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Europe-wide expansion and eradication of multidrug-resistant Neisseria gonorrhoeae lineages: a genomic surveillance study

2022-06Journal article Open access
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dc.contributor.authorSánchez-Busó, Leonor
dc.contributor.authorCole, Michelle J.
dc.contributor.authorSpiteri, Gianfranco
dc.contributor.authorDay, Michaela
dc.contributor.authorJacobsson, Susanne
dc.contributor.authorGolparian, Daniel
dc.contributor.authorSajedi, Noshin
dc.contributor.authorYeats, Corin A.
dc.contributor.authorAbudahab, Khalil
dc.contributor.authorUnderwood, Anthony
dc.contributor.authorBluemel, Benjamin
dc.contributor.authorAanensen, David M.
dc.contributor.authorUnemo, Magnus
dc.contributor.authorPleininger, Sonja
dc.contributor.authorIndra, Alexander
dc.contributor.authorDe Baetselier, Irith
dc.contributor.authorVanden Berghe, Wim
dc.contributor.authorHunjak, Blaženka
dc.contributor.authorBlažić, Tatjana Nemeth
dc.contributor.authorMaikanti-Charalambous, Panayiota
dc.contributor.authorPieridou, Despo
dc.contributor.authorZákoucká, Hana
dc.contributor.authorŽemličková, Helena
dc.contributor.authorHoffmann, Steen
dc.contributor.authorCowan, Susan
dc.contributor.authorSchwartz, Lasse Jessen
dc.contributor.authorPeetso, Rita
dc.contributor.authorEpstein, Jevgenia
dc.contributor.authorViktorova, Jelena
dc.contributor.authorNdeikoundam, Ndeindo
dc.contributor.authorBercot, Beatrice
dc.contributor.authorBébéar, Cécile
dc.contributor.authorLot, Florence
dc.contributor.authorBuder, Susanne
dc.contributor.authorJansen, Klaus
dc.contributor.authorMiriagou, Vivi
dc.contributor.authorRigakos, Georgios
dc.contributor.authorRaftopoulos, Vasilios
dc.contributor.authorBalla, Eszter
dc.contributor.authorDudás, Mária
dc.contributor.authorÁsmundsdóttir, Lena Rós
dc.contributor.authorSigmundsdóttir, Guðrún
dc.contributor.authorHauksdóttir, Guðrún Svanborg
dc.contributor.authorGudnason, Thorolfur
dc.contributor.authorColgan, Aoife
dc.contributor.authorCrowley, Brendan
dc.contributor.authorSaab, Sinéad
dc.contributor.authorStefanelli, Paola
dc.contributor.authorCarannante, Anna
dc.contributor.authorParodi, Patrizia
dc.contributor.authorPakarna, Gatis
dc.contributor.authorNikiforova, Raina
dc.contributor.authorBormane, Antra
dc.contributor.authorDimina, Elina
dc.contributor.authorPerrin, Monique
dc.contributor.authorAbdelrahman, Tamir
dc.contributor.authorMossong, Joël
dc.contributor.authorSchmit, Jean-Claude
dc.contributor.authorMühlschlegel, Friedrich
dc.contributor.authorBarbara, Christopher
dc.contributor.authorMifsud, Francesca
dc.contributor.authorVan Dam, Alje
dc.contributor.authorVan Benthem, Birgit
dc.contributor.authorVisser, Maartje
dc.contributor.authorLinde, Ineke
dc.contributor.authorKløvstad, Hilde
dc.contributor.authorCaugant, Dominique
dc.contributor.authorMłynarczyk-Bonikowska, Beata
dc.contributor.authorAzevedo, Jacinta
dc.contributor.authorBorrego, Maria-José
dc.contributor.authorNascimento, Marina Lurdes Ramos
dc.contributor.authorPavlik, Peter
dc.contributor.authorKlavs, Irena
dc.contributor.authorMurnik, Andreja
dc.contributor.authorJeverica, Samo
dc.contributor.authorKustec, Tanja
dc.contributor.authorVázquez Moreno, Julio
dc.contributor.authorDiaz, Asuncion
dc.contributor.authorAbad, Raquel
dc.contributor.authorVelicko, Inga
dc.contributor.authorUnemo, Magnus
dc.contributor.authorFifer, Helen
dc.contributor.authorShepherd, Jill
dc.contributor.authorPatterson, Lynsey
dc.date.accessioned2023-03-24T12:06:56Z
dc.date.available2023-03-24T12:06:56Z
dc.date.issued2022-06
dc.descriptionCentre for Genomic Pathogen Surveillance and the Euro-GASP study group: Sonja Pleininger, Alexander Indra, Irith De Baetselier, Wim Vanden Berghe, Blaženka Hunjak, Tatjana Nemeth Blažić, Panayiota Maikanti-Charalambous, Despo Pieridou, Hana Zákoucká, Helena Žemličková, Steen Hoffmann, Susan Cowan, Lasse Jessen Schwartz, Rita Peetso, Jevgenia Epstein, Jelena Viktorova, Ndeindo Ndeikoundam, Beatrice Bercot, Cécile Bébéar, Florence Lot, Susanne Buder, Klaus Jansen, Vivi Miriagou, Georgios Rigakos, Vasilios Raftopoulos, Eszter Balla, Mária Dudás, Lena Rós Ásmundsdóttir, Guðrún Sigmundsdóttir, Guðrún Svanborg Hauksdóttir, Thorolfur Gudnason, Aoife Colgan, Brendan Crowley, Sinéad Saab, Paola Stefanelli, Anna Carannante, Patrizia Parodi, Gatis Pakarna, Raina Nikiforova, Antra Bormane, Elina Dimina, Monique Perrin, Tamir Abdelrahman, Joël Mossong, Jean-Claude Schmit, Friedrich Mühlschlegel, Christopher Barbara, Francesca Mifsud, Alje Van Dam, Birgit Van Benthem, Maartje Visser, Ineke Linde, Hilde Kløvstad, Dominique Caugant, Beata Młynarczyk-Bonikowska, Jacinta Azevedo, Maria-José Borrego, Marina Lurdes Ramos Nascimento, Peter Pavlik, Irena Klavs, Andreja Murnik, Samo Jeverica, Tanja Kustec, Julio Vázquez Moreno, Asuncion Diaz, Raquel Abad, Inga Velicko, Magnus Unemo, Helen Fifer, Jill Shepherd, Lynsey Pattersonpt_PT
