Outbreak of Sexually Transmitted Nongroupable Neisseria meningitidis-Associated Urethritis, Vietnam

Abstract

We report on an outbreak of nongroupable Neisseria meningitidis-associated urethritis, primarily among men who have sex with men in southern Vietnam. Nearly 50% of N. meningitidis isolates were resistant to ciprofloxacin. This emerging pathogen should be considered in the differential diagnosis and management of urethritis.

Keywords: Neisseria meningitidis; Vietnam; antimicrobial resistance; bacteria; men who have sex with men; sexually transmitted infections; urethritis.

Figure 1

Plylogenetic tree of isolates from an outbreak of sexually transmitted nongroupable Neisseria meningitidis–associated urethritis, Vietnam. Phylogenetic tree was constructed using Baysian Skygrid model, performing with BEAST/BEAGLE version 1.10.4 (https://beast.community/beagle), and displaying with FigTree version 1.4.4 (http://tree.bio.ed.ac.uk/software/Figtree). Blue text indicates ciprofloxacin-resistant strains. Scale bar indicates the time of evolutionary history.

Figure 2

Whole-genome analysis of isolates from an outbreak of sexually transmitted nongroupable Neisseria meningitidis–associated urethritis, Vietnam. Comparison generated in RDP4 (https://rdp4.software.informer.com) for full length of 2,751-bp. A) Tree shows the genetic relationship between isolate 20158_gyrA381 and gonococci_gyrA9 using unweighted pair group method with arithmetic mean of the region derived from their parents, beginning at 1 to ending breakpoint at 337 bp. B) Bars show potential recombination breakage points identified with at least 1 of the 7 methods contained in RDP4. NmB, N. meningitidis B; NmC, N. meningitidis C.