The Distribution and Spread of Susceptible and Resistant Neisseria gonorrhoeae Across Demographic Groups in a Major Metropolitan Center.
The Distribution and Spread of Susceptible and Resistant Neisseria gonorrhoeae Across Demographic Groups in a Major Metropolitan Center.
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DOI：
10.1093/cid/ciaa1229
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发表时间：
2021-11-02
期刊：
影响因子：
--
通讯作者：
Grad YH
中科院分区：
文献类型：
--
作者：
Mortimer TD;Pathela P;Crawley A;Rakeman JL;Lin Y;Harris SR;Blank S;Schillinger JA;Grad YH
在美国，淋病的基因组流行病学研究主要集中在国家对抗生素耐药性的监测上，耐药株和敏感株的人口群体之间的局部传播模式尚不清楚。我们分析了在纽约市(NYC)公共卫生实验室培养的897株淋球菌分离株的基因组序列、抗生素敏感性和患者数据的便利样本，这些分离株来自纽约市卫生和精神卫生部门(DOHMH)性健康诊所(SHC)的患者，主要是2012-2013年。我们重建了淋球菌的系统发育，使用10个非重组单核苷酸多态阈值定义了传播簇，测试了人口统计学群体的聚集性，并将NYC分离株置于全球系统发育背景中。纽约市淋球菌的系统发育反映了全球多样性，分离株来自全球流行谱系中的22/23(96%)。根据患者的性行为(P<；.001)和种族/民族(P<；.001)，分离株在系统发育树上聚集。与异性恋者(P<；.001)和白人异性恋者(P<；.01)相比，男男性行为者分离株中抗生素的最低抑菌浓度更高。在我们的数据集中，所有淋球菌的大传播群(≥10个样本)都对环丙沙星、头孢曲松和阿奇霉素敏感，并包括来自不同人口统计学群体的患者的分离株。所有的大型传播群对淋病疗法都很敏感，这表明对经验性疗法的耐药性不是传播的主要驱动因素，尽管耐药性的风险在不同的人口群体中有所不同。需要对本地传输网络进行进一步研究，以确定传输的驱动因素。我们使用淋病奈瑟菌基因组以及临床和人口学数据来研究纽约市的传播。我们的结果表明淋病在人群中传播，并表明抗生素耐药性不是淋病传播的主要驱动因素。
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. We analyzed a convenience sample of genome sequences, antibiotic susceptibility, and patient data from 897 gonococcal isolates cultured at the New York City (NYC) Public Health Laboratory from NYC Department of Health and Mental Hygiene (DOHMH) Sexual Health Clinic (SHC) patients, primarily in 2012–2013. We reconstructed the gonococcal phylogeny, defined transmission clusters using a 10 nonrecombinant single nucleotide polymorphism threshold, tested for clustering of demographic groups, and placed NYC isolates in a global phylogenetic context. 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 < .001) and race/ethnicity (P < .001). Minimum inhibitory concentrations were higher across antibiotics in isolates from men who have sex with men compared to heterosexuals (P < .001) and white heterosexuals compared to black heterosexuals (P < .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. 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. We used Neisseria gonorrhoeae genomes together with clinical and demographic data to study transmission in New York City. Our results indicate transmission across demographic groups and suggest that antibiotic resistance is not the main driver of gonorrhea spread.
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影响因子：
56.3
作者：
Grad, Yonatan H.;Kirkcaldy, Robert D.;Trees, David;Dordel, Janina;Harris, Simon R.;Goldstein, Edward;Weinstock, Hillard;Parkhill, Julian;Hanage, William P.;Bentley, Stephen;Lipsitch, Marc
通讯作者：
Lipsitch, Marc
影响因子：
3.6
作者：
Dave, Jayshree;Paul, John;Eyre, David W.
通讯作者：
Eyre, David W.
影响因子：
3.1
作者：
Pathela P;Klingler EJ;Guerry SL;Bernstein KT;Kerani RP;Llata L;Mark HD;Tabidze I;Rietmeijer CA;SSuN Working Group
通讯作者：
SSuN Working Group
影响因子：
1.7
作者：
Bankevich, Anton;Nurk, Sergey;Pevzner, Pavel A.
通讯作者：
Pevzner, Pavel A.
影响因子：
11.8
作者：
Bauer, HM;Mark, KE;Bolan, G
通讯作者：
Bolan, G