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Evaluation of Drugs with Therapeutic Potential for Susceptibility of Neisseria Gonorrhoeae Isolates from 8 Provinces in China from 2018

Authors Zheng XL, Xu WQ, Liu JW, Zhu XY, Chen SC, Han Y, Dai XQ, Goodman IG, Budjan C, Chen XS, Yin YP

Received 21 August 2020

Accepted for publication 20 October 2020

Published 15 December 2020 Volume 2020:13 Pages 4475—4486

DOI https://doi.org/10.2147/IDR.S278020

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Héctor M. Mora-Montes


Xiao-Li Zheng,1,2 Wen-Qi Xu,1,2 Jing-Wei Liu,1,2 Xiao-Yu Zhu,1,2 Shao-Chun Chen,1,2 Yan Han,1,2 Xiu-Qin Dai,1,2 Isabelle Griffin Goodman,3 Christoph Budjan,4,5 Xiang-Sheng Chen,1,2 Yue-Ping Yin1,2

1Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, People’s Republic of China; 2National Center for Sexually Transmitted Diseases Control, Chinese Center for Disease Control and Prevention, Nanjing, People’s Republic of China; 3Boston University, Boston, MA, USA; 4Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA; 5Department of Systems Biology, Harvard Medical School, Boston, MA, USA

Correspondence: Yue-Ping Yin
Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 12, Jiangwangmiao Street, Nanjing 210042, People’s Republic of China
Tel/Fax +86 258 547 8024
Email [email protected]

Purpose: The study aimed to evaluate meropenem, fosfomycin, berberine hydrochloride, and doxycycline minimum inhibitory concentrations (MICs) of Neisseria gonorrhoeae collected from eight provinces in China in 2018.
Methods: The MICs of 540 Neisseria gonorrhoeae isolates (451 isolates selected randomly and 89 isolates selected with preference) were determined to meropenem, fosfomycin, berberine hydrochloride, and doxycycline using the agar dilution method, and the MICs of ceftriaxone and azithromycin were detected for comparison.
Results: Among 451 randomly selected isolates, the MIC90 was 0.06 mg/L for meropenem, 64 mg/L for fosfomycin, 64 mg/L for berberine hydrochloride, and 16 mg/L for doxycycline. All isolates showed the MIC ≤ 0.125 mg/L to meropenem, 13 isolates (2.9%) showed MIC > 64 mg/L to fosfomycin, 8 isolates (1.8%) demonstrated MIC > 64 mg/L to berberine hydrochloride, and 271 isolates (60.1%) demonstrated MIC > 1 mg/L to doxycycline. Comparing all 540 tested isolates, a correlation of r = 0.50 (P < 0.001) between meropenem and ceftriaxone MIC was observed. In 24 ceftriaxone-decreased susceptibility isolates, all isolates showed an MIC ≤ 0.125 mg/L for meropenem, 1 isolate (4.2%) showed an MIC > 64 mg/L for fosfomycin, 1 isolate (4.2%) showed an MIC > 64 mg/L for berberine hydrochloride, and 13 isolates (54.2%) showed an MIC > 1 mg/L for doxycycline. In 87 azithromycin resistant isolates, all isolates showed an MIC ≤ 0.125 mg/L for meropenem, 2 isolates (2.3%) showed an MIC > 64 mg/L for fosfomycin, 4 isolates (4.6%) showed an MIC > 64 mg/L for berberine hydrochloride, and 64 isolates (73.6%) showed an MIC > 1 mg/L for doxycycline.
Conclusion: The in vitro results suggest that meropenem might be a promising treatment option for resistant gonococcal infections, while the effects of fosfomycin and berberine hydrochloride should be further evaluated as potential therapeutic agents. The effectiveness of these drugs in animal experiments and clinical use may need further study.

Keywords: Neisseria gonorrhoeae, treatment, antimicrobial resistance, meropenem, fosfomycin

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