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Public health surve...
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Harris, Simon R.Infection Genomics, Wellcome Sanger Institute, Hinxton, United Kingdom
(author)
Public health surveillance of multidrug-resistant clones of Neisseria gonorrhoeae in Europe : a genomic survey
- Article/chapterEnglish2018
Publisher, publication year, extent ...
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Elsevier,2018
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:oru-68145
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-68145URI
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https://doi.org/10.1016/S1473-3099(18)30225-1DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Funding Agencies:European Centre for Disease Prevention and Control Centre for Genomic Pathogen Surveillance Örebro University Hospital Wellcome
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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.
Subject headings and genre
Added entries (persons, corporate bodies, meetings, titles ...)
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Cole, Michelle J.Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, National Infection Service, Public Health England, London, United Kingdom
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Spiteri, GianfrancoEuropean Centre for Disease Prevention and Control, Stockholm, Sweden
(author)
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Sanchez-Buso, LeonorInfection Genomics, Wellcome Sanger Institute, Hinxton, United Kingdom
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Golparian, Daniel,1984-Örebro universitet,Institutionen för medicinska vetenskaper,WHO Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University Hospital, Örebro, Sweden(Swepub:oru)degn
(author)
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Jacobsson, Susanne,1974-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,WHO Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University Hospital, Örebro, Sweden(Swepub:oru)sajn
(author)
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Goater, RichardCentre for Genomic Pathogen Surveillance, Wellcome Sanger Institute, Hinxton, United Kingdom
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Abudahab, KhalilCentre for Genomic Pathogen Surveillance, Wellcome Sanger Institute, Hinxton, United Kingdom
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Yeats, Corin A.Centre for Genomic Pathogen Surveillance, Wellcome Sanger Institute, Hinxton, United Kingdom
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Bercot, BeatriceSt Louis Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
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Borrego, Maria JoseNational Institute of Health, Lisbon, Portugal
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Crowley, BrendanSt James's Hospital, Dublin, Ireland
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Stefanelli, PaolaIstituto Superiore di Sanitá, Rome, Italy
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Tripodo, FrancescoAntimicrobial Resistance and Healthcare Associated Infections Reference Unit, National Infection Service, Public Health England, London, United Kingdom
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Abad, RaquelCarlos III Health Institute, Madrid, Spain
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Aanensen, David M.Centre for Genomic Pathogen Surveillance, Wellcome Sanger Institute, Hinxton, United Kingdom; Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
(author)
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Unemo, Magnus,1970-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,WHO Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University Hospital, Örebro, Sweden(Swepub:oru)muo
(author)
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Infection Genomics, Wellcome Sanger Institute, Hinxton, United KingdomAntimicrobial Resistance and Healthcare Associated Infections Reference Unit, National Infection Service, Public Health England, London, United Kingdom
(creator_code:org_t)
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In:The Lancet - Infectious diseases: Elsevier18:7, s. 758-7681473-30991474-4457
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