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Nat Microbiol. 2019 Nov;4(11):1941-1950. doi: 10.1038/s41564-019-0501-y. Epub 2019 Jul 29.

The impact of antimicrobials on gonococcal evolution.

Author information

1
Pathogen Genomics, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK.
2
WHO Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, National Reference Laboratory for Sexually Transmitted Infections, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
3
Helsinki Institute for Information Technology, Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland.
4
Department of Biostatistics, University of Oslo, Oslo, Norway.
5
Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, MA, USA.
6
Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
7
Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan.
8
Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
9
Faculty of Classics, University of Cambridge, Cambridge, UK.
10
Pathogen Genomics, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK. sh16@sanger.ac.uk.

Abstract

The sexually transmitted pathogen Neisseria gonorrhoeae is regarded as being on the way to becoming an untreatable superbug. Despite its clinical importance, little is known about its emergence and evolution, and how this corresponds with the introduction of antimicrobials. We present a genome-based phylogeographical analysis of 419 gonococcal isolates from across the globe. Results indicate that modern gonococci originated in Europe or Africa, possibly as late as the sixteenth century and subsequently disseminated globally. We provide evidence that the modern gonococcal population has been shaped by antimicrobial treatment of sexually transmitted infections as well as other infections, leading to the emergence of two major lineages with different evolutionary strategies. The well-described multidrug-resistant lineage is associated with high rates of homologous recombination and infection in high-risk sexual networks. A second, multisusceptible lineage is more associated with heterosexual networks, with potential implications for infection control.

PMID:
31358980
PMCID:
PMC6817357
DOI:
10.1038/s41564-019-0501-y
[Indexed for MEDLINE]
Free PMC Article

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