ArticleBMC genomics2020
Genomic evolution of Neisseria gonorrhoeae since the preantibiotic era (1928-2013): antimicrobial use/misuse selects for resistance and drives evolution.
Article in BMC genomics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 3 of them syntheses that pooled it.
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47 citing papers in PubMed, 3 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- Temporal and geographic trends in extended-spectrum cephalosporins resistance among Neisseria gonorrhoeae isolates worldwide: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Global trends of antimicrobial resistance rates inFrontiers in pharmacology · 2024Pooled it
- Global status of Azithromycin and Erythromycin Resistance Rates inThe Yale journal of biology and medicine · 2022Pooled it
- Antimicrobial resistance crisis in STIs: Gonorrhea andNew microbes and new infections · 2026Review
- Emergence, evolution and temporal spread of ceftriaxone-resistantEmerging microbes & infections · 2025Article
- CommensalAnnual review of microbiology · 2025Review
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- Exploring SNP filtering strategies: the influence of strict vs soft core.Microbial genomics · 2025Article
- Zap the clap with DNA: a novel microbicide for preventingAntimicrobial agents and chemotherapy · 2024Article
- Longitudinal genomic analysis of Neisseria gonorrhoeae transmission dynamics in Australia.Nature communications · 2024Article
- In silico gepotidacin target mining among 33 213 global Neisseria gonorrhoeae genomes from 1928 to 2023 combined with gepotidacin MIC testing of 22 gonococcal isolates with different GyrA and ParC substitutions.The Journal of antimicrobial chemotherapy · 2024Article
- Genome analysis of Streptococcus spp. isolates from animals in pre-antibiotic era with respect to antibiotic susceptibility and virulence gene profiles.Veterinary research · 2024Article
- Complete reference genomes of two ceftriaxone-resistantMicrobiology resource announcements · 2024Article
- Characterizing the diversity and commensal origins ofMicrobial genomics · 2024Article
- Article
- High-level in vitro resistance to gentamicin acquired in a stepwise manner in Neisseria gonorrhoeae.The Journal of antimicrobial chemotherapy · 2023Article
- The Gonococcal Genetic Island defines distinct sub-populations ofMicrobial genomics · 2023Article
- Whole genome analysis and antimicrobial resistance ofFrontiers in microbiology · 2023Article
- CanB is a metabolic mediator of antibiotic resistance in Neisseria gonorrhoeae.Nature microbiology · 2023Article
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Authors and funding
8 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundMultidrug-resistant Neisseria gonorrhoeae strains are prevalent, threatening gonorrhoea treatment globally, and understanding of emergence, evolution, and spread of antimicrobial resistance (AMR) in gonococci remains limited. We describe the genomic evolution of gonococci and their AMR, related to the introduction of antimicrobial therapies, examining isolates from 1928 (preantibiotic era) to 2013 in Denmark. This is, to our knowledge, the oldest gonococcal collection globally.
methodsLyophilised isolates were revived and examined using Etest (18 antimicrobials) and whole-genome sequencing (WGS). Quality-assured genome sequences were obtained for 191 viable and 40 non-viable isolates and analysed with multiple phylogenomic approaches.
resultsGonococcal AMR, including an accumulation of multiple AMR determinants, started to emerge particularly in the 1950s-1970s. By the twenty-first century, resistance to most antimicrobials was common. Despite that some AMR determinants affect many physiological functions and fitness, AMR determinants were mainly selected by the use/misuse of gonorrhoea therapeutic antimicrobials. Most AMR developed in strains belonging to one multidrug-resistant (MDR) clade with close to three times higher genomic mutation rate. Modern N. gonorrhoeae was inferred to have emerged in the late-1500s and its genome became increasingly conserved over time.
conclusionsWGS of gonococci from 1928 to 2013 showed that no AMR determinants, except penB, were in detectable frequency before the introduction of gonorrhoea therapeutic antimicrobials. The modern gonococcus is substantially younger than previously hypothesized and has been evolving into a more clonal species, driven by the use/misuse of antimicrobials. The MDR gonococcal clade should be further investigated for early detection of strains with predispositions to develop and maintain MDR and for initiation of public health interventions.
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