Epidemiological profile and genetic resistance of Neisseria gonorrhoeae infection in women in a poor region of São Paulo, Brazil

Acta Trop. 2024 Jan:249:107047. doi: 10.1016/j.actatropica.2023.107047. Epub 2023 Oct 20.

Abstract

Background and aim: Gonorrhea is a bacterial infection in the urogenital tract, transmitted by sexual or perinatal contact, caused by Neisseria gonorrhoeae, a gram-negative diplococcus. The present study evaluates the frequency of N. gonorrhoeae in women treated at Hospital Wladimir Arruda in poor area of São Paulo and also verifies the presence of genetic resistance against three antimicrobials of different classes: Tetracycline, Azithromycin and Ciprofloxacin.

Methods: This is an observational and descriptive study with a quantitative approach. Samples were collected at Hospital Escola Wladimir Arruda. The volunteers are women from 16 to 65 years of age. Sociodemographic, gynecological, sexual and health data are collected through a questionnaire, their symptoms/clinical manifestation were requested by the medical records, and then the participant is referred for collection of samples of cervical vaginal smear. The samples were screened for N. gonorrhoeae (dcmH gene) and tested for resistance genes to Tetracycline, Azithromycin and Ciprofloxacin through PCR.

Results: In the total of 127 samples analyzed by Real-Time PCR, 23 were positive and correspond to a general prevalence of a gonococcal infection in the studied population of 17% (CI:95%), and the participants were married (43.4%), had active sexual life (56.5%) and did not use any type of condom during sexual intercourse (52.1%). The resistance to the tetM ribosomal gene was found in 14 samples, prevalence of 60% (CI= 95%).

Conclusions: We have described a concerning frequency of N. gonorrhoeae infection in females attended in an outcare patient. Also, most of the strains detected presented resistance to one or more antimicrobials.

Keywords: Antimicrobials; Genetic resistance; Infection; Neisseria gonorrhoeae; Sexually transmitted infections.

Publication types

  • Observational Study

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents* / therapeutic use
  • Azithromycin / therapeutic use
  • Brazil / epidemiology
  • Ciprofloxacin / therapeutic use
  • Female
  • Gonorrhea* / drug therapy
  • Gonorrhea* / epidemiology
  • Gonorrhea* / microbiology
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Neisseria gonorrhoeae / genetics
  • Tetracycline

Substances

  • Azithromycin
  • Anti-Bacterial Agents
  • Ciprofloxacin
  • Tetracycline
  • Anti-Infective Agents