High susceptibility to the novel antimicrobial zoliflodacin among Neisseria gonorrhoeae isolates in eight WHO Enhanced Gonococcal Antimicrobial Surveillance Programme countries in three WHO regions, 2021-2024

作者：Susanne Jacobsson, Thitima Cherdtrakulkiat, Daniel Golparian, Heng Li, Irving Hoffman, Manuel C Jamoralin, Francis Kakooza, Rossaphorn Kittiyaowamarn, Peter Kyambadde, Phạm Thị Làn, Venessa Maseko, Mitch Matoga, E Müller, Thuy Thi Phan Nguyen, Vichea Ouk, Daniel Schröder, Vivi Setiawaty, Sonia Sia, Verawati Sulaiman, Mot Virak, Nguyễn Thị Thúy Vân, Ismaël Maatouk, Teodora Wi, Magnus Unemo · 发表于：IJID Regions · 年份：2025 · DOI：10.1016/j.ijregi.2025.100624 · 被引用次数：10 · 研究领域：Reproductive tract infections research、Bacterial Infections and Vaccines、Neonatal and Maternal Infections

• Resistance in Neisseria gonorrhoeae has emerged to the last treatment, ceftriaxone • We show a high zoliflodacin susceptibility among gonococci from three WHO Regions • We found two gonococcal isolates from Cambodia with increased zoliflodacin MICs • Our study supports the further development of zoliflodacin for gonorrhoea treatment Zoliflodacin, a novel spiropyrimidinetrione, showed non-inferiority compared to recommended ceftriaxone plus azithromycin treatment in a recent global phase 3 randomized controlled trial for gonorrhoea treatment. We evaluated the susceptibility of zoliflodacin among 2993 contemporary gonococcal isolates collected in 2021-2024 in eight World Health Organization Enhanced Gonococcal Antimicrobial Surveillance Programme (WHO EGASP) countries in the WHO South-East Asian Region (Indonesia, Thailand), WHO Western Pacific Region (Cambodia, The Philippines, Viet Nam), and WHO African Region (Malawi, South Africa, Uganda). Minimum inhibitory concentrations (MICs) of zoliflodacin were determined using the agar dilution technique and the zoliflodacin target gene ( gyrB ) was examined with Illumina sequencing. Zoliflodacin exhibited high activity: MICs ranging from 0.001 to 1 mg/L and a modal MIC of 0.032 mg/L. The zoliflodacin MIC distribution showed mostly a wild-type profile, however, two isolates from Cambodia had MICs of 0.5 mg/L and 1 mg/L. Both these isolates also harboured the GyrB D429N mutation, associated with increased zoliflodacin MICs. We show ...