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Background  The spread of  Neisseria gonorrhoeae  ( Ng ) isolates resistant to the clinically implemented antibiotics is challenging the efficacy of treatments. Unfortunately, phenotypic and molecular data regarding  Ng  detected in Switzerland are scarce.    Methods  We compared the characteristics of  Ng  detected during 1998–2001 (n = 26) to those detected during 2009–2012 (n = 34). MICs were obtained with the Etest and interpreted as non-susceptible (non-S) according to EUCAST criteria. Sequence type (ST) was achieved implementing the NG-MAST.  Bla  TEM ,  ponA ,  penA ,  mtrR ,  penB ,  tet (M),  gyrA ,  parC ,  mefA ,  ermA/B/C/F ,  rplD ,  rplV , and 23S rRNA genes were analyzed.    Results  The following susceptibility results were obtained (period: % of non-S, MIC 90  in mg/L): penicillin (1998–2001: 42.3%, 3; 2009–2012: 85.3%, 16), cefixime (1998–2001: 0%, ≤0.016; 2009–2012: 8.8%, 0.125), ceftriaxone (1998–2001: 0%, 0.004; 2009–2012: 0%, 0.047), ciprofloxacin (1998–2001: 7.7%, 0.006; 2009–2012: 73.5%, ≥32), azithromycin (1998–2001: 11.5%, 0.25; 2009–2012: 23.6%, 0.38), tetracycline (1998–2001: 65.4%, 12; 2009–2012: 88.2%, 24), spectinomycin (1998–2001: 0%, 12; 2009–2012: 0%, 8). The prevalence of multidrug-resistant (MDR) isolates increased from 7.7% in 1998–2001 to 70.6% in 2009–2012. International STs and genogroups (G) emerged during 2009–2012 (G1407, 29.4%; G2992, 11.7%; G225, 8.8%). These isolates possessed distinctive mechanisms of resistance (e.g., G1407: PBP1 with L421, PBP2 pattern XXXIV, GyrA with S91F and D95G, ParC with S87R, PorB with G120K and A121N,  mtrR  promoter with A deletion).    Conclusions  The prevalence of penicillin- ciprofloxacin- and tetracycline-resistant  Ng  has reached dramatic levels, whereas cefixime and ceftriaxone show MICs that tend to increase during time. International MDR clones less susceptible to cephalosporins are rapidly emerging indicating that the era of untreatable gonococcal infections is close.

bmc infectious diseases

Characterization of Neisseria gonorrhoeaeisolates detected in Switzerland (1998–2012): emergence of multidrug-resistant clones less susceptible to cephalosporins