Observational studyThe Lancet. Infectious diseases2016
Whole-genome sequencing to determine transmission of Neisseria gonorrhoeae: an observational study.
Observational study in The Lancet. Infectious diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 100 papers, 2 of them syntheses that pooled it.
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Who cites it
100 citing papers in PubMed, 2 syntheses or guidelines pooled it, 170 citations in OpenAlex.
- Evaluation of parameters affecting performance and reliability of machine learning-based antibiotic susceptibility testing from whole genome sequencing data.PLoS computational biology · 2019Pooled it
- Neisseria gonorrhoeae molecular typing for understanding sexual networks and antimicrobial resistance transmission: A systematic review.The Journal of infection · 2018Pooled it
- Antimicrobial Resistance in Neisseria gonorrhoeae: Proceedings of the STAR Sexually Transmitted Infection-Clinical Trial Group Programmatic Meeting.Sexually transmitted diseases · 2019Trial
- Phenotypic and genotypic characterization ofJAC-antimicrobial resistance · 2026Article
- Bayesian mixture models for phylogenetic source attribution from consensus sequences and time since infection estimates.Statistical methods in medical research · 2025Article
- Whole-genome sequencing-based source tracing and infection control ofFrontiers in microbiology · 2025Article
- Exploring SNP filtering strategies: the influence of strict vs soft core.Microbial genomics · 2025Article
- Longitudinal genomic analysis of Neisseria gonorrhoeae transmission dynamics in Australia.Nature communications · 2024Article
- Integrating Genomic Data with the Development of CRISPR-Based Point-of-Care-Testing for Bacterial Infections.Current clinical microbiology reports · 2024Review
- Time Required for Nanopore Whole-Genome Sequencing of Neisseria gonorrhoeae for Identification of Phylogenetic Relationships.The Journal of infectious diseases · 2023Article
- Epidemiology and determinants of reemerging bacterial sexually transmitted infections (STIs) and emerging STIs in Europe.The Lancet regional health. Europe · 2023Review
- A Genomic Perspective on the Near-term Impact of Doxycycline Post-exposure Prophylaxis on Neisseria gonorrhoeae Antimicrobial Resistance.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Sustained Transmission of Neisseria gonorrhoeae Strains with High-Level Azithromycin Resistance (MIC ≥ 256 μg/mL) in Argentina, 2018 to 2022.Microbiology spectrum · 2023Article
- A genomic perspective on the near-term impact of doxycycline post-exposure prophylaxis onmedRxiv : the preprint server for health sciences · 2023Article
- Travel-associated lineages and unique endemic antimicrobial-susceptible lineages ofMicrobial genomics · 2023Article
- Machine learning models for Neisseria gonorrhoeae antimicrobial susceptibility tests.Annals of the New York Academy of Sciences · 2023Review
- Prophage-encoded immune evasion factors are critical forCell genomics · 2022Article
- Prevalence and antimicrobial resistance profiles of Neisseria gonorrhea and Chlamydia trachomatis isolated from individuals attending STD clinics in Kampala, Uganda.African health sciences · 2022Article
- Naturally occurringMicrobial genomics · 2022Article
- Within-Host Genetic Variation in Neisseria gonorrhoeae over the Course of Infection.Microbiology spectrum · 2022Article
40 more citing papers are in PubMed but not listed here.
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Authors and funding
18 authors at 8 institutions in 2 countries.
Funding
Abstract
backgroundNew approaches are urgently required to address increasing rates of gonorrhoea and the emergence and global spread of antibiotic-resistant Neisseria gonorrhoeae. We used whole-genome sequencing to study transmission and track resistance in N gonorrhoeae isolates.
methodsWe did whole-genome sequencing of isolates obtained from samples collected from patients attending sexual health services in Brighton, UK, between Jan 1, 2011, and March 9, 2015. We also included isolates from other UK locations, historical isolates from Brighton, and previous data from a US study. Samples from symptomatic patients and asymptomatic sexual health screening underwent nucleic acid amplification testing; positive samples and all samples from symptomatic patients were cultured for N gonorrhoeae, and resulting isolates were whole-genome sequenced. Cefixime susceptibility testing was done in selected isolates by agar incorporation, and we used sequence data to determine multi-antigen sequence types and penA genotypes. We derived a transmission nomogram to determine the plausibility of direct or indirect transmission between any two cases depending on the time between samples: estimated mutation rates, plus diversity noted within patients across anatomical sites and probable transmission pairs, were used to fit a coalescent model to determine the number of single nucleotide polymorphisms expected.
findings1407 (98%) of 1437 Brighton isolates between Jan 1, 2011, and March 9, 2015 were successfully sequenced. We identified 1061 infections from 907 patients. 281 (26%) of these infections were indistinguishable (ie, differed by zero single nucleotide polymorphisms) from one or more previous cases, and 786 (74%) had evidence of a sampled direct or indirect Brighton source. We observed multiple related samples across geographical locations. Of 1273 infections in Brighton (including historical data), 225 (18%) were linked to another case elsewhere in the UK, and 115 (9%) to a case in the USA. Four lineages initially identified in Brighton could be linked to 70 USA sequences, including 61 from a lineage carrying the mosaic penA XXXIV allele, which is associated with reduced cefixime susceptibility.
interpretationWe present a whole-genome-sequencing-based tool for genomic contact tracing of N gonorrhoeae and demonstrate local, national, and international transmission. Whole-genome sequencing can be applied across geographical boundaries to investigate gonorrhoea transmission and to track antimicrobial resistance.
fundingOxford National Institute for Health Research Health Protection Research Unit and Biomedical Research Centre.
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