Diagnostic Microbiology & Infectious Disease
Volume 67, Issue 4 , Pages 350-354, August 2010

Trend of ciprofloxacin resistance in Neisseria gonorrhoeae strains isolated in Italy and analysis of the molecular determinants

  • Stefania Starnino

      Affiliations

    • Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, 00161-Rome, Italy
    • ,
  • Ivano Dal Conte

      Affiliations

    • STI Clinic Savoia Hospital, Turin, Italy
    • These authors contributed equally to this work.
    • ,
  • Alberto Matteelli

      Affiliations

    • Institute of Infectious and Tropical Diseases, University of Brescia, Italy
    • These authors contributed equally to this work.
    • ,
  • Emma Galluppi

      Affiliations

    • Azienda Ospedaliero-Universitaria di Bologna Policlinico S. Orsola-Malpighi U.O. of Microbiology, Bologna, Italy
    • These authors contributed equally to this work.
    • ,
  • Marco Cusini

      Affiliations

    • U.O. Dermatology Fondazione Policlinico Mangiagalli Regina Elena, Milan, Italy
    • These authors contributed equally to this work.
    • ,
  • Aldo Di Carlo

      Affiliations

    • San Gallicano Dermatologic Institute-IRCSS, Rome, Italy
    • These authors contributed equally to this work.
    • ,
  • Sergio Delmonte

      Affiliations

    • S.C. Dermosifilopatia-2 ASO-U.S. Giovanni Battista, Turin, Italy
    • These authors contributed equally to this work.
    • ,
  • Paola Stefanelli

      Affiliations

    • Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, 00161-Rome, Italy
    • Corresponding Author InformationCorresponding author. Tel.: +39-06-49902126; fax: +39-06-49387112.

Received 25 January 2010; accepted 16 March 2010.

Abstract 

A total of 599 Neisseria gonorrhoeae strains collected in Italy in 2 periods, 2003 to 2005 and 2007 to 2008, were screened for ciprofloxacin susceptibility by Etest. Ciprofloxacin-resistant strains (49.7%) were characterized by i) serovar determination, patterns of mutation in gyrA, and parC genes (38%, randomly selected) and ii) N. gonorrhoeae multiantigen sequence typing (56% of the strains isolated from patients who declared their sexual orientation). The percentage of ciprofloxacin-resistant strains increased from 42 (2003–2005) to 58 (2007–2008); in the second period, strains with MIC value >32 μg/mL have been observed. Mutations in gyrA and parC genes were identified in the majority of strains (88%). Ciprofloxacin-resistant isolates among men who have sex with men (MSM) increased from 24% in 2003 to 2005 to 47% in 2007 to 2008. However, sequence types exclusively found among MSM were mostly due to a single strain. This is the first study in Italy combining N. gonorrhoeae ciprofloxacin susceptibility testing with molecular analyses and comparing the results over time.

Keywords: Neisseria gonorrhoeae, Ciprofloxacin resistance, Molecular analysis

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PII: S0732-8893(10)00085-4

doi:10.1016/j.diagmicrobio.2010.03.001

Diagnostic Microbiology & Infectious Disease
Volume 67, Issue 4 , Pages 350-354, August 2010

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