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1. The changing epidemiology of carbapenemase-producing Klebsiella pneumoniae in Italy: Toward polyclonal evolution with emergence of high-risk lineages

Author

Di Pilato V., Errico G., Monaco M., Giani T., Del Grosso M., Antonelli A., David S., Lindh E., Camilli R., Aanensen D. M., Rossolini G. M., Pantosti A., Manso E., Pedna M. F., Mungiguerra M., Mosca A., Vailati F., Aschbacher R., Imbriani A., Sartore P., Giraldi C., Piana F., Pecile P., de Nittis R., Pini B., Mirri P., Bianchi E., Restelli A., Morelli D., Catania M. R., Barbaro A., Bernaschi P, Parisi G, Gualdi P, Dusi PA, Bona R, D'Andrea M M, Cavallo R, Lanzafame P, Sartor A, Grandesso S, Milano F, Di Pilato, V., Errico, G., Monaco, M., Giani, T., Del Grosso, M., Antonelli, A., David, S., Lindh, E., Camilli, R., Aanensen, D. M., Rossolini, G. M., Pantosti, A., Manso, E., Pedna, M. F., Mungiguerra, M., Mosca, A., Vailati, F., Aschbacher, R., Imbriani, A., Sartore, P., Giraldi, C., Piana, F., Pecile, P., de Nittis, R., Pini, B., Mirri, P., Bianchi, E., Restelli, A., Morelli, D., Catania, M. R., Barbaro, A., Bernaschi, P, Parisi, G, Gualdi, P, Dusi, Pa, Bona, R, D'Andrea, M M, Cavallo, R, Lanzafame, P, Sartor, A, Grandesso, S, and Milano, F

Subjects
Microbiology (medical), Imipenem, Klebsiella pneumoniae, Population, Microbial Sensitivity Tests, Meropenem, beta-Lactamases, Settore MED/07, Antibiotic resistance, Bacterial Proteins, Genotype, medicine, Humans, Pharmacology (medical), education, Pharmacology, Genetics, education.field_of_study, biology, Settore BIO/19, biology.organism_classification, Anti-Bacterial Agents, Klebsiella Infections, Resistome, Infectious Diseases, Italy, Multilocus sequence typing, Multilocus Sequence Typing, medicine.drug
Abstract

BackgroundPrevious studies showed that the epidemic of carbapenem-resistant Klebsiella pneumoniae (CR-KP) observed in Italy since 2010 was sustained mostly by strains of clonal group (CG) 258 producing KPC-type carbapenemases. In the framework of the National Antibiotic-Resistance Surveillance (AR-ISS), a countrywide survey was conducted in 2016 to explore the evolution of the phenotypic and genotypic characteristics of CR-KP isolates.MethodsFrom March to July 2016, hospital laboratories participating in AR-ISS were requested to provide consecutive, non-duplicated CR-KP (meropenem and/or imipenem MIC >1 mg/L) from invasive infections. Antibiotic susceptibility was determined according to EUCAST recommendations. A WGS approach was adopted to characterize the isolates by investigating phylogeny, resistome and virulome.ResultsTwenty-four laboratories provided 157 CR-KP isolates, of which 156 were confirmed as K. pneumoniae sensu stricto by WGS and found to carry at least one carbapenemase-encoding gene, corresponding in most cases (96.1%) to blaKPC. MLST- and SNP-based phylogeny revealed that 87.8% of the isolates clustered in four major lineages: CG258 (47.4%), with ST512 as the most common clone, CG307 (19.9%), ST101 (15.4%) and ST395 (5.1%). A close association was identified between lineages and antibiotic resistance phenotypes and genotypes, virulence traits and capsular types. Colistin resistance, mainly associated with mgrB mutations, was common in all major lineages except ST395.ConclusionsThis WGS-based survey showed that, although CG258 remained the most common CR-KP lineage in Italy, a polyclonal population has emerged with the spread of the new high-risk lineages CG307, ST101 and ST395, while KPC remained the most common carbapenemase.

