The impact of antimicrobials on gonococcal evolution

Sánchez-Busó, Leonor; Golparian, Daniel; Corander, Jukka; Grad, Yonatan H.; Ohnishi, Makoto; Flemming, Rebecca; Parkhill, Julian; Bentley, Stephen D.; Unemo, Magnus; Harris, Simon R.

doi:10.1038/s41564-019-0501-y

Cited by 104 publications

(124 citation statements)

References 69 publications

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“…A recent global collection of 419 genomes from 58 countries (including the Philippines) defined two major lineages with different evolutionary strategies. The genomes from this study were mostly found within a subclade of Lineage A, a multidrug-resistant lineage associated with infection in high-risk sexual networks ( Figure 3A), and mixed with genomes from Europe, Pakistan, and SE Asia, including previously isolated genomes from the Philippines (1998 and 2008, 16 ). The genome from DMC was found within a separate subclade with genomes from India, Pakistan, and Europe, which also carried the mtrR_A24-promoter deletion.…”

Section: N Gonorrhoeae From the Philippines In Global Contextmentioning

confidence: 78%

“…There was no evidence of geographical clustering of the isolates, in line with previous global datasets. 16,19 A recent report suggested rapid recent intercontinental transmission of gonorrhoea with common introductions from Asia to the rest of the world. 16 In agreement with this, the Philippine genomes were interspersed with those from other countries ( Figure 3A).…”

Section: Discussionmentioning

confidence: 99%

“…16,19 A recent report suggested rapid recent intercontinental transmission of gonorrhoea with common introductions from Asia to the rest of the world. 16 In agreement with this, the Philippine genomes were interspersed with those from other countries ( Figure 3A). In addition, we found evidence of an introduction event from the Philippines to Norway, which was associated with travel of a Norwegian male to the Philippines ( Figure 3B).…”

Section: Discussionmentioning

confidence: 99%

“…To contextualize the genomes from this study with public global genomes we combined them with two surveys available on Pathogenwatch, a European survey of 1054 genomes 15 and a global survey of 419 genomes. 16 The outputs from Pathogenwatch (tree, genotyping and AMR predictions) together with the metadata collected from the sentinel sites were visualised with Microreact. 11 The genomic predictions of AMR obtained with Pathogenwatch (test) were compared to the phenotypic results (reference) and the concordance between the two methods was computed for each of 5 antibiotics (105 total comparisons).…”

Section: Bioinformatics Analysismentioning

confidence: 99%

“…The Philippine genomes were contextualized with two recently published collections 15,16 available in Pathogenwatch. A recent global collection of 419 genomes from 58 countries (including the Philippines) defined two major lineages with different evolutionary strategies.…”

Section: N Gonorrhoeae From the Philippines In Global Contextmentioning

confidence: 99%

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Genomic surveillance ofNeisseria gonorrhoeaein the Philippines, 2013–2014

Villamin

Argimón²,

Jamoralín

et al. 2020

Preprint

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Antimicrobial-resistant Neisseria gonorrhoeae is a major threat to public health, and of particular concern in the Western Pacific Region, where the incidence of gonorrhoea is high. The Antimicrobial Resistance Surveillance Program (ARSP) has been capturing information on resistant gonorrhoea since 1996, but studies of the genomic epidemiology of gonorrhoea in the Philippines are lacking.We sequenced the whole genomes of 21 N. gonorrhoeae isolates collected in 2013-2014 by the ARSP. The multi-locus sequence type, multi-antigen sequence type, presence of antimicrobial resistance (AMR) determinants, and relatedness between the isolates were all derived from the sequence data. The concordance between phenotypic and genotypic resistance was also determined.Ten out of 21 isolates were resistant to penicillin, ciprofloxacin and tetracycline, mostly linked to the presence of blaTEM gene, the S91F mutation in the gyrA gene, and the tetM gene, respectively. None of the isolates were resistant to azithromycin, ceftriaxone or cefixime, although we identified the A24-deletion in the mtrR promoter in one isolate. The concordance between phenotypic and genotypic resistance was 92.38% overall for 5 antibiotics in 4 classes. Despite the small number of isolates studied, they were genetically diverse, as shown by the sequence types, the NG-MAST types and the tree. Comparison with global genomes placed the Philippine genomes within global Lineage A and led to the identification of an international transmission route.This first genomic survey of N. gonorrhoeae isolates collected by ARSP will be used to contextualize ongoing prospective surveillance, and it highlights the importance of genomic surveillance in the Western Pacific and other endemic regions to understand the spread of drug-resistant gonorrhoea worldwide.

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Section: N Gonorrhoeae From the Philippines In Global Contextmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Bioinformatics Analysismentioning

confidence: 99%

Section: N Gonorrhoeae From the Philippines In Global Contextmentioning

confidence: 99%

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Genomic surveillance ofNeisseria gonorrhoeaein the Philippines, 2013–2014

Villamin

Argimón²,

Jamoralín

et al. 2020

Preprint

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Epidemiology, Treatments, and Vaccine Development for Antimicrobial-Resistant Neisseria gonorrhoeae: Current Strategies and Future Directions

Lin

Adamson

Klausner

2021

Drugs

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Neisseria gonorrhoeae is the second most common bacterial sexually transmitted infection in the world after Chlamydia trachomatis . The pathogen has developed resistance to every antibiotic currently approved for treatment, and multidrug-resistant strains have been identified globally. The current treatment recommended by the World Health Organization is ceftriaxone and azithromycin dual therapy. However, resistance to azithromycin and ceftriaxone are increasing and treatment failures have been reported. As a result, there is a critical need to develop novel strategies for mitigating the spread of antimicrobial-resistant N. gonorrhoeae through improved diagnosis and treatment of resistant infections. Strategies that are currently being pursued include developing molecular assays to predict resistance, utilizing higher doses of ceftriaxone, repurposing older antibiotics, and developing newer agents. In addition, efforts to discover a vaccine for N. gonorrhoeae have been reignited in recent years with the cross-protectivity provided by the N. meningitidis vaccine, with several new strategies and targets. Despite the significant progress that has been made, there is still much work ahead to combat antimicrobial-resistant N. gonorrhoeae globally.

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