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Public health surveillance of multidrug-resistant clones of Neisseria gonorrhoeae in Europe: a genomic survey

2018-07Journal article Restricted access
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dc.contributor.authorHarris, Simon R.
dc.contributor.authorCole, Michelle J.
dc.contributor.authorSpiteri, Gianfranco
dc.contributor.authorSánchez-Busó, Leonor
dc.contributor.authorGolparian, Daniel
dc.contributor.authorJacobsson, Susanne
dc.contributor.authorGoater, Richard
dc.contributor.authorAbudahab, Khalil
dc.contributor.authorYeats, Corin A.
dc.contributor.authorBercot, Beatrice
dc.contributor.authorBorrego, Maria José
dc.contributor.authorCrowley, Brendan
dc.contributor.authorStefanelli, Paola
dc.contributor.authorTripodo, Francesco
dc.contributor.authorAbad, Raquel
dc.contributor.authorAanensen, David M.
dc.contributor.authorUnemo, Magnus
dc.contributor.authorEuro-GASP study group
dc.date.accessioned2019-03-20T15:19:29Z
dc.date.available2019-03-20T15:19:29Z
dc.date.issued2018-07
dc.descriptionEuro-GASP study group: INSA - Maria José Borregopt_PT
dc.descriptionFree PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010626/pt_PT
dc.description.abstractBackground: 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.pt_PT
dc.description.sponsorshipThe European Centre for Disease Prevention and Control, The Centre for Genomic Pathogen Surveillance, Örebro University Hospital, and Wellcome.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationLancet Infect Dis. 2018 Jul;18(7):758-768. doi: 10.1016/S1473-3099(18)30225-1. Epub 2018 May 15pt_PT
dc.identifier.doi10.1016/S1473-3099(18)30225-1pt_PT
dc.identifier.issn1473-3099
dc.identifier.urihttp://hdl.handle.net/10400.18/6243
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier/ Lancetpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/pii/S1473309918302251?via%3Dihubpt_PT
dc.subjectNeisseria gonorrhoeaept_PT
dc.subjectPublic Health Surveillancept_PT
dc.subjectMultidrug-resistantspt_PT
dc.subjectEuropept_PT
dc.subjectGenomic Surveypt_PT
dc.subjectInfecções Sexualmente Transmissíveispt_PT
dc.titlePublic health surveillance of multidrug-resistant clones of Neisseria gonorrhoeae in Europe: a genomic surveypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage768pt_PT
oaire.citation.issue7pt_PT
oaire.citation.startPage758pt_PT
oaire.citation.titleLancet Infectious Diseasespt_PT
oaire.citation.volume18pt_PT
rcaap.embargofctPolítica editorial da revista.pt_PT
rcaap.rightsembargoedAccesspt_PT
rcaap.typearticlept_PT

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