Published
2021

2. The Italian arm of the PREPARE study: an international project to evaluate and license a maternal vaccine against group B streptococcus

Author

Berardi A., Cassetti T., Creti R., Vocale C., Ambretti S., Sarti M., Facchinetti F., Cose S., van Bijlsma M., van De Beek D., Poyart C., French N., Nielsen M., Musoke P., Davies H., Ovale S., Lugli L., Capretti M. G., Lanari M., Dondi A., Ciccia M., Francavilla R., Lanzoni A., Baroni L., Fornaciari S., Carretto E., Alessandrini C., Lucia G., Perrone S., Calderaro A., Bacchini P., Giugno C., Rota C., Pagano R., Guidi B., Biasucci G., Benenati B., Schiavo R., Piccinini G., Pulvirenti R., Rizzo V., Ancora G., China C., Papa I., Viola L., Pedna M. F., Bua J., Travan L., Busetti M., Santori D., Merazzi D., Papa A., Laura L., Auriti C., Bernaschi P., Vento G., Giordano L., Spanu T., Haass C., Margiotta M. C., Nardella G., De Nittis R., Laforgia N., Loprieno S., Giuseppe L., Moramarco A. M., Tzialla C., Fasolato V., Orlandini S., Decembrino L., Del Campo G., Maiocchi A., Cuttano A., Tuoni C., Barnini S., Carnielli V., Perrone B., Orecchioni F., Visintini F., Arzese A., Heath P., Le Doare K., Neurology, Amsterdam Neuroscience - Neuroinfection & -inflammation, AII - Infectious diseases, Berardi A., Cassetti T., Creti R., Vocale C., Ambretti S., Sarti M., Facchinetti F., Cose S., van Bijlsma M., van De Beek D., Poyart C., French N., Nielsen M., Musoke P., Davies H., Ovale S., Lugli L., Capretti M.G., Lanari M., Dondi A., Ciccia M., Francavilla R., Lanzoni A., Baroni L., Fornaciari S., Carretto E., Alessandrini C., Lucia G., Perrone S., Calderaro A., Bacchini P., Giugno C., Rota C., Pagano R., Guidi B., Biasucci G., Benenati B., Schiavo R., Piccinini G., Pulvirenti R., Rizzo V., Ancora G., China C., Papa I., Viola L., Pedna M.F., Bua J., Travan L., Busetti M., Santori D., Merazzi D., Papa A., Laura L., Auriti C., Bernaschi P., Vento G., Giordano L., Spanu T., Haass C., Margiotta M.C., Nardella G., De Nittis R., Laforgia N., Loprieno S., Giuseppe L., Moramarco A.M., Tzialla C., Fasolato V., Orlandini S., Decembrino L., Del Campo G., Maiocchi A., Cuttano A., Tuoni C., Barnini S., Carnielli V., Perrone B., Orecchioni F., Visintini F., Arzese A., Heath P., and Le Doare K.

Subjects
0301 basic medicine, Pediatrics, medicine.medical_specialty, Group B streptococcus, Sepsi, International Cooperation, 030106 microbiology, Disease, Abortion, Group B, Streptococcus agalactiae, Sepsis, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Streptococcal Infections, medicine, Humans, Meningitis, 030212 general & internal medicine, Newborn, Prevention, Vaccine, Pregnancy Complications, Infectious, Antibiotic prophylaxis, reproductive and urinary physiology, Group B streptococcu, business.industry, Streptococcal Vaccines, Infant, Newborn, lcsh:RJ1-570, lcsh:Pediatrics, Antibiotic Prophylaxis, medicine.disease, Infectious Disease Transmission, Vertical, Meningiti, Pneumonia, Italy, Immunization, Commentary, Female, business
Abstract

Background Group B streptococcus (GBS) is a leading cause of sepsis, pneumonia and meningitis in infants, with long term neurodevelopmental sequelae. GBS may be associated with poor pregnancy outcomes, including spontaneous abortion, stillbirth and preterm birth. Intrapartum antibiotic prophylaxis (IAP) is currently the only way to prevent early-onset disease (presenting at 0 to 6 days of life), although it has no impact on the disease presenting over 6 days of life and its implementation is challenging in resource poor countries. A maternal vaccine against GBS could reduce all GBS manifestations as well as improve pregnancy outcomes, even in low-income countries. Main body The term “PREPARE” designates an international project aimed at developing a maternal vaccination platform to test vaccines against neonatal GBS infections by maternal immunization. It is a non-profit, multi-center, interventional and experimental study (promoted by the St George University of London. [UK]) with the aim of developing a maternal vaccination platform, determining pregnancy outcomes, and defining the extent of GBS infections in children and mothers in Africa. PREPARE also aims to estimate the protective serocorrelates against the main GBS serotypes that cause diseases in Europe and Africa and to conduct two trials on candidate GBS vaccines. PREPARE consists of 6 work packages. In four European countries (Italy, UK, Netherlands, France) the recruitment of cases and controls will start in 2020 and will end in 2022. The Italian PREPARE network includes 41 centers. The Italian network aims to collect: GBS isolates from infants with invasive disease, maternal and neonatal sera (cases); cord sera and GBS strains from colonized mothers whose infants do not develop GBS infection (controls). Short conclusion PREPARE will contribute information on protective serocorrelates against the main GBS serotypes that cause diseases in Europe and Africa. The vaccine that will be tested by the PREPARE study could be an effective strategy to prevent GBS disease.

