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Emergence and Spread of Cephalosporin-Resistant Neisseria gonorrhoeae with Mosaic penA Alleles, South Korea, 2012-2017

 Hyukmin Lee  ;  Young Hee Suh  ;  Sunhwa Lee  ;  Yong-Kyun Kim  ;  Mi-Soon Han  ;  Hye Gyung Bae  ;  Magnus Unemo  ;  Kyungwon Lee 
 Emerging Infectious Diseases, Vol.25(3) : 416-424, 2019 
Journal Title
 Emerging Infectious Diseases 
Issue Date
Alleles ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Cephalosporin Resistance* ; Communicable Diseases, Emerging/drug therapy ; Communicable Diseases, Emerging/epidemiology* ; Communicable Diseases, Emerging/microbiology* ; Communicable Diseases, Emerging/transmission ; Female ; Gonorrhea/drug therapy ; Gonorrhea/epidemiology* ; Gonorrhea/microbiology* ; Gonorrhea/transmission ; Humans ; Microbial Sensitivity Tests ; Molecular Typing ; Neisseria gonorrhoeae/classification ; Neisseria gonorrhoeae/drug effects* ; Neisseria gonorrhoeae/genetics* ; Neisseria gonorrhoeae/isolation & purification ; Penicillin-Binding Proteins/genetics* ; Republic of Korea/epidemiology
AMR ; MLST ; NG-MAST ; Neisseria gonorrhoeae ; South Korea ; antimicrobial resistance ; antimicrobial treatment ; bacteria ; cefixime ; ceftriaxone ; cephalosporin ; gonorrhea ; penA ; sexually transmitted infections
In South Korea, surveillance of antimicrobial drug resistance in Neisseria gonorrhoeae is extremely limited. We describe the emergence and subsequent national spread of N. gonorrhoeae strains with mosaic penA alleles associated with decreased susceptibility and resistance to extended-spectrum cephalosporins. From 2012 through 2017, the proportion of mosaic penA alleles in gonococcal-positive nucleic acid amplification test (NAAT) specimens across South Korea increased from 1.1% to 23.9%. Gonococcal strains with mosaic penA alleles emerged in the international hubs of Seoul in Gyeonggi Province and Busan in South Gyeongsang Province and subsequently spread across South Korea. Most common was mosaic penA-10.001 (n = 572 isolates; 94.7%), which is associated with cefixime resistance. We also identified mosaic penA-34.001 and penA-60.001, both of which are associated with multidrug-resistant gonococcal strains and spread of cefixime and ceftriaxone resistance. Implementation of molecular resistance prediction from N. gonorrhoeae-positive nucleic acid amplification test specimens is imperative in South Korea and internationally.
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1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
Lee, Hyuk Min(이혁민) ORCID logo https://orcid.org/0000-0002-8523-4126
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