Culture-Independent Genotyping Improves Surveillance of INeisseria gonorrhoeae/I, Especially in Oropharyngeal Samples, the Netherlands, 2017 to 2018

• Published in: Pathogens (Basel) Vol. 11; no. 11
• Main Authors: Slaats, Michiel H. C, van der Veer, Brian M. J. W, van Alphen, Lieke B, Hoebe, Christian J. P. A, Dukers-Muijrers, Nicole H. T. M, Wolffs, Petra F. G
• Format: Journal Article
• Language: English
• Published: MDPI AG 01.11.2022
• Subjects: Bacteriology; Cultures and culture media; Diagnosis; Genetic aspects; Genotype; Identification and classification; Medical research; Medicine, Experimental; Methods; Neisseria gonorrhoeae; Neisseria infections; Sentinel health events; Netherlands
• ISSN: 2076-0817; 2076-0817
• DOI: 10.3390/pathogens11111344

It is important i to monitor the transmission and antimicrobial resistance of Neisseria gonorrhoeae (NG). Current surveillance relies on culturing, which frequently fails. Previously, a culture-independent genotyping method was developed based on NG multi-antigen sequence typing (NG-MAST). To determine whether crucial sequence types (STs) are missed during culture-dependent surveillance, NG-positive NAAT samples were genotyped, and the results of the culture-positive and culture-negative samples were compared. In total, 196 NG-positive NAAT samples, from January 2017 until August 2018, which were also routinely cultured, were retrospectively included. Genotyping was successful in 152 NAAT samples (77.0%), 33 NAAT samples failed, and 11 NAAT samples showed possible mixed strain infections. Oropharyngeal samples (n = 16) showed the largest increase in typing rate from 6.3% (1/16) success in culture-dependent genotyping to 81.3% (13/16) in culture-independent genotyping. Nine genogroups (n ≥ 5 samples) were found; all included both culture-positive and culture-negative NG. However, culture-independent surveillance revealed 14 additional STs in the culture-negative samples. Overall, culture-dependent surveillance could detect all genogroups, indicating that major trends could be identified with culture-dependent surveillance. However, culture-independent surveillance provides more STs, mixed infections and more oropharyngeal samples, giving a more detailed view and could result in an earlier detection of outbreaks and transmission.