Published
2020

3. Trend in rifampicin-, multidrug- and extensively drug-resistant tuberculosis in Italy, 2009-2016

Author

Mustazzolu, A., Borroni, E., Cirillo, D. M., Giannoni, F., Iacobino, A., Fattorini, L., Ghisetti, V., Mondo, A., Avolio, M., Barbui, A., Lorenzetti, P., De Renzi, G., Chirillo, M. G., Molinari, G., Camaggi, A., Andreoni, S., Piana, F., Marchese, A., Gritti, P., Icardi, G., Varnier, O., Mazzola, E., Gesu, G., Cichero, P., Lombardi, A., Libanori, E., Viggiani, P., De Lorenzo, S., Pinsi, G., Marone, P., Monzillo, V., Barbarini, D., Farina, C., Arosio, M., Peracchi, M., Manganelli, R., Fabris, C., Di Santolo, M., Busetti, M., Scarparo, C., Sartor, A., Pedrotti, C., Caola, I., Frizzera, E., Dal Monte, P., Pietrosemoli, P., Pecorari, M., Fabio, A., La Regina, A., Matteucci, M., Piersimoni, C., Bartolesi, A., Mannino, R., Simonetti, T., Tortoli, E., Rindi, L., Mencacci, A., Cenci, E., Luciano, E., Mazzolla, R., Sanguigni, I., Parisi, G., Chiaradonna, P., Altieri, A. M., D'Arezzo, S., Mazzarelli, A., Di Caro, A., Bordi, E., Sali, M., Delogu, G., Sanguinetti, M., Russo, C., Coltella, L., Ciocco, A., Meledandri, M., Gambi, A., Tomei, G., Conte, M., Santoro, G., Del Giudice, A., Nuzzolese, N., Vitullo, E., Sinno, A., Buono, L., Costa, D., Grimaldi, A., Di Taranto, A., De Nittis, R., Palumbo, G., Dodaro, S., Giraldi, C., Cavalcanti, P., Nistico, S., Vinci, L., Di Naso, C., Bonura, C., Maida, C. M., Mammina, C., Podda, G. S., Caddeu, R., Mustazzolu A., Borroni E., Cirillo D.M., Giannoni F., Iacobino A., Fattorini L., Ghisetti V., Mondo A., Avolio M., Barbui A., Lorenzetti P., De Renzi G., Chirillo M.G., Molinari G., Camaggi A., Andreoni S., Piana F., Marchese A., Gritti P., Icardi G., Varnier O., Mazzola E., Gesu G., Cichero P., Lombardi A., Libanori E., Viggiani P., De Lorenzo S., Pinsi G., Marone P., Monzillo V., Barbarini D., Farina C., Arosio M., Peracchi M., Manganelli R., Fabris C., Di Santolo M., Busetti M., Scarparo C., Sartor A., Pedrotti C., Caola I., Frizzera E., Dal Monte P., Pietrosemoli P., Pecorari M., Fabio A., La Regina A., Matteucci M., Piersimoni C., Bartolesi A., Mannino R., Simonetti T., Tortoli E., Rindi L., Mencacci A., Cenci E., Luciano E., Mazzolla R., Sanguigni I., Parisi G., Chiaradonna P., Altieri A.M., D'Arezzo S., Mazzarelli A., Di Caro A., Bordi E., Sali M., Delogu G., Sanguinetti M., Russo C., Coltella L., Ciocco A., Meledandri M., Gambi A., Tomei G., Conte M., Santoro G., Del Giudice A., Nuzzolese N., Vitullo E., Sinno A., Buono L., Costa D., Grimaldi A., Di Taranto A., De Nittis R., Palumbo G., Dodaro S., Giraldi C., Cavalcanti P., Nistico S., Vinci L., Di Naso C., Bonura C., Maida C.M., Mammina C., Podda G.S., and Caddeu R.

