Evaluation of antimicrobial susceptibility profile, resistance mechanisms and genotypic characterization of Neisseria gonorrhoeae isolated in São Paulo - Brazil

Abstract

Gonorrhea is a sexually transmitted infection (STI) caused by Neisseria gonorrhoeae. This microorganism can infect the urogenital and/or oropharynx mucosa through sexual transmission, causing asymptomatic symptomatic and or symptomatic infections. Untreated gonococcal infection may lead chronic infection, and consequently to ectopic pregnancy, chronic pelvic inflammatory disease, and infertility. The emergence of antimicrobial resistance among N. gonorrhoeae isolates is a cause of major concern because may jeopardize the disease control. The main objective of this study is to evaluate the antimicrobial susceptibility profile, detect resistance encoding genes, and study the genetic relationship among 150 clinical isolates of N. gonorrheae isolated from outpatients assisted at the Centro de Referência e Treinamento DST/AIDS-CRT Santa Cruz, São Paulo - SP. The N. gonorrhoeae isolates were previously stored at -70°C in the bank of microorganisms of the CRT-Santa Cruz. The microorganisms were subcultured onto chocolate agar (BioMerieux, Marcy I'Etoile, France), referred and stored at -70ºC in the bank of microorganisms of the Laboratório Especial de Microbiologia Clínica/Alerta, at Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP). Clinical isolates of N. gonorrhoeae will have their identification at the species level confirmed by MALDI-TOF technique. The determination of the susceptible profile will be performed by agar-dilution according to the CLSI guidelines. Isolates showing reduced susceptible to fluoroquinolones and ceftriaxone will be selected for detection of resistance encoding genes by PCR followed by DNA sequencing. The genetic similarity will be analyzed. In this matter, we intend to recognize which antimicrobials could constitute good therapeutic options for treatment of gonorrhea, understand the resistance mechanisms and determine how the spread of resistance has occurred among the isolated gonococcus. (AU)