Reflex Detection of Ciprofloxacin Resistance in Neisseria gonorrhoeae by Use of the SpeeDx ResistancePlus GC Assay

Darren Y J Lee; Melinda M Ashcroft; Eric P F Chow; Michelle Sait; Vesna De Petra; Marlene Tschaepe; Sigrid Lange; George Taiaroa; Catriona S Bradshaw; David M Whiley; Christopher K Fairley; Benjamin P Howden; Marcus Y Chen; Shivani Pasricha; Deborah A Williamson

doi:10.1128/JCM.00089-21

Reflex Detection of Ciprofloxacin Resistance in Neisseria gonorrhoeae by Use of the SpeeDx ResistancePlus GC Assay

J Clin Microbiol. 2021 Apr 20;59(5):e00089-21. doi: 10.1128/JCM.00089-21. Print 2021 Apr 20.

Authors

Darren Y J Lee¹, Melinda M Ashcroft¹, Eric P F Chow^{2

3

4}, Michelle Sait⁵, Vesna De Petra⁵, Marlene Tschaepe⁵, Sigrid Lange⁵, George Taiaroa¹, Catriona S Bradshaw^{2

3}, David M Whiley⁶, Christopher K Fairley^{2

3}, Benjamin P Howden⁵, Marcus Y Chen^{2

3}, Shivani Pasricha¹, Deborah A Williamson^{7

5

8}

Affiliations

¹ Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia.
² Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.
³ Central Clinical School, Monash University, Melbourne, Victoria, Australia.
⁴ Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
⁵ Microbiological Diagnostic Unit Public Health Laboratory, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia.
⁶ The University of Queensland Centre for Clinical Research (UQ-CCR), Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
⁷ Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia deborah.williamson@unimelb.edu.au.
⁸ Department of Microbiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Abstract

Resistance-guided therapy (RGT) for gonorrhea may reduce unnecessary use of broad-spectrum antibiotics. When reflexed from the Aptima Combo 2 assay, the ResistancePlus GC assay demonstrated 94.8% sensitivity and 100.0% specificity for Neisseria gonorrhoeae detection. Of the 379 concordant N. gonorrhoeae-positive samples, 86.8% were found to possess the gyrA S91F mutation, which was highly predictive for ciprofloxacin resistance and stable across 3,144 publicly available N. gonorrhoeae genomes. Our work supports the feasibility of implementing RGT for gonorrhea into routine molecular workflows.

Keywords: Neisseria gonorrhoeae; antimicrobial resistance; molecular diagnostic; whole-genome sequencing.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anti-Bacterial Agents / pharmacology
Anti-Bacterial Agents / therapeutic use
Ciprofloxacin / pharmacology
Drug Resistance, Bacterial
Gonorrhea* / diagnosis
Gonorrhea* / drug therapy
Humans
Microbial Sensitivity Tests
Neisseria gonorrhoeae* / genetics
Reflex

Substances

Anti-Bacterial Agents
Ciprofloxacin