Subjects
0301 basic medicine, Pulmonary and Respiratory Medicine, Extensively Drug-Resistant Tuberculosis, Antitubercular Agents, Emigrants and Immigrants, Humans, Italy, Mycobacterium tuberculosis, Rifampin, Tuberculosis, Multidrug-Resistant, 03 medical and health sciences, 0302 clinical medicine, polycyclic compounds, medicine, Tuberculosis, biology, business.industry, Extensively drug-resistant tuberculosis, Multidrug-Resistant, medicine.disease, biology.organism_classification, Virology, 030104 developmental biology, 030228 respiratory system, business, Rifampicin, medicine.drug
Abstract

In Italy, rifampicin-resistant and MDR-TB were high in foreign-born persons, but decreased from 2009 to 2016

Published
2018

4. Molecular epidemiology of KPC-producing Klebsiella pneumoniae from invasive infections in Italy: Increasing diversity with predominance of the ST512 clade II sublineage

Author

Conte, Viola, Monaco, Monica, Giani, Tommaso, D'Ancona, Fortunato, Moro, Maria Luisa, Arena, Fabio, D'Andrea, Marco Maria, Rossolini, Gian Maria, Pantosti, Annalisa, Bianchi, E., Catania, M. R., Cavalcanti, P., De Nittis, R., Dusi, P. A., Grandesso, S., Gualdi, P., Imbriani, A., Pini, B., Vincenzi, C., Meledandri, M., Agrappi, C., Parisi, G., Pollini, S., Restelli, A., Rocchetti, A., Vailati, F., Aschbacher, R., Barbaro, A., Bona, R., Chirillo, M., Corradini, S., Cuccurullo, S., De Bernochi, A., Dodi, C., Giammanco, A., Mencacci, Antonella, Milano, F., Miragliotta, G., Mungiguerra, M., Pedna, M. F., Piana, Francesca, Porcheddu, G. M., Rossi, M. R., Santino, I., Sartor, A., Sartore, P., Conte V., Monaco M., Giani T., D'Ancona F., Moro M.L., Arena F., D'Andrea M.M., Rossolini G.M., Pantosti A., Bianchi E., Catania M.R., Cavalcanti P., De Nittis R., Dusi P.A., Grandesso S., Gualdi P., Imbriani A., Pini B., Vincenzi C., Meledandri M., Agrappi C., Parisi G., Pollini S., Restelli A., Rocchetti A., Vailati F., Aschbacher R., Barbaro A., Bona R., Chirillo M., Corradini S., Cuccurullo S., De Bernochi A., Dodi C., Giammanco A., Mencacci A., Milano F., Miragliotta G., Mungiguerra M., Pedna M.F., Piana F., Porcheddu G.M., Rossi M.R., Santino I., Sartor A., Sartore P., Conte, V, Monaco, M, Giani, T, D'Ancona, F, Moro, Ml, Arena, F, D'Andrea, Mm, Rossolini, Gm, Pantosti, A, AR-ISS Study Group on Carbapenemase-Producing K., pneumoniae: Bianchi E, Catania, Mr, Cavalcanti, P, De Nittis, R, Dusi, Pa, Grandesso, S, Gualdi, P, Imbriani, A, Pini, B, Vincenzi, C, Meledandri, Alessio, Agrappi, C, Parisi, G, Pollini, S, Restelli, Ugo, Rocchetti, Romualdo, Vailati, F, Aschbacher, R, Barbaro, A, Bona, R, Chirillo, M, Corradini, S, Cuccurullo, S, De Bernochi, A, Dodi, C, Giammanco, Anna, Mencacci, A, Milano, F, Miragliotta, Giuseppe, Mungiguerra, M, Pedna, Mf, Piana, Daniela, Porcheddu, Gm, Rossi, Mr, Santino, I, Sartor, A, and Sartore, P.

Subjects
0301 basic medicine, Microbiology (medical), gel, Klebsiella pneumoniae, genotype, 030106 microbiology, Population, cross-sectional studies, pulsed-field, multilocus sequence typing, electrophoresis, gel, pulsed-field, humans, italy, klebsiella infections, klebsiella pneumoniae, molecular epidemiology, serogroup, beta-lactamases, genetic variation, Settore BIO/19 - Microbiologia Generale, Cross-Sectional Studies, Electrophoresis, Gel, Pulsed-Field, Humans, Italy, Klebsiella Infections, Molecular Epidemiology, Multilocus Sequence Typing, Serogroup, beta-Lactamases, Genetic Variation, Genotype, Pharmacology, Pharmacology (medical), Infectious Diseases, law.invention, Microbiology, beta-Lactamase, 03 medical and health sciences, law, Pulsed-field gel electrophoresis, Typing, education, Polymerase chain reaction, Cross-Sectional Studie, education.field_of_study, biology, Molecular epidemiology, biochemical phenomena, metabolism, and nutrition, biology.organism_classification, Settore MED/07 - Microbiologia e Microbiologia Clinica, bacterial infections and mycoses, Virology, electrophoresis, Multilocus sequence typing, Human, Klebsiella Infection
Abstract

