Are Less Susceptible to Ceftriaxone{triangledown}

David M. Whiley,1,2 E. Athena Limnios,3 Sanghamitra Ray,3 Theo P. Sloots,1,2,4,5 and John W. Tapsall3*

Queensland Paediatric Infectious Diseases Laboratory, Sir Albert Sakzewski Virus Research Centre, Royal Children's Hospital and Health Service District, Brisbane, Queensland, Australia,1 Clinical Medical Virology Centre, University of Queensland, Brisbane, Queensland, Australia,2 WHO Collaborating Centre for STD and HIV, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales, Australia,3 Microbiology Division, Queensland Health Pathology Service, Royal Brisbane Hospital Campus, Brisbane, Queensland, Australia,4 Department of Paediatric and Child Health, University of Queensland, Brisbane, Queensland, Australia5

Received 5 March 2007/ Returned for modification 4 May 2007/ Accepted 14 June 2007

Increasing numbers of Neisseria gonorrhoeae strains with decreased susceptibilities to ceftriaxone and other oral cephalosporins widely used for the treatment of gonorrhea have been isolated in Sydney, Australia, over several years. In this study, we examined the complete penicillin-binding protein 2 (PBP 2) amino acid sequences of 109 gonococci, selected on the basis of their diverse temporal and geographic origins and because they exhibited a range of ceftriaxone MICs: ≤0.03 µg/ml (n = 59), 0.06 µg/ml (n = 43), and 0.125 µg/ml (n = 7). Auxotyping, serotyping, and genotyping by N. gonorrhoeae multiantigen sequence typing sequence-based analysis was also performed. In total, 20 different amino acid sequence patterns were identified, indicating considerable variation in the PBP 2 sequences in this study sample. Only some of the N. gonorrhoeae isolates with significantly higher ceftriaxone MICs contained a mosaic PBP 2 pattern, while more isolates exhibited a nonmosaic PBP 2 pattern containing an A501V substitution. Although particular N. gonorrhoeae genotypes in our sample were shown to be less susceptible to ceftriaxone, the reduced susceptibility to ceftriaxone was not specific to any particular genotype and was observed in a broad range of auxotypes, serotypes, and genotypes. Overall, the results of our study show that N. gonorrhoeae strains exhibiting reduced sensitivity to ceftriaxone are not of a particular subtype and that a number of different mutations in PBP 2 may contribute to this phenomenon.

* Corresponding author. Mailing address: Department of Microbiology, The Prince of Wales Hospital, Barker Street, Randwick, Sydney 2031, Australia. Phone: 612 9382 9079. Fax: 612 9398 4275. E-mail: j.tapsall{at}unsw.edu.au

{triangledown} Published ahead of print on 25 June 2007.

Antimicrobial Agents and Chemotherapy, September 2007, p. 3111-3116, Vol. 51, No. 9
0066-4804/07/$08.00+0     doi:10.1128/AAC.00306-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.



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