The resistance of Neisseria gonorrhoeae to ceftriaxone is unusual in Switzerland. The underlying genotype responsible for resistance is suspected to be novel. Generally, resistance in Neisseria gonorrhoeae (Ng) involves a comprehensive set of genes with many different mutations leading to resistance to different β-lactams and fluoroquinolones. A patient had a positive result from specific PCR for Ng. We routinely culture all clinical specimens with a positive NG-PCR. In this particular case, we isolated a strain with resistance to ceftriaxone in Switzerland. A total of seven different genes (penA, ponA, porinB, mtr, gyrA, parC, 23S rRNA gene) in this strain were partially sequenced for comparison with phenotypic susceptibility testing. Interestingly, two different mutations in the porinB gene were observed, and data on this gene are limited. Information on the identified allele type of the penA gene is very limited as well. Three different mutations of parC and gyrA that correlate with ciprofloxacin resistance were found. The combination of ceftriaxone and ciprofloxacin resistance makes an appropriate treatment difficult to obtain due to multidrug resistance. The combined results for all genes show the appearance of new mutations in central Europe either due to worldwide spread or the emergence of new genetic combinations of mutations.

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在瑞士发现的耐头孢曲松淋球菌菌株的分子特征：病例报告

淋病奈瑟菌对头孢曲松的耐药性在瑞士并不常见。导致抗性的潜在基因型被怀疑是新的。一般来说，淋病奈瑟菌 (Ng) 的耐药性涉及一组具有许多不同突变的综合基因，这些突变导致对不同 β-内酰胺类和氟喹诺酮类药物的耐药性。一名患者的 Ng 特异性 PCR 结果呈阳性。我们常规培养具有阳性 NG-PCR 的所有临床标本。在这种特殊情况下，我们在瑞士分离出一种对头孢曲松具有抗药性的菌株。对该菌株中总共七种不同的基因（penA、ponA、porinB、mtr、gyrA、parC、23S rRNA 基因）进行了部分测序，用于与表型敏感性测试进行比较。有趣的是，在 porinB 基因中观察到两种不同的突变，而关于该基因的数据有限。penA 基因等位基因类型的信息也非常有限。发现了与环丙沙星耐药相关的三种不同的parC和gyrA突变。头孢曲松和环丙沙星的联合耐药由于多药耐药而难以获得适当的治疗。所有基因的综合结果表明，中欧出现了新的突变，这可能是由于全球传播或新的突变基因组合的出现。