Objectives The spread of carbapenem-resistant Enterobacteriaceae (CRE) represents one of the most worrisome problems for clinical medicine worldwide. In Italy, the Antibiotic-Resistance-Istituto Superiore di Sanita surveillance network, in collaboration with the Committee for Antimicrobial Agents of the Italian Society of Clinical Microbiologists, promoted a study to investigate the carbapenem-resistance mechanisms, clonal relatedness and capsular typing of a recent collection of carbapenem-resistant Klebsiella pneumoniae (CR-KP). Methods A total of 17 laboratories distributed across Italy collected all consecutive non-replicate CR-KP isolated from invasive infections during two different study periods (2011-12 and 2013). Carbapenemase genes were searched for by filter hybridization and confirmed by PCR and sequencing. KPC-producing K. pneumoniae (KPC-KP) were typed by PFGE and MLST. Capsular types were identified by wzi gene typing. Results Of the collected K. pneumoniae isolates (n = 461), the overall proportion of CR-KP was 36.2% (n = 167). The majority (97%) of the CR-KP were positive for the blaKPC gene. Among the KPC-KP population, nine different STs were detected with the majority of isolates (94%) belonging to the clonal group (CG) 258. A subpopulation that belonged to ST512 and showed an identical PFGE profile represented the majority (57%) of KPC-KP strains, with a countrywide distribution. Capsular characterization showed the predominance of the wzi154, cps-2 capsular type (88.8% of all CG258 strains). ST258 strains were associated with both cps-1 and cps-2 capsular types, while ST512 was associated with cps-2 only. Conclusions Although a trend to a polyclonal evolution of the Italian KPC-KP was noted, this study showed that the KPC-KP population remained largely oligoclonal with the wide diffusion of an ST512 lineage carrying cps-2 capsular type and producing the KPC-3 enzyme.

Published
2016

5. Tuberculosis in migrants from 106 countries to Italy, 2008-2014

Author

Lanfranco, Fattorini, Alessandro, Mustazzolu, Emanuele, Borroni, Giovanni, Piccaro, Federico, Giannoni, Daniela Maria Cirillo, the Italian Multicentre Study on Resistance to Antituberculosis drugs Group: Ghisetti, V, Mondo, A, Milano, R, Barbui, A, Lorenzetti, P, De Renzi, G, Chirillo, Mg, Molinari, G, Camaggi, A, Carità, Md, Gritti, P, Varnier, O, Senno, E, Mazzola, E, Gesu, G, Cichero, P, Lombardi, A, Libanori, E, De Lorenzo, S, Pinsi, G, Marone, P, Monzillo, V, Matteo, S, Farina, C, Arosio, M, Xxiii, G, Peracchi, M, Manganelli, R, Fabris, C, Scarparo, C, Pedrotti, C, Frizzera, E, Larcher, C, Monte, P, Lombardi, G, Fabio, A, Matteucci, M, Piersimoni, C, Simonetti, Mt, Tortoli, E, Rindi, Laura, Mazzolla, R, Luciano, E, Sanguigni, I, Chiaradonna, P, Tronci, M, Parisi, G, Natili, S, Bordi, E, De Mori, P, Sali, M, Delogu, G, Sanguinetti, M, Russo, C, Coltella, L, Meledandri, M, Ballardini, M, Tomei, G, Santoro, G, Conte, M, Nuzzolese, N, Colonna, C, Buono, L, Sinno, A, Vitullo, E, Costa, D, Grimaldi, A, Di Taranto, A, De Nittis, R, Dodaro, S, Cavalcanti, P, Giraldi, C, Nisticò, S, Di Naso, C, Caddeu, R., Lanfranco Fattorini, Alessandro Mustazzolu, Emanuele Borroni, Giovanni Piccaro, Federico Giannoni, Daniela Maria Cirillo, SMIRA laboratory network: [.., Dal Monte, P., Lombardi, G., and ]

