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. 2025 Apr;54(4):850-859.
doi: 10.18502/ijph.v54i4.18424.

Exploring the Prevalence of Neisseria gonorrhoeae in Women with Genitourinary Symptoms in Tehran, Iran

Narjes Noori Goodarzi  1 , Shaghayegh Zafar  1 , Naghmeh Pourmand  2 , Soheila Ajdary  3 , Mir Saeed Yekaninejad  4 , Mohammad Reza Pourmand  1 , Farzad Badmasti  5
Affiliations

Exploring the Prevalence of Neisseria gonorrhoeae in Women with Genitourinary Symptoms in Tehran, Iran

Narjes Noori Goodarzi et al. Iran J Public Health. 2025 Apr.

Abstract

Background: Neisseria gonorrhoeae, the second most common sexually transmitted infection (STI) worldwide, affects one million people daily. We aimed to investigate the prevalence of gonorrhea in females with genital infections in Tehran, Iran.

Methods: First, a bioinformatic study was conducted to identify a conserved and high-prevalent gene marker for detection of N. gonorrhoeae. One desirable marker was selected and a pair of specific primers was designed to amplify it. The reliability of the primer pair was evaluated in silico and in vitro. Subsequently, 172 patients with genitourinary symptoms were enrolled and an endocervical swab specimen was obtained from each patient to evaluate the presence of N. gonorrhoeae in clinical specimens using the specific primers.

Results: Restriction endonuclease subunit S (resS, WP_003687768.1) was selected as a specific detection marker. The designed primer pair targeting resS showed specific and reliable detection of N. gonorrhoeae in silico and in vitro. Out of 172 clinical samples, seven (4.06%) cases were infected by N. gonorrhoeae. Statistical analysis of clinical manifestations showed that there was a significant association between the occurrence of N. gonorrhoeae and dysuria (P= 0.043), pelvic pain (P= 0.017), and fever (P = 0.045).Conclusion: Three promising markers were introduced for development of point-of-care testing approaches. Moreover, this study highlights a 4% prevalence of gonorrhea among women with genitourinary symptoms in Iran, which reminds the urgent need for routine surveillance and new policies in management of STIs, particularly gonorrhea.

Keywords: Gonorrhea; Neisseria gonorrhoeae; Prevalence.

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Figures

Fig. 1:
Fig. 1:
Sequence conservation of resS among 155 N. gonorrhoeae strains using WebLogo online server
Fig. 2:
Fig. 2:
The resS (NGO0357) is a unique gene in N. gonorrhoeae genomes and not present in non-gonorrhoeae Neisseria species (http://wishart.biology.ualberta.ca/BacMap/). This gene is involved in Restriction-modification (R-M) system
Fig. 3:
Fig. 3:
Amplification of a 255 bp fragment of resS gene of N. gonorrhoeae using PCR. M: Marker; 1: N. gonorrhoeae ATCC 19424; 2: Positive clinical sample; 3: N. sicca ATCC 9913; 4: N. subflava CCM 3482; 5: N. meningitidis ATCC 13090; 6: Negative control
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