Mutations in the Determining Region of Quinolone Resistance (QRDR) of the gyrA gene of Neisseria gonorrhoeae present in clinical samples of men who have sex with men

Abstract

Neisseria gonorrhoeae resistant to quinolones (QRNG) becomes a very important problem in public health due to the development of rapid resistance to quinolones, which is why the WHO recommends reinforcing antimicrobial resistance monitoring to guide treatment. In Peru there are few reports on QRNG surveillance and still less work related to mutation patterns. This study aims to find mutations in the Determinant Region of Quinolone Resistance (QRDR) of the gyrA gene of N. gonorrhoeae from 1096 clinical samples of urine and swabs from 367 men who have sex with men (MSM) collected during the period 2012-2013. We detected 58 N. gonorrhoeae positive samples in 45 MSM by means of the APTIMA Combo 2 assay, and 11 QRNG positive samples of 11 MSM by Real Time PCR. The quinolone-resistant bacteria were analyzed by sequencing and we identified that the frequent mutation pattern was the double mutation of Ser-91 to Phe and Asp-95 to Gly in the QRDR of the gyrA gene. In conclusion, these double mutations in the QRDR sequence of the gyrA gene would indicate the presence of N. gonorrhoeae with quinolone resistant phenotype in clinical samples of MSM from Lima-Peru, noting that this is the first study done in Peru on this high population risk.