Ethnically diverse urban transmission networks of Neisseria gonorrhoeae without evidence of HIV serosorting

• Published in: Sexually transmitted infections Vol. 96; no. 2; pp. 106 - 109
• Main Authors: Dave, Jayshree, Paul, John, Pasvol, Thomas Joshua, Williams, Andy, Warburton, Fiona, Cole, Kevin, Miari, Victoria Fotini, Stabler, Richard, Eyre, David W
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.03.2020; BMJ Publishing Group
• Series: Short report
• Subjects: Antibiotics; Antimicrobial agents; Drug use; Ethnicity; Genomes; Gonorrhea; Health Services Research; Hepatitis; HIV; Human immunodeficiency virus; Minority & ethnic groups; Patients; Population; Sexual orientation; United Kingdom > UK; Europe; neisseria gonorrhoeae; epidemiology (molecular); sexual networks
• ISSN: 1368-4973; 1472-3263
• DOI: 10.1136/sextrans-2019-054025

ObjectiveWe aimed to characterise gonorrhoea transmission patterns in a diverse urban population by linking genomic, epidemiological and antimicrobial susceptibility data.Methods Neisseria gonorrhoeae isolates from patients attending sexual health clinics at Barts Health NHS Trust, London, UK, during an 11-month period underwent whole-genome sequencing and antimicrobial susceptibility testing. We combined laboratory and patient data to investigate the transmission network structure.ResultsOne hundred and fifty-eight isolates from 158 patients were available with associated descriptive data. One hundred and twenty-nine (82%) patients identified as male and 25 (16%) as female; four (3%) records lacked gender information. Self-described ethnicities were: 51 (32%) English/Welsh/Scottish; 33 (21%) white, other; 23 (15%) black British/black African/black, other; 12 (8%) Caribbean; 9 (6%) South Asian; 6 (4%) mixed ethnicity; and 10 (6%) other; data were missing for 14 (9%). Self-reported sexual orientations were 82 (52%) men who have sex with men (MSM); 49 (31%) heterosexual; 2 (1%) bisexual; data were missing for 25 individuals. Twenty-two (14%) patients were HIV positive. Whole-genome sequence data were generated for 151 isolates, which linked 75 (50%) patients to at least one other case. Using sequencing data, we found no evidence of transmission networks related to specific ethnic groups (p=0.64) or of HIV serosorting (p=0.35). Of 82 MSM/bisexual patients with sequencing data, 45 (55%) belonged to clusters of ≥2 cases, compared with 16/44 (36%) heterosexuals with sequencing data (p=0.06).ConclusionWe demonstrate links between 50% of patients in transmission networks using a relatively small sample in a large cosmopolitan city. We found no evidence of HIV serosorting. Our results do not support assortative selectivity as an explanation for differences in gonorrhoea incidence between ethnic groups.