Tatum D Mortimer1, Preeti Pathela2, Addie Crawley2, Jennifer L Rakeman3, Ying Lin3, Simon R Harris4, Susan Blank2,5, Julia A Schillinger2,5, Yonatan H Grad1,6. 1. Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, United States of America. 2. Bureau of Sexually Transmitted Infections, New York City Department of Health and Mental Hygiene, New York City, United States of America. 3. Bureau of Public Health Laboratory, New York City Department of Health and Mental Hygiene, New York City, United States of America. 4. Microbiotica Ltd, Biodata Innovation Centre, Wellcome Genome Campus, Hinxton, United Kingdom. 5. Division of STD Prevention, National Center for HIV, Hepatitis, STD, and TB Prevention, US Centers for Disease Control and Prevention, Atlanta, United States of America. 6. Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America.
Abstract
BACKGROUND: Genomic epidemiology studies of gonorrhea in the United States have primarily focused on national surveillance for antibiotic resistance, and patterns of local transmission between demographic groups of resistant and susceptible strains are unknown. METHODS: We analyzed a convenience sample of genome sequences, antibiotic susceptibility, and patient data from 897 gonococcal isolates cultured at the NYC Public Health Laboratory from NYC Department of Health and Mental Hygiene (DOHMH) Sexual Health Clinic (SHC) patients, primarily in 2012-13. We reconstructed the gonococcal phylogeny, defined transmission clusters using a 10 non-recombinant single nucleotide polymorphism threshold, tested for clustering of demographic groups, and placed NYC isolates in a global phylogenetic context. RESULTS: The NYC gonococcal phylogeny reflected global diversity with isolates from 22/23 of the prevalent global lineages (96%). Isolates clustered on the phylogeny by patient sexual behavior (p&0.001) and race/ethnicity (p&0.001). Minimum inhibitory concentrations were higher across antibiotics in isolates from men who have sex with men compared to heterosexuals (p&0.001) and white heterosexuals compared to black heterosexuals (p&0.01). In our dataset, all large transmission clusters (≥10 samples) of N. gonorrhoeae were susceptible to ciprofloxacin, ceftriaxone, and azithromycin and comprised isolates from patients across demographic groups. CONCLUSIONS: All large transmission clusters were susceptible to gonorrhea therapies, suggesting that resistance to empiric therapy was not a main driver of spread, even as risk for resistance varied across demographic groups. Further study of local transmission networks is needed to identify drivers of transmission.
BACKGROUND: Genomic epidemiology studies of gonorrhea in the United States have primarily focused on national surveillance for antibiotic resistance, and patterns of local transmission between demographic groups of resistant and susceptible strains are unknown. METHODS: We analyzed a convenience sample of genome sequences, antibiotic susceptibility, and patient data from 897 gonococcal isolates cultured at the NYC Public Health Laboratory from NYC Department of Health and Mental Hygiene (DOHMH) Sexual Health Clinic (SHC) patients, primarily in 2012-13. We reconstructed the gonococcal phylogeny, defined transmission clusters using a 10 non-recombinant single nucleotide polymorphism threshold, tested for clustering of demographic groups, and placed NYC isolates in a global phylogenetic context. RESULTS: The NYC gonococcal phylogeny reflected global diversity with isolates from 22/23 of the prevalent global lineages (96%). Isolates clustered on the phylogeny by patient sexual behavior (p&0.001) and race/ethnicity (p&0.001). Minimum inhibitory concentrations were higher across antibiotics in isolates from men who have sex with men compared to heterosexuals (p&0.001) and white heterosexuals compared to black heterosexuals (p&0.01). In our dataset, all large transmission clusters (≥10 samples) of N. gonorrhoeae were susceptible to ciprofloxacin, ceftriaxone, and azithromycin and comprised isolates from patients across demographic groups. CONCLUSIONS: All large transmission clusters were susceptible to gonorrhea therapies, suggesting that resistance to empiric therapy was not a main driver of spread, even as risk for resistance varied across demographic groups. Further study of local transmission networks is needed to identify drivers of transmission.
Authors: Leonor Sánchez-Busó; Corin A Yeats; Benjamin Taylor; Richard J Goater; Anthony Underwood; Khalil Abudahab; Silvia Argimón; Kevin C Ma; Tatum D Mortimer; Daniel Golparian; Michelle J Cole; Yonatan H Grad; Irene Martin; Brian H Raphael; William M Shafer; Katy Town; Teodora Wi; Simon R Harris; Magnus Unemo; David M Aanensen Journal: Genome Med Date: 2021-04-19 Impact factor: 11.117
Authors: Kevin C Ma; Tatum D Mortimer; Marissa A Duckett; Allison L Hicks; Nicole E Wheeler; Leonor Sánchez-Busó; Yonatan H Grad Journal: Nat Commun Date: 2020-10-23 Impact factor: 14.919