2026-06-14T03:54:53Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/139002025-03-26T13:43:46Zcom_20.500.12105_2052com_20.500.12105_2051col_20.500.12105_19609
Repisalud
author
Harris, Simon R
author
Cole, Michelle J
author
Spiteri, Gianfranco
author
Sánchez-Busó, Leonor
author
Golparian, Daniel
author
Jacobsson, Susanne
author
Goater, Richard
author
Abudahab, Khalil
author
Yeats, Corin A
author
Bercot, Beatrice
author
Borrego, María-José
author
Crowley, Brendan
author
Stefanelli, Paola
author
Tripodo, Francesco
author
Abad, Raquel
author
Aanensen, David M
author
Unemo, Magnus
author
Euro-GASP study group
funder
Unión Europea. European Centre for Disease Prevention and Control (ECDC)
funder
Centre for Genomic Pathogen Surveillance
funder
Örebro University Hospital (Suecia)
funder
Wellcome Trust
2022-03-30T07:23:46Z
2022-03-30T07:23:46Z
2018-07
Lancet Infect Dis. 2018 Jul;18(7):758-768.
10.1016/S1473-3099(18)30225-1
1474-4457
The Lancet. Infectious Diseases
29776807
http://hdl.handle.net/20.500.12105/13900
Background: Traditional methods for molecular epidemiology of Neisseria gonorrhoeae are suboptimal. Whole-genome sequencing (WGS) offers ideal resolution to describe population dynamics and to predict and infer transmission of antimicrobial resistance, and can enhance infection control through linkage with epidemiological data. We used WGS, in conjunction with linked epidemiological and phenotypic data, to describe the gonococcal population in 20 European countries. We aimed to detail changes in phenotypic antimicrobial resistance levels (and the reasons for these changes) and strain distribution (with a focus on antimicrobial resistance strains in risk groups), and to predict antimicrobial resistance from WGS data. Methods: We carried out an observational study, in which we sequenced isolates taken from patients with gonorrhoea from the European Gonococcal Antimicrobial Surveillance Programme in 20 countries from September to November, 2013. We also developed a web platform that we used for automated antimicrobial resistance prediction, molecular typing (N gonorrhoeae multi-antigen sequence typing [NG-MAST] and multilocus sequence typing), and phylogenetic clustering in conjunction with epidemiological and phenotypic data. Findings: The multidrug-resistant NG-MAST genogroup G1407 was predominant and accounted for the most cephalosporin resistance, but the prevalence of this genogroup decreased from 248 (23%) of 1066 isolates in a previous study from 2009-10 to 174 (17%) of 1054 isolates in this survey in 2013. This genogroup previously showed an association with men who have sex with men, but changed to an association with heterosexual people (odds ratio=4·29). WGS provided substantially improved resolution and accuracy over NG-MAST and multilocus sequence typing, predicted antimicrobial resistance relatively well, and identified discrepant isolates, mixed infections or contaminants, and multidrug-resistant clades linked to risk groups. Interpretation: To our knowledge, we provide the first use of joint analysis of WGS and epidemiological data in an international programme for regional surveillance of sexually transmitted infections. WGS provided enhanced understanding of the distribution of antimicrobial resistance clones, including replacement with clones that were more susceptible to antimicrobials, in several risk groups nationally and regionally. We provide a framework for genomic surveillance of gonococci through standardised sampling, use of WGS, and a shared information architecture for interpretation and dissemination by use of open access software.
eng
Public health surveillance of multidrug-resistant clones of Neisseria gonorrhoeae in Europe: a genomic survey
research article
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