Antimicrobial Resistance Patterns and Molecular Characterisation of Neisseria Gonorrhoeae Isolated at Regional and National Referral Hospitals in Uganda

Abstract Gonococcal infections (gonorrhoea) are increasingly becoming important sexually spread infections in humans in sub-Saharan countries including Uganda. Antimicrobial resistance associated withNeisseria gonorrhoeaeis rising threatening health crisis. However, the antimicrobial phenotypic and genotypic resistance patterns of the circulatingNeisseria gonorrhoeaestrains in Uganda have not been fully characterized and known. This study was carried out to investigate genetic characterization ofNeisseria gonorrhoeaeisolates and their antibiotic resistance in Western and Central Uganda. Fifty four isolates cultured from July 2019 to June 2021 were examined. The isolates were sub cultured on Thayer-Martin agar. Phenotypic antibiotic resistance was carried out using Kirby-Bauer disc diffusion method as per Clinical and Laboratory Standards Institute (CLSI) standards. Molecular techniques (End-point PCR) was used to screenNeisseria gonorrhoeaeantibiotic resistant strains at three important gene loci; penA, gyr A and parC. 56.8% of participants were male with mean age of 30 years. The adults aged 45 and above were the most sexually active with high odds ratio (OR = 2.88) followed by the middle aged (OR = 1.43). High resistance was observed amongst Penicillin (100%), Tetracycline (98.15%), and Ciprofloxacin (87.04%) and least resistance was with Cefixime (33.33%) and cefoxitin (28.26%). PenA was predominant genetic determinant of resistance. In conclusion, there is high genetic variation among theNeisseria gonorrhoeaestrains with high sensitivity to Cefixime and Ceftriaxome. There is need to strengthen clinical laboratory diagnosis and sensitise population on rational use of drugs in treatment of sexually transmitted infections.