WGS of Commensal <i>Neisseria</i> Reveals Acquisition of a New Ribosomal Protection Protein (MsrD) as a Possible Explanation for High Level Azithromycin Resistance in Belgium
In this study, we characterized all oropharyngeal and anorectal isolates of <i>Neisseria</i> spp. in a cohort of men who have sex with men. This resulted in a panel of pathogenic <i>Neisseria</i> (<i>N. gonorrhoeae</i> [n = 5] and <i>N. meningitidis</i>...
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doaj-f4323d4897b844229572112c0ebf00552021-03-24T00:04:51ZengMDPI AGPathogens2076-08172021-03-011038438410.3390/pathogens10030384WGS of Commensal <i>Neisseria</i> Reveals Acquisition of a New Ribosomal Protection Protein (MsrD) as a Possible Explanation for High Level Azithromycin Resistance in BelgiumTessa de Block0Jolein Gyonne Elise Laumen1Christophe Van Dijck2Said Abdellati3Irith De Baetselier4Sheeba Santhini Manoharan-Basil5Dorien Van den Bossche6Chris Kenyon7Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, BelgiumDepartment of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, BelgiumDepartment of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, BelgiumDepartment of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, BelgiumDepartment of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, BelgiumDepartment of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, BelgiumDepartment of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, BelgiumDepartment of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, BelgiumIn this study, we characterized all oropharyngeal and anorectal isolates of <i>Neisseria</i> spp. in a cohort of men who have sex with men. This resulted in a panel of pathogenic <i>Neisseria</i> (<i>N. gonorrhoeae</i> [n = 5] and <i>N. meningitidis</i> [n = 5]) and nonpathogenic <i>Neisseria</i> (<i>N. subflava</i> [n = 11], <i>N. mucosa</i> [n = 3] and <i>N. oralis</i> [n = 2]). A high proportion of strains in this panel were resistant to azithromycin (18/26) and ceftriaxone (3/26). Whole genome sequencing (WGS) of these strains identified numerous mutations that are known to confer reduced susceptibility to azithromycin and ceftriaxone in <i>N. gonorrhoeae</i>. The presence or absence of these known mutations did not explain the high level resistance to azithromycin (>256 mg/L) in the nonpathogenic isolates (8/16). After screening for antimicrobial resistance (AMR) genes, we found a ribosomal protection protein, Msr(D), in these highly azithromycin resistant nonpathogenic strains. The complete integration site originated from <i>Streptococcus pneumoniae</i> and is associated with high level resistance to azithromycin in many other bacterial species. This novel AMR resistance mechanism to azithromycin in nonpathogenic <i>Neisseria</i> could be a public health concern if it were to be transmitted to pathogenic <i>Neisseria</i>. This study demonstrates the utility of WGS-based surveillance of nonpathogenic <i>Neisseria</i>.https://www.mdpi.com/2076-0817/10/3/384antimicrobial resistancecommensal <i>Neisseria</i>horizontal gene transfer<i>msrD</i> |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Tessa de Block Jolein Gyonne Elise Laumen Christophe Van Dijck Said Abdellati Irith De Baetselier Sheeba Santhini Manoharan-Basil Dorien Van den Bossche Chris Kenyon |
spellingShingle |
Tessa de Block Jolein Gyonne Elise Laumen Christophe Van Dijck Said Abdellati Irith De Baetselier Sheeba Santhini Manoharan-Basil Dorien Van den Bossche Chris Kenyon WGS of Commensal <i>Neisseria</i> Reveals Acquisition of a New Ribosomal Protection Protein (MsrD) as a Possible Explanation for High Level Azithromycin Resistance in Belgium Pathogens antimicrobial resistance commensal <i>Neisseria</i> horizontal gene transfer <i>msrD</i> |
author_facet |
Tessa de Block Jolein Gyonne Elise Laumen Christophe Van Dijck Said Abdellati Irith De Baetselier Sheeba Santhini Manoharan-Basil Dorien Van den Bossche Chris Kenyon |
author_sort |
Tessa de Block |
title |
WGS of Commensal <i>Neisseria</i> Reveals Acquisition of a New Ribosomal Protection Protein (MsrD) as a Possible Explanation for High Level Azithromycin Resistance in Belgium |
title_short |
WGS of Commensal <i>Neisseria</i> Reveals Acquisition of a New Ribosomal Protection Protein (MsrD) as a Possible Explanation for High Level Azithromycin Resistance in Belgium |
title_full |
WGS of Commensal <i>Neisseria</i> Reveals Acquisition of a New Ribosomal Protection Protein (MsrD) as a Possible Explanation for High Level Azithromycin Resistance in Belgium |
title_fullStr |
WGS of Commensal <i>Neisseria</i> Reveals Acquisition of a New Ribosomal Protection Protein (MsrD) as a Possible Explanation for High Level Azithromycin Resistance in Belgium |
title_full_unstemmed |
WGS of Commensal <i>Neisseria</i> Reveals Acquisition of a New Ribosomal Protection Protein (MsrD) as a Possible Explanation for High Level Azithromycin Resistance in Belgium |
title_sort |
wgs of commensal <i>neisseria</i> reveals acquisition of a new ribosomal protection protein (msrd) as a possible explanation for high level azithromycin resistance in belgium |
publisher |
MDPI AG |
series |
Pathogens |
issn |
2076-0817 |
publishDate |
2021-03-01 |
description |
In this study, we characterized all oropharyngeal and anorectal isolates of <i>Neisseria</i> spp. in a cohort of men who have sex with men. This resulted in a panel of pathogenic <i>Neisseria</i> (<i>N. gonorrhoeae</i> [n = 5] and <i>N. meningitidis</i> [n = 5]) and nonpathogenic <i>Neisseria</i> (<i>N. subflava</i> [n = 11], <i>N. mucosa</i> [n = 3] and <i>N. oralis</i> [n = 2]). A high proportion of strains in this panel were resistant to azithromycin (18/26) and ceftriaxone (3/26). Whole genome sequencing (WGS) of these strains identified numerous mutations that are known to confer reduced susceptibility to azithromycin and ceftriaxone in <i>N. gonorrhoeae</i>. The presence or absence of these known mutations did not explain the high level resistance to azithromycin (>256 mg/L) in the nonpathogenic isolates (8/16). After screening for antimicrobial resistance (AMR) genes, we found a ribosomal protection protein, Msr(D), in these highly azithromycin resistant nonpathogenic strains. The complete integration site originated from <i>Streptococcus pneumoniae</i> and is associated with high level resistance to azithromycin in many other bacterial species. This novel AMR resistance mechanism to azithromycin in nonpathogenic <i>Neisseria</i> could be a public health concern if it were to be transmitted to pathogenic <i>Neisseria</i>. This study demonstrates the utility of WGS-based surveillance of nonpathogenic <i>Neisseria</i>. |
topic |
antimicrobial resistance commensal <i>Neisseria</i> horizontal gene transfer <i>msrD</i> |
url |
https://www.mdpi.com/2076-0817/10/3/384 |
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