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

作者：Leonor Sánchez-Busó, Michelle Cole, Gianfranco Spiteri, Michaela Day, Susanne Jacobsson, Daniel Golparian, Noshin Sajedi, Corin Yeats, Khalil Abudahab, Anthony Underwood, Benjamin Bluemel, David M. Aanensen, Magnus Unemo, 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 Epštein, Jelena Viktorova, Ndeindo Ndeikoundam, Béatrice Berçot, Cécile Bébéar, Florence Lot, Susanne Buder, Klaus Jansen, Vivì Miriagou, Georgios Rigakos, Vasilios Raftopoulos, Eszter Balla, Mária Dudás, Lena Rós Ásmundsdóttir, Guðrún Sigmundsdóttir, Guðrún Svanborg Hauksdóttir, Þórólfur Guðnason, Aoife Colgan, Brendan Crowley, Sinéad Saab, Paola Stefanelli, Anna Carannante, Patrizia Parodi, Gatis Pakarna, Raina Nikiforova, Antra Bormane, Elīna Dimiņa, Monique Perrin, Tamir Abdelrahman, Joël Mossong, Jean‐Claude Schmit, Friedrich Mühlschlegel, Christopher Barbara, Francesca Mifsud, Alje P. 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, Asunción Díaz, Raquel Abad, Inga Veličko, Magnus Unemo, Helen Fifer, Jill Shepherd, Lynsey Patterson · 发表于：The Lancet Microbe · 年份：2022 · DOI：10.1016/s2666-5247(22)00044-1 · 被引用次数：95 · 研究领域：Reproductive tract infections research、Bacterial Infections and Vaccines、Pneumonia and Respiratory Infections

BACKGROUND: 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...