Surveillance of Gonococci-National Isolate Collection for Epidemiology (G-NICE), 2010

Kun-Yen Lin1、Chun-Chen Chen1、Yen-Lin Huang1、Shu-Ying Li1

2012 Vol.28 NO.23

Correspondence Author： Shu-Ying Li

Abstract：

The surveillance program of Gonococci-National Isolate Collection for Epidemiology 2010 (G-NICE 2010) was implemented during January to December, 2010, enrolling 21 hospitals and clinics. The program collected 644 gonococcal isolates nationwide. Using disk diffusion test, the proportions of isolates resistant to penicillin, ciprofloxacin, cefpodoxime, cefixime, and ceftriaxone were 70.34%, 89.60%, 2.95%, 3.73%, and 1.24%, respectively. 4.35% and 0.78% of isolates showed reduced susceptibility to cefixime (0.125 mg/L) and ceftriaxone (0.125 mg/L). The highest Minimum Inhibitory Concentration (MIC) of cefixime and ceftriaxone were 0.38 mg/L and 0.125 mg/L, respectively. The 644 isolates were delineated into 208 sequence types (STs) by Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST) method. Among the 208 STs, 13 had more than 6 isolates collected, including ST421 (n = 82), ST359 (n = 35), ST419(n = 32), ST3684 (n = 28), ST225 (n = 23), ST2175 (n = 17), ST1971 (n = 13), ST3680 (n = 13), ST4378 (n = 13), ST2178 (n = 11), ST1614 (n = 9), ST4352 (n = 8), and ST4376 (n = 6). Among them, ST359, ST3684, ST3680, ST4378, and ST1614 are new emerging STs. ST4378 was resistant to ciprofloxacin, penicillin and cefpodoxime and was only susceptible to cefixime and ceftriaxone. The ST4378 is phylogenetically closely related to ST1407, a successful clone causing cephalosporin treatment failure in many countries.Based on the G-NICE 2010 surveillance, the gonococcal isolates in Taiwan showed high resistance rate to penicillin and ciprofloxacin. Regarding the 3rd generation of cephalosporin, the isolates with MIC 0.125 mg/L to oral cefixime remained under 5%. Isolates with reduced susceptibility to cephalosporin were mostly multidrug-resistant and from high-risk sexual networks. People should be alerted that contact with high-risk sexual networks will not only increase the risk of infecting with HIV and other sexually-transmitted diseases but also bear higher possibility of contracting “super drug” gonorrhea.