Subjects
Pulmonary and Respiratory Medicine, Tuberculosis, Tuberculosi, Extensively Drug-Resistant Tuberculosis, Antitubercular Agents, Microbial Sensitivity Tests, Mycobacterium tuberculosi, World Health Organization, Russia, Mycobacterium tuberculosis, Antitubercular Agent, 03 medical and health sciences, 0302 clinical medicine, Environmental protection, Tuberculosis, Multidrug-Resistant, Humans, Medicine, 030212 general & internal medicine, Socioeconomics, Transients and Migrants, Geography, biology, Microbial Sensitivity Test, business.industry, Extensively drug-resistant tuberculosis, biology.organism_classification, medicine.disease, Europe, Italy, 030228 respiratory system, Multicenter study, Extensively Drug-Resistant Tuberculosi, Africa, business, Soviet union, Human
Abstract

In migrants coming to Italy from 106 countries, MDR-TB was high from the former Soviet Union and low from Africa http://ow.ly/WZDbo

Published
2016

6. Changing Antimicrobial Resistance Profiles among Neisseria gonorrhoeae Isolates in Italy, 2003 to 2012

Author

Carannante, Anna, Renna, Giovanna, Dal Conte, Ivano, Ghisetti, Valeria, Matteelli, Alberto, Prignano, Grazia, Impara, Giampaolo, Cusini, Marco, D'Antuono, Antonietta, Vocale, Caterina, Antonetti, Raffaele, Gaino, Marina, Busetti, Marina, Latino, Maria Agnese, Mencacci, Antonella, Bonanno, Carmen, Cava, Maria Carmela, Giraldi, Cristina, Stefanelli, Paola, Del Re, S., Milano, R., Di Carlo, A., Cristaudo, A., Palamara, G., Scioccati, L., Ramoni, S., DE FRANCESCO, Maria Antonia, Sambri, V., Landini, M. P., Cavrini, F., Fiore, J., Di Taranto, A., De Nittis, R., Predazzer, R., Ober, P., Urbani, F., Petix, V., Rossi, T., Pauri, P., Meucci, M., Tagliaferro, L., Colaci, C., Carannante, Anna, Renna, Giovanna, Conte, Ivano Dal, Ghisetti, Valeria, Matteelli, Alberto, Prignano, Grazia, Impara, Giampaolo, Cusini, Marco, D'Antuono, Antonietta, Vocale, Caterina, Antonetti, Raffaele, Gaino, Marina, Busetti, Marina, Latino, Maria Agnese, Mencacci, Antonella, Bonanno, Carmen, La Cava, Maria Carmela, Giraldi, Cristina, and Stefanelli, Paola

Subjects
Male, Anti-Bacterial Agents, Azithromycin, Cefixime, Ciprofloxacin, Humans, Italy, Neisseria gonorrhoeae, Penicillinase, Penicillins, Retrospective Studies, Tetracycline, Pharmacology (medical), Pharmacology, Infectious Diseases, Gonorrhea, Infectious Disease, Biology, medicine.disease_cause, urologic and male genital diseases, Microbiology, Epidemiology and Surveillance, Antibiotic resistance, Retrospective Studie, Anti-Bacterial Agent, medicine, Etest, Medicine (all), Penicillin, Antimicrobial, medicine.disease, Virology, Human, medicine.drug
Abstract

The emergence of Neisseria gonorrhoeae isolates displaying resistance to antimicrobial agents is a major public health concern and a serious issue related to the occurrence of further untreatable gonorrhea infections. A retrospective analysis on 1,430 N. gonorrhoeae isolates, collected from 2003 through 2012, for antimicrobial susceptibility by Etest and molecular characterization by Neisseria gonorrhoeae multiantigen sequence typing (NG-MAST) was carried out in Italy. Azithromycin-resistant gonococci decreased from 14% in 2007 to 2.2% in 2012. Similarly, isolates with high MICs to cefixime (>0.125 mg/liter) decreased from 11% in 2008 to 3.3% in 2012. The ciprofloxacin resistance rate remains quite stable, following an increasing trend up to 64% in 2012. The percentage of penicillinase-producing N. gonorrhoeae (PPNG) significantly declined from 77% in 2003 to 7% in 2012. A total of 81 multidrug-resistant (MDR) gonococci were identified, showing 11 different antimicrobial resistance patterns. These were isolated from men who have sex with men (MSM) and from heterosexual patients. Two sequence types (STs), ST661 and ST1407, were the most common. Genogroup 1407, which included cefixime-, ciprofloxacin-, and azithromycin-resistant isolates, was found. In conclusion, a change in the antimicrobial resistance profiles among gonococci was identified in Italy together with a percentage of MDR isolates.

Published
2014

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