Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/19454
Title: Whole-genome sequencing reveals transmission of gonococcal antibiotic resistance among men who have sex with men: an observational study.
Authors: Kwong, Jason C;Chow, Eric P F;Stevens, Kerrie;Stinear, Timothy P;Seemann, Torsten;Fairley, Christopher K;Chen, Marcus Y;Howden, Benjamin P
Affiliation: Victorian Life Sciences Computation Initiative, University of Melbourne, Melbourne, Victoria, Australia
Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
Doherty Applied Microbial Genomics, Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Mar-2018
EDate: 2017-12-15
Citation: Sexually transmitted infections 2018; 94(2): 151-157
Abstract: Drug-resistant Neisseria gonorrhoeae are now a global public health threat. Direct transmission of antibiotic-resistant gonococci between individuals has been proposed as a driver for the increased transmission of resistance, but direct evidence of such transmission is limited. Whole-genome sequencing (WGS) has superior resolution to investigate outbreaks and disease transmission compared with traditional molecular typing methods such as multilocus sequence typing (MLST) and N. gonorrhoeae multiantigen sequence (NG-MAST). We therefore aimed to systematically investigate the transmission of N. gonorrhoeae between men in sexual partnerships using WGS to compare isolates and their resistance to antibiotics at a genome level. 458 couples from a large prospective cohort of men who have sex with men (MSM) tested for gonorrhoea together between 2005 and 2014 were included, and WGS was conducted on all isolates from couples where both men were culture-positive for N. gonorrhoeae. Resistance-determining sequences were identified from genome assemblies, and comparison of isolates between and within individuals was performed by pairwise single nucleotide polymorphism and pangenome comparisons, and in silico predictions of NG-MAST and MLST. For 33 of 34 (97%; 95% CI 85% to 100%) couples where both partners were positive for gonorrhoea, the resistance-determining genes and mutations were identical in isolates from each partner (94 isolates in total). Resistance determinants in isolates from 23 of 23 (100%; 95% CI 86% to 100%) men with multisite infections were also identical within an individual. These partner and within-host isolates were indistinguishable by NG-MAST, MLST and whole genomic comparisons. These data support the transmission of antibiotic-resistant strains between sexual partners as a key driver of resistance rates in gonorrhoea among MSM. This improved understanding of the transmission dynamics of N. gonorrhoeae between sexual partners will inform treatment and prevention guidelines.
URI: http://ahro.austin.org.au/austinjspui/handle/1/19454
DOI: 10.1136/sextrans-2017-053287
ORCID: 0000-0003-1766-0657
0000-0003-0237-1473
PubMed URL: 29247013
Type: Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Subjects: antibiotic resistance
gonorrhoea
modes of transmission
Appears in Collections:Journal articles

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