Genomic Analysis and Comparison of Two Gonorrhea Outbreaks

ABSTRACT Gonorrhea is a sexually transmitted disease causing growing concern, with a substantial increase in reported incidence over the past few years in the United Kingdom and rising levels of resistance to a wide range of antibiotics. Understanding its epidemiology is therefore of major biomedica...

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Autores principales:	Xavier Didelot, Janina Dordel, Lilith K. Whittles, Caitlin Collins, Nicole Bilek, Cynthia J. Bishop, Peter J. White, David M. Aanensen, Julian Parkhill, Stephen D. Bentley, Brian G. Spratt, Simon R. Harris
Formato:	article
Lenguaje:	EN
Publicado:	American Society for Microbiology 2016
Materias:	Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/769806f9e84942298bfd7d1a3efc6bcd
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spelling	oai:doaj.org-article:769806f9e84942298bfd7d1a3efc6bcd2021-11-15T15:50:15ZGenomic Analysis and Comparison of Two Gonorrhea Outbreaks10.1128/mBio.00525-162150-7511https://doaj.org/article/769806f9e84942298bfd7d1a3efc6bcd2016-07-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mBio.00525-16https://doaj.org/toc/2150-7511ABSTRACT Gonorrhea is a sexually transmitted disease causing growing concern, with a substantial increase in reported incidence over the past few years in the United Kingdom and rising levels of resistance to a wide range of antibiotics. Understanding its epidemiology is therefore of major biomedical importance, not only on a population scale but also at the level of direct transmission. However, the molecular typing techniques traditionally used for gonorrhea infections do not provide sufficient resolution to investigate such fine-scale patterns. Here we sequenced the genomes of 237 isolates from two local collections of isolates from Sheffield and London, each of which was resolved into a single type using traditional methods. The two data sets were selected to have different epidemiological properties: the Sheffield data were collected over 6 years from a predominantly heterosexual population, whereas the London data were gathered within half a year and strongly associated with men who have sex with men. Based on contact tracing information between individuals in Sheffield, we found that transmission is associated with a median time to most recent common ancestor of 3.4 months, with an upper bound of 8 months, which we used as a criterion to identify likely transmission links in both data sets. In London, we found that transmission happened predominantly between individuals of similar age, sexual orientation, and location and also with the same HIV serostatus, which may reflect serosorting and associated risk behaviors. Comparison of the two data sets suggests that the London epidemic involved about ten times more cases than the Sheffield outbreak. IMPORTANCE The recent increases in gonorrhea incidence and antibiotic resistance are cause for public health concern. Successful intervention requires a better understanding of transmission patterns, which is not uncovered by traditional molecular epidemiology techniques. Here we studied two outbreaks that took place in Sheffield and London, United Kingdom. We show that whole-genome sequencing provides the resolution to investigate direct gonorrhea transmission between infected individuals. Combining genome sequencing with rich epidemiological information about infected individuals reveals the importance of several transmission routes and risk factors, which can be used to design better control measures.Xavier DidelotJanina DordelLilith K. WhittlesCaitlin CollinsNicole BilekCynthia J. BishopPeter J. WhiteDavid M. AanensenJulian ParkhillStephen D. BentleyBrian G. SprattSimon R. HarrisAmerican Society for MicrobiologyarticleMicrobiologyQR1-502ENmBio, Vol 7, Iss 3 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Microbiology QR1-502
spellingShingle	Microbiology QR1-502 Xavier Didelot Janina Dordel Lilith K. Whittles Caitlin Collins Nicole Bilek Cynthia J. Bishop Peter J. White David M. Aanensen Julian Parkhill Stephen D. Bentley Brian G. Spratt Simon R. Harris Genomic Analysis and Comparison of Two Gonorrhea Outbreaks
description	ABSTRACT Gonorrhea is a sexually transmitted disease causing growing concern, with a substantial increase in reported incidence over the past few years in the United Kingdom and rising levels of resistance to a wide range of antibiotics. Understanding its epidemiology is therefore of major biomedical importance, not only on a population scale but also at the level of direct transmission. However, the molecular typing techniques traditionally used for gonorrhea infections do not provide sufficient resolution to investigate such fine-scale patterns. Here we sequenced the genomes of 237 isolates from two local collections of isolates from Sheffield and London, each of which was resolved into a single type using traditional methods. The two data sets were selected to have different epidemiological properties: the Sheffield data were collected over 6 years from a predominantly heterosexual population, whereas the London data were gathered within half a year and strongly associated with men who have sex with men. Based on contact tracing information between individuals in Sheffield, we found that transmission is associated with a median time to most recent common ancestor of 3.4 months, with an upper bound of 8 months, which we used as a criterion to identify likely transmission links in both data sets. In London, we found that transmission happened predominantly between individuals of similar age, sexual orientation, and location and also with the same HIV serostatus, which may reflect serosorting and associated risk behaviors. Comparison of the two data sets suggests that the London epidemic involved about ten times more cases than the Sheffield outbreak. IMPORTANCE The recent increases in gonorrhea incidence and antibiotic resistance are cause for public health concern. Successful intervention requires a better understanding of transmission patterns, which is not uncovered by traditional molecular epidemiology techniques. Here we studied two outbreaks that took place in Sheffield and London, United Kingdom. We show that whole-genome sequencing provides the resolution to investigate direct gonorrhea transmission between infected individuals. Combining genome sequencing with rich epidemiological information about infected individuals reveals the importance of several transmission routes and risk factors, which can be used to design better control measures.
format	article
author	Xavier Didelot Janina Dordel Lilith K. Whittles Caitlin Collins Nicole Bilek Cynthia J. Bishop Peter J. White David M. Aanensen Julian Parkhill Stephen D. Bentley Brian G. Spratt Simon R. Harris
author_facet	Xavier Didelot Janina Dordel Lilith K. Whittles Caitlin Collins Nicole Bilek Cynthia J. Bishop Peter J. White David M. Aanensen Julian Parkhill Stephen D. Bentley Brian G. Spratt Simon R. Harris
author_sort	Xavier Didelot
title	Genomic Analysis and Comparison of Two Gonorrhea Outbreaks
title_short	Genomic Analysis and Comparison of Two Gonorrhea Outbreaks
title_full	Genomic Analysis and Comparison of Two Gonorrhea Outbreaks
title_fullStr	Genomic Analysis and Comparison of Two Gonorrhea Outbreaks
title_full_unstemmed	Genomic Analysis and Comparison of Two Gonorrhea Outbreaks
title_sort	genomic analysis and comparison of two gonorrhea outbreaks
publisher	American Society for Microbiology
publishDate	2016
url	https://doaj.org/article/769806f9e84942298bfd7d1a3efc6bcd
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Genomic Analysis and Comparison of Two Gonorrhea Outbreaks

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