dc.description.abstractBackground: Genomic surveillance using quality-assured whole-genome sequencing (WGS) together with epidemiological and antimicrobial resistance (AMR) data is essential to characterise the circulating Neisseria gonorrhoeae lineages and their association to patient groups (defined by demographic and epidemiological factors). In 2013, the European gonococcal population was characterised genomically for the first time. We describe the European gonococcal population in 2018 and identify emerging or vanishing lineages associated with AMR and epidemiological characteristics of patients, to elucidate recent changes in AMR and gonorrhoea epidemiology in Europe. Methods: We did WGS on 2375 gonococcal isolates from 2018 (mainly Sept 1-Nov 30) in 26 EU and EEA countries. Molecular typing and AMR determinants were extracted from quality-checked genomic data. Association analyses identified links between genomic lineages, AMR, and epidemiological data. Findings: Azithromycin-resistant N gonorrhoeae (8·0% [191/2375] in 2018) is rising in Europe due to the introduction or emergence and subsequent expansion of a novel N gonorrhoeae multi-antigen sequence typing (NG-MAST) genogroup, G12302 (132 [5·6%] of 2375; N gonorrhoeae sequence typing for antimicrobial resistance [NG-STAR] clonal complex [CC]168/63), carrying a mosaic mtrR promoter and mtrD sequence and found in 24 countries in 2018. CC63 was associated with pharyngeal infections in men who have sex with men. Susceptibility to ceftriaxone and cefixime is increasing, as the resistance-associated lineage, NG-MAST G1407 (51 [2·1%] of 2375), is progressively vanishing since 2009-10. Interpretation: Enhanced gonococcal AMR surveillance is imperative worldwide. WGS, linked to epidemiological and AMR data, is essential to elucidate the dynamics in gonorrhoea epidemiology and gonococcal populations as well as to predict AMR. When feasible, WGS should supplement the national and international AMR surveillance programmes to elucidate AMR changes over time. In the EU and EEA, increasing low-level azithromycin resistance could threaten the recommended ceftriaxone-azithromycin dual therapy, and an evidence-based clinical azithromycin resistance breakpoint is needed. Nevertheless, increasing ceftriaxone susceptibility, declining cefixime resistance, and absence of known resistance mutations for new treatments (zoliflodacin, gepotidacin) are promising.pt_PT
dc.description.sponsorshipThis study was supported by the European Centre for Disease Prevention and Control, the Centre for Genomic Pathogen Surveillance, the Li Ka Shing Foundation (Big Data Institute, University of Oxford), the Wellcome Genome Campus, the Foundation for Medical Research at Örebro University Hospital, and grants from Wellcome (098051 and 099202). LSB was funded by Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana (Plan GenT CDEI-06/20-B), Valencia, Spain, and Ministry of Science, Innovation and Universities (PID2020–120113RA-I00), Spain, at the time of analysing and writing this manuscript.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationLancet Microbe. 2022 Jun;3(6):e452-e463. doi: 10.1016/S2666-5247(22)00044-1. Epub 2022 May 10.pt_PT
dc.identifier.doi10.1016/S2666-5247(22)00044-1pt_PT
dc.identifier.issn2666-5247
dc.identifier.urihttp://hdl.handle.net/10400.18/8605
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(22)00044-1/fulltextpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectEuropean Centre for Disease Prevention and Controlpt_PT
dc.subjectCentre for Genomic Pathogen Surveillancept_PT
dc.subjectÖrebro University Hospitalpt_PT
dc.subjectWellcomept_PT
dc.subjectEuropept_PT
dc.subjectInfecções Sexualmente Transmissíveispt_PT
dc.subjectResistência aos Antimicrobianospt_PT
dc.titleEurope-wide expansion and eradication of multidrug-resistant Neisseria gonorrhoeae lineages: a genomic surveillance studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPagee463pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPagee452pt_PT
oaire.citation.titleThe Lancet Microbept_PT
oaire.citation.volume3pt_PT
rcaap.embargofctAcesso de acordo com página web do editor da revista.pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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