Whole genome analysis and antimicrobial resistance of Neisseria gonorrhoeae isolates from Ghana
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Date
2023
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Frontiers in Microbiology
Abstract
Introduction: Gonorrhoea is a major public health concern. With the global
emergence and spread of resistance to last-line antibiotic treatment options,
gonorrhoea threatens to be untreatable in the future. Therefore, this study
performed whole genome characterization of Neisseria gonorrhoeae collected
in Ghana to identify lineages of circulating strains as well as their phenotypic and
genotypic antimicrobial resistance (AMR) profiles.
Methods: Whole genome sequencing (WGS) was performed on 56 isolates using
both the Oxford Nanopore MinION and Illumina MiSeq sequencing platforms.
The Comprehensive Antimicrobial Resistance Database (CARD) and PUBMLST.
org/neisseria databases were used to catalogue chromosomal and plasmid genes
implicated in AMR. The core genome multi-locus sequence typing (cgMLST)
approach was used for comparative genomics analysis.
Results and Discussion: In vitro resistance measured by the E-test method revealed
100%, 91.0% and 85.7% resistance to tetracycline, penicillin and ciprofloxacin,
respectively. A total of 22 sequence types (STs) were identified by multilocus
sequence typing (MLST), with ST-14422 (n = 10), ST-1927 (n = 8) and ST-11210
(n = 7) being the most prevalent. Six novel STs were also identified (ST-15634,
15636-15639 and 15641). All isolates harboured chromosomal AMR determinants
that confer resistance to beta-lactam antimicrobials and tetracycline. A single
cefixime-resistant strain, that belongs to N. gonorrhoeae multiantigen sequence
type (NG-MAST) ST1407, a type associated with widespread cephalosporin
resistance was identified. Neisseria gonorrhoeae Sequence Typing for Antimicrobial
Resistance (NG-STAR), identified 29 unique sequence types, with ST-464 (n = 8)
and the novel ST-3366 (n = 8) being the most prevalent. Notably, 20 of the 29 STs
were novel, indicative of the unique nature of molecular AMR determinants in the
Ghanaian strains. Plasmids were highly prevalent: pTetM and pblaTEM were found
in 96% and 92% of isolates, respectively. The TEM-135 allele, which is an amino
acid change away from producing a stable extended-spectrum β-lactamase that
could result in complete cephalosporin resistance, was identified in 28.5% of the isolates. Using WGS, we characterized N. gonorrhoeae strains from Ghana, giving
a snapshot of the current state of gonococcal AMR in the country and highlighting
the need for constant genomic surveillance.
Description
Research Article
Keywords
Neisseria gonorrhoeae, antimicrobial resistance, Ghana
Citation
Agbodzi B, Duodu S, Dela H, Kumordjie S, Yeboah C, Behene E, Ocansey K, Yanney JN, Boateng-Sarfo G, Kwofie SK, Egyir B, Colston SM, Miranda HV, Watters C, Sanders T, Fox AT, Letizia AG, Wiley MR and Attram N (2023) Whole genome analysis and antimicrobial resistance of Neisseria gonorrhoeae isolates from Ghana. Front. Microbiol. 14:1163450. doi: 10.3389/fmicb.2023.1163450