Public health surveillance of multidrug-resistant clones of Neisseria gonorrhoeae in Europe: a genomic survey
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Le résumé fourni par la source
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. FUNDING: The European Centre for Disease Prevention and Control, The Centre for Genomic Pathogen Surveillance, Örebro University Hospital, and Wellcome.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Public health surveillance of multidrug-resistant clones of Neisseria gonorrhoeae in Europe: a genomic survey
- Date Crossref
- 01/07/2018
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Wellcome Sanger Institute Infection Genomics pays non établi dans la noticeOrganisation à but non lucratif
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Public Health England pays non établi dans la noticeOrganisme public
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European Centre for Disease Prevention and Control pays non établi dans la noticeOrganisme public
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Örebro University pays non établi dans la noticeUniversité ou école supérieure
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Örebro University Hospital pays non établi dans la noticeÉtablissement de santé
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Assistance Publique – Hôpitaux de Paris pays non établi dans la noticeÉtablissement de santé
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National Institute of Health Dr. Ricardo Jorge pays non établi dans la noticeInstitution
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St. James's Hospital pays non établi dans la noticeÉtablissement de santé
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Istituto Superiore di Sanità pays non établi dans la noticeOrganisme public
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Instituto de Salud Carlos III pays non établi dans la noticeOrganisation à but non lucratif
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University of Oxford Wellcome Sanger Institute pays non établi dans la noticeUniversité ou école supérieure
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Antimicrobial Resistance and Healthcare Associated Infections Reference Unit pays non établi dans la noticeInstitution
Infection Genomics — Wellcome Sanger Institute, Public Health England et European Centre for Disease Prevention and Control, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.