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. 2022 Aug 2;12(8):e061040.
doi: 10.1136/bmjopen-2022-061040.

Molecular characterisation of Neisseria gonorrhoeae associated with disseminated gonococcal infections in Queensland, Australia: a retrospective surveillance study

Christine J D Guglielmino  1 , Sumeet Sandhu  1 , Colleen L Lau  2   3 , Cameron Buckely  4   5 , Ella Trembizki  4 , David M Whiley  4   5 , Amy V Jennison  6
Affiliations

Molecular characterisation of Neisseria gonorrhoeae associated with disseminated gonococcal infections in Queensland, Australia: a retrospective surveillance study

Christine J D Guglielmino et al. BMJ Open. .

Abstract

Objectives: Gonorrhoea caused by Neisseria gonorrhoeae is the second most notified sexually transmitted infection (STI) in Australia and the case numbers for this STI have been increasing globally. Progressive gonococcal infection may lead to disseminated gonococcal infection (DGI), which causes significant morbidity among patients. This study aims to examine the genetic diversity of N. gonorrhoeae isolates collected in Queensland from January 2010 to August 2015 and to determine factors associated with DGI in Queensland.

Design: Retrospective surveillance study for epidemiological purposes.

Setting: All gonorrhoeae isolates referred by private and public pathology laboratories to the state of Queensland, Australia Neisseria reference laboratory.

Methods: Between January 2010 and August 2015, 3953 N. gonorrhoeae isolates from both metropolitan and regional Queensland infections were typed with NG-MAST (N. gonorrhoeae multiantigen sequence typing) to assess the genetic diversity between strains. Whole-genome sequencing (WGS) was used to investigate strain-related factors associated with DGI.

Results: ST6876 was the most common NG-MAST type, detected in 7.6% of the isolates. DGI was significantly more likely in females <30 years (OR 13.02, p<0.0001) and in older males >30 years (OR 6.04, p<0.0001), with most cases originating from North Queensland (OR 8.5, p<0.0001). Strains harbouring PIA class of porB type were associated with DGI (OR 33.23, p<0.0001).

Conclusion: Genotyping techniques, such as NG-MAST and WGS, are proving instrumental in providing an insight into the population structure of N. gonorrhoeae, and genetic mechanisms of pathogenesis, such as for DGI.

Keywords: Epidemiology; INFECTIOUS DISEASES; MOLECULAR BIOLOGY.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Core genome maximum likelihood phylogeny of 16 PIA strains of Neisseria gonorrhoeae from Queensland based on cgMLST. The tree is rooted at centre point and annotated with strain ID, NG-MAST associated with DGI, and sequence types derived from MLST and NG-MAST, with presence/absence of phase variable pglA and gonococcal genetic island. The phylogenetic distance is indicated by the length of the horizontal lines. Visualised with iTOL. DGI, disseminated gonococcal infection; NG-MAST, Neisseria gonorrhoeae multiantigen sequence typing.
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