Neisseria gonorrhoeae Sequence Typing for Antimicrobial Resistance (NG-STAR) clonal complexes are consistent with genomic phylogeny and provide simple nomenclature, rapid visualization and antimicrobial resistance (AMR) lineage predictions. (7th January 2021)

• Record Type: Journal Article
• Authors: Golparian, Daniel; Sánchez-Busó, Leonor; Cole, Michelle; Unemo, Magnus
• Is Part Of: Journal of antimicrobial chemotherapy. Volume 76:Number 4(2021)
• Page Start: 940
• Page End: 944
• Publication Date: 2021-01-07
• Subjects: Anti-infective agents -- Periodicals; Chemotherapy -- Periodicals; 615.58
• DOI: 10.1093/jac/dkaa552
• Languages: English
• ISSNs: 0305-7453

Abstract

Abstract: Objectives: Surveillance of antimicrobial resistance (AMR) in Neisseria gonorrhoeae, supported by molecular typing, ideally through genome sequencing, is imperative. We defined N. gonorrhoeae Sequence Typing for Antimicrobial Resistance (NG-STAR) clonal complexes (CCs) and validated their usefulness in gonococcal AMR surveillance. Methods: All NG-STAR alleles and STs available in the public database (https://ngstar.canada.ca/ ) were analysed using PHYLOViZ 2.0 to define CCs according to the closest founder ST with ≥5 identical alleles and founding ST with the highest number of links. The published 2013 European gonococcal dataset ( n = 1054), the 2016 WHO reference strain panel ( n = 14) and N. gonorrhoeae isolates with ceftriaxone resistance determinant penA- 60.001 ( n = 7) from several countries were used for validation. Results: The majority of the isolates ( n = 1063) were designated to 71 CCs. The most common CC was CC90 ( n = 194), followed by CC63 ( n = 166), CC139 ( n = 73), CC158 ( n = 73) and CC127 ( n = 62). CC90 included isolates belonging to the internationally spread MDR clone N. gonorrhoeae Multi-Antigen Sequence Typing (NG-MAST) G1407 (predominantly MLST ST1901). The ceftriaxone-resistant isolates with penA- 60.001 ( n = 7) belonged to CC73 or STs linking between CC90 and CC73 (ST233 and ST1133). Phylogenomic analysis revealed that NG-STAR CCs more appropriately correlated to phylogenomic AMR clusters compared with MLST STs, NG-MAST STs, NG-MAST genogroups and NG-STAR STs. Conclusions: NG-STAR CCs: are consistent with the gonococcal genome phylogeny; allow rapid visualizations with limited computational requirements; provide a simple, reproducible and portable nomenclature (for WGS and conventional Sanger sequencing data); and predict AMR lineages. Phenotypic AMR surveillance, supplemented with WGS, is imperative and NG-STAR CCs can effectively support this.