Search

Neisseria elongata is part of the commensal microbiota of the oropharynx. Although it is not considered pathogenic to humans, N. elongata has been implicated in several cases of infective endocarditis (IE). Here, we report a case of IE caused by N. elongata subsp. nitroreducens (Nel_M001) and compare its genome with 17 N. elongata genomes available in GenBank. We also evaluated resistance and virulence profiles with Comprehensive Antibiotic Resistance and Virulence Finder databases. The results showed a wide diversity among N. elongata isolates. Based on the pangenome cumulative curve, we demonstrate that N. elongata has an open pangenome. We found several different resistance genes, mainly associated with antibiotic efflux pumps. A wide range of virulence genes was observed, predominantly pilus formation genes. Nel_M001 was the only isolate to present two copies of some pilus genes and not present nspA gene. Together, our results provide insights into how this commensal microorganism can cause IE and may assist further biological investigations on nonpathogenic Neisseria spp. Case reporting and pangenome analyses are critical for enhancing our understanding of IE pathogenesis, as well as for alerting physicians and microbiologists to enable rapid identification and treatment to avoid unfavorable outcomes., We report a case of a 71‐year‐old male with infective endocarditis caused by Neisseria elongata. This microorganism was isolated from blood culture, and its whole genome was sequenced. We also performed a comparative genomic analysis with seventeen N. elongata genomes available in GenBank to explore virulence and resistance in N. elongata, as well as its pangenome.

Background Neisseria gonorrhoeae (NG) has an extraordinary ability to develop resistance to all antimicrobials used for its treatment. This study analysed molecular determinants of antimicrobial resistance and NG-MAST of 153 NG isolates collected at Florianopolis metropolitan area during 2008–2016. Methods Minimal Inhibitory Concentration (MIC) was determined by agar dilution and the molecular epidemiology was evaluated by NG-MAST. Results Resistance was observed to penicillin (PEN) (26.1%), tetracycline (TET) (41.2%), ciprofloxacin (CIP) (52.3%) and azithromycin (AZT) (5.2%). All isolates were susceptible to cefixime (CFX) and ceftriaxone (CRO). However, 8.5% of isolates had MIC=0.125 mg/L for CFX, one log below the resistance cut-off point (EUCAST). β-lactamase production was detected in 12.4% of isolates and one of them carried the blaTEM-135 allele. The American or Dutch tetM gene were carried by 5.2% of the isolates. Mutations in the QRDR were observed in 87.5% of isolates resistant to CIP. NG-MAST showed 64 different sequence types (STs), including 19 novel STs. ST225, ST2992, ST1582, ST338, ST1407, ST2202 and ST6827 were most prevalent. G225 genogroup was associated with resistance to CIP (p Conclusion This study showed high rates of resistance to PEN, TET and CIP associated with persistence and dissemination of gonococcal strains resistant to CIP and plasmid resistance to PEN and TET. Despite the high resistance profile to CIP, the treatment recommended to the south region of Brazil was the association of CIP-AZT until 2017, when the national recommendation changed it to CRO-AZT. Disclosure No significant relationships.

Introduction: Neisseria gonorrhoeae (NG) was originally highly susceptible to antimicrobials. The ongoing selective pressure allied to the bacterium’s ability to develop and retain resistance factors has been indicating the possibility of NG to evolve into untreatable forms. Therefore, constant monitoring of antimicrobial resistance and updates of treatment guidelines are mandatory. The aim of this study was to evaluate the evolution of NG antimicrobial resistance in a historical series of isolates from Sao Paulo/Brazil. Methods A total of 173 NG isolates obtained between 2003 and 2016 from the STD/AIDS Reference and Training Centre of Sao Paulo were analysed. The bacterial species identification was confirmed by MALDI-TOF and the minimum inhibitory concentration (MIC) for penicillin (PEN), tetracycline (TET), ciprofloxacin (CIP), azithromycin (AZT), ceftriaxone (CRO) and cefixime (CFX) was determined by agar dilution. Results The isolates were divided into two periods, from 2003 to 2010 and 2011 to 2016. The susceptibility profile for PEN did not differ between the two periods, 77.8% of the isolates had intermediate (I) and 19% resistant (R) from 2003 to 2010, while 74.5% I and 25.5% R from 2011 to 2016. The susceptibility profile for TET showed a different behaviour with more intermediates in the second period (59.6% I and 31.9% R) compared to the first period (29.4% I and 60.3% R). For AZT, there was an increase in the number of resistant isolates over the years: 0.8% I and 1.6% R (2003 to 2010), and 10.6% I and 12.8% R (2011 to 2016). CIP was the drug that presented the major difference between the periods with 86.5% of isolates being sensitive, 1.6% I and 11.9% R in the first period and 46.8% R in the second period. The isolates were 100% sensitive to cefixime and ceftriaxone. Conclusion The study showed an increase in resistance to azithromycin and especially to ciprofloxacin. Ceftriaxone and cefixime isolates, both rarely used in clinic in Brazil, did not present resistance.

Introduction: Neisseria gonorrhoeae (NG), initially highly susceptible to many antimicrobials, was recently assigned as a superbug due to its ability to develop resistance to all antimicrobials introduced for treatment during the last years. This study aimed to determine the prevalence and trends of NG antimicrobial resistance (AMR) during 2008–2016 in Grande Florianopolis, Santa Catarina, Brazil. Methods A total of 152 gonococcal isolates from urogenital specimens were submitted to Santa Luzia Medical Laboratory, Florianopolis, Brazil. All isolates were identified to the species level using MALDI-TOF. The minimum inhibitory concentration (MIC) was determined using agar dilution method to penicillin, tetracycline, ciprofloxacin, ceftriaxone, cefixime and azithromycin. Quality control was performed using NG WHO reference strains and ATCC 49226. Results All isolates were sensitive to ceftriaxone (MIC 0.001–0.06 µg/ml) and cefixime (MIC: 0.0005–0.125 µg/ml). Resistance to penicilin, tetracycline, ciprofloxacin and azithromycin were 26.3%, 40.8%, 52.0% and 5.2% respectively. Conclusion The study showed increased resistance to penicillin, tetracycline, ciprofloxacin and azithromycin. No resistance to ceftriaxone and cefixime was detected. Due to the high level ciprofloxacin resistance, the dual therapy currently recommended in Brazil for gonococcal infections (ciprofloxacin plus azithromycin) is no more an effective treatment option in Grande Florianopolis. Thus, ceftriaxone constitute the treatment option for gonococcal infections, as well as in the states of Rio de Janeiro, Sao Paulo and Minas Gerais, where regional studies have already detected high level ciprofloxacin resistance. AMR testing needs to be frequently performed to ensure the treatment effectiveness.