Ethnically diverse urban transmission networks of Neisseria gonorrhoeae without evidence of HIV serosorting
Ethnically diverse urban transmission networks of Neisseria gonorrhoeae without evidence of HIV serosorting
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DOI：
10.1136/sextrans-2019-054025
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发表时间：
2020-03-01
影响因子：
3.6
通讯作者：
Eyre, David W.
中科院分区：
文献类型：
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作者：
Dave, Jayshree;Paul, John;Eyre, David W.
目的 我们旨在通过联系基因组、流行病学和抗菌药物敏感性数据来描述不同城市人群中淋病的传播模式。方法 在 11 个月的时间内，从英国伦敦 Barts Health NHS Trust 性健康诊所就诊的患者中分离出的淋病奈瑟菌进行了全基因组测序和抗菌药物敏感性测试。我们结合实验室和患者数据来研究传播网络结构。结果 158 名患者的 158 个分离株具有相关的描述性数据。 129 名 (82%) 患者为男性，25 名 (16%) 为女性；四 (3%) 记录缺乏性别信息。自称种族为： 51 (32%) 英格兰/威尔士/苏格兰； 33 (21%) 白色，其他； 23 (15%) 英国黑人/非洲黑人/黑人，其他； 12 (8%) 加勒比海； 9 (6%) 南亚裔； 6 (4%) 混血儿； 10 (6%) 其他； 14 个（9%）的数据缺失。自我报告的性取向为 82 名 (52%) 男男性行为者 (MSM)； 49 (31%) 异性恋； 2 (1%) 双性恋； 25 人的数据缺失。二十二名 (14%) 患者 HIV 呈阳性。生成了 151 个分离株的全基因组序列数据，将 75 名患者（50%）与至少一个其他病例联系起来。使用测序数据，我们没有发现与特定种族群体（p=0.64）或艾滋病毒血清分类（p=0.35）相关的传播网络的证据。在 82 名拥有测序数据的 MSM/双性恋患者中，有 45 名 (55%) 属于≥ 2 例病例的集群，而拥有测序数据的异性恋患者则为 16/44 (36%) (p=0.06)。结论 我们使用大城市中相对较小的样本证明了传播网络中 50% 的患者之间存在联系。我们没有发现 HIV 血清分选的证据。我们的结果不支持用选型选择性来解释种族间淋病发病率的差异。
Objective We aimed to characterise gonorrhoea transmission patterns in a diverse urban population by linking genomic, epidemiological and antimicrobial susceptibility data.Methods Neisseria gonorrhoeae isolates from patients attending sexual health clinics at Barts Health NHS Trust, London, UK, during an 11-month period underwent whole-genome sequencing and antimicrobial susceptibility testing. We combined laboratory and patient data to investigate the transmission network structure.Results One hundred and fifty-eight isolates from 158 patients were available with associated descriptive data. One hundred and twenty-nine (82%) patients identified as male and 25 (16%) as female; four (3%) records lacked gender information. Self-described ethnicities were: 51 (32%) English/Welsh/Scottish; 33 (21%) white, other; 23 (15%) black British/black African/black, other; 12 (8%) Caribbean; 9 (6%) South Asian; 6 (4%) mixed ethnicity; and 10 (6%) other; data were missing for 14 (9%). Self-reported sexual orientations were 82 (52%) men who have sex with men (MSM); 49 (31%) heterosexual; 2 (1%) bisexual; data were missing for 25 individuals. Twenty-two (14%) patients were HIV positive. Whole-genome sequence data were generated for 151 isolates, which linked 75 (50%) patients to at least one other case. Using sequencing data, we found no evidence of transmission networks related to specific ethnic groups (p=0.64) or of HIV serosorting (p=0.35). Of 82 MSM/bisexual patients with sequencing data, 45 (55%) belonged to clusters of >= 2 cases, compared with 16/44 (36%) heterosexuals with sequencing data (p=0.06).Conclusion We demonstrate links between 50% of patients in transmission networks using a relatively small sample in a large cosmopolitan city. We found no evidence of HIV serosorting. Our results do not support assortative selectivity as an explanation for differences in gonorrhoea incidence between ethnic groups.