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Detection of antimicrobial resistance in <5 h in Neisseria gonorrhoeae isolates using flow cytometry-proof of concept for seven clinically relevant antimicrobials
Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.ORCID iD: 0000-0003-0433-8079
Region Kronoberg, Sweden.
Region Kronoberg, Sweden.ORCID iD: 0000-0001-6621-0244
Örebro University, Sweden;UCL, UK.
2024 (English)In: Journal of Antimicrobial Chemotherapy, ISSN 0305-7453, E-ISSN 1460-2091, Vol. 79, no 4, p. 815-819Article in journal (Refereed) Published
Abstract [en]

Introduction: Antimicrobial resistance in Neisseria gonorrhoeae compromises gonorrhoea treatment and rapid antimicrobial susceptibility testing (AST) would be valuable. We have developed a rapid and accurate flow cytometry method (FCM) for AST of gonococci. Methods: The 2016 WHO gonococcal reference strains, and WHO Q, R and S (n = 17) were tested against seven clinically relevant antibiotics (ceftriaxone, cefixime, azithromycin, spectinomycin, ciprofloxacin, tetracycline and gentamicin). After 4.5 h incubation of inoculated broth, the fluorescent dye Syto (TM) 9 was added, followed by FCM analysis. After gating, the relative remaining population of gonococci, compared with unexposed growth control samples, was plotted against antimicrobial concentration, followed by non-linear curve regression analysis. Furthermore, the response at one single concentration/tested antibiotic was evaluated with the intention to use as a screening test for detection of resistant gonococci. Results: A dose-dependent response was seen in susceptible isolates for all tested antimicrobials. There was a clear separation between susceptible/WT and resistant/non-WT isolates for ceftriaxone, cefixime, spectinomycin, ciprofloxacin and tetracycline. In contrast, for azithromycin, only high-level-resistant isolates were distinguished, while resistant isolates with MICs of 4 mg/L were indistinguishable from WT (MIC <= 1 mg/L) isolates. For gentamicin, all tested 17 isolates were WT and FCM analysis resulted in uniform dose-response curves. Using a single antibiotic concentration and a 50% remaining cell population cut-off, the overall sensitivity and specificity for resistance detection were 93% and 99%, respectively. Conclusions: By providing results in <5 h for gonococcal isolates, FCM-based AST can become a rapid screening method for antimicrobial resistance or antimicrobial susceptibility in gonococci.

Place, publisher, year, edition, pages
Oxford University Press, 2024. Vol. 79, no 4, p. 815-819
National Category
Microbiology in the medical area
Research subject
Natural Science, Chemistry
Identifiers
URN: urn:nbn:se:lnu:diva-127875DOI: 10.1093/jac/dkae034ISI: 001160693500001PubMedID: 38334417Scopus ID: 2-s2.0-85189524569OAI: oai:DiVA.org:lnu-127875DiVA, id: diva2:1839371
Available from: 2024-02-20 Created: 2024-02-20 Last updated: 2025-03-19Bibliographically approved

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Somajo, Sofia

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