Genomic Analysis and Comparison of Two Gonorrhea Outbreaks.
Genomic Analysis and Comparison of Two Gonorrhea Outbreaks.
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DOI：
10.1128/mbio.00525-16
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发表时间：
2016-06-28
期刊：
影响因子：
6.4
通讯作者：
Harris SR
中科院分区：
文献类型：
--
作者：
Didelot X;Dordel J;Whittles LK;Collins C;Bilek N;Bishop CJ;White PJ;Aanensen DM;Parkhill J;Bentley SD;Spratt BG;Harris SR
淋病是一种引起越来越多关注的性传播疾病，过去几年在英国报告的发病率大幅增加，对各种抗生素的耐药性水平不断上升。因此，了解其流行病学具有重大的生物医学意义，不仅在人口规模上，而且在直接传播水平上。然而，传统上用于淋病感染的分子分型技术不能提供足够的分辨率来研究这种精细的模式。在这里，我们对来自谢菲尔德和伦敦的两个地方分离株收集的237个分离株的基因组进行了测序，每个分离株都使用传统方法解析成一个类型。这两个数据集被选择为具有不同的流行病学特性：谢菲尔德的数据是在6年内从以异性恋为主的人群中收集的，而伦敦的数据是在半年内收集的，与男男性行为密切相关。根据谢菲尔德个人之间的接触者追踪信息，我们发现传播与最近共同祖先的中位时间3.4个月相关，上限为8个月，我们将其用作在两个数据集中确定可能传播联系的标准。在伦敦，我们发现传播主要发生在年龄、性取向和地点相似的个体之间，也有相同的艾滋病毒血清状态，这可能反映了血清分类和相关的风险行为。两组数据的比较表明，伦敦疫情涉及的病例是谢菲尔德疫情的十倍。最近淋病发病率和抗生素耐药性的增加引起了公众健康问题。成功的干预需要更好地了解传播模式，这是传统的分子流行病学技术所不能揭示的。在这里，我们研究了发生在英国谢菲尔德和伦敦的两次疫情。我们表明，全基因组测序提供了调查感染个体之间直接淋病传播的解决方案。将基因组测序与感染者的丰富流行病学信息相结合，揭示了几种传播途径和风险因素的重要性，可用于设计更好的控制措施。
Gonorrhea is a sexually transmitted disease causing growing concern, with a substantial increase in reported incidence over the past few years in the United Kingdom and rising levels of resistance to a wide range of antibiotics. Understanding its epidemiology is therefore of major biomedical importance, not only on a population scale but also at the level of direct transmission. However, the molecular typing techniques traditionally used for gonorrhea infections do not provide sufficient resolution to investigate such fine-scale patterns. Here we sequenced the genomes of 237 isolates from two local collections of isolates from Sheffield and London, each of which was resolved into a single type using traditional methods. The two data sets were selected to have different epidemiological properties: the Sheffield data were collected over 6 years from a predominantly heterosexual population, whereas the London data were gathered within half a year and strongly associated with men who have sex with men. Based on contact tracing information between individuals in Sheffield, we found that transmission is associated with a median time to most recent common ancestor of 3.4 months, with an upper bound of 8 months, which we used as a criterion to identify likely transmission links in both data sets. In London, we found that transmission happened predominantly between individuals of similar age, sexual orientation, and location and also with the same HIV serostatus, which may reflect serosorting and associated risk behaviors. Comparison of the two data sets suggests that the London epidemic involved about ten times more cases than the Sheffield outbreak. The recent increases in gonorrhea incidence and antibiotic resistance are cause for public health concern. Successful intervention requires a better understanding of transmission patterns, which is not uncovered by traditional molecular epidemiology techniques. Here we studied two outbreaks that took place in Sheffield and London, United Kingdom. We show that whole-genome sequencing provides the resolution to investigate direct gonorrhea transmission between infected individuals. Combining genome sequencing with rich epidemiological information about infected individuals reveals the importance of several transmission routes and risk factors, which can be used to design better control measures.