Molecular Epidemiology of Neisseria gonorrhoeae in Amsterdam, The Netherlands, Shows Distinct Heterosexual and Homosexual Networks

Abstract

patients with a laboratory-confirmed diagnosis of gonorrhea at the Clinic for Sexually Transmitted Infections in Amsterdam, The Netherlands, were subjected to a questionnaire pertaining to sexual risk behavior and sexual partners in the 6 months prior to the diagnosis. The Neisseria gonorrhoeae isolates were all genotyped using PCR-restriction fragment length polymorphism of the porin and opacity genes. All patients with a completed questionnaire and genotyped isolates were included in the study. We obtained 885 N. gonorrhoeae isolates from 696 patients that revealed 88 clusters and 46 unique genotypes. Patients infected at multiple anatomical sites with one or more strains and patients infected several times during the study period were shown to pursue high-risk sexual behavior and were considered core groups. There were 11 clusters of >20 patients; in seven clusters, 81% to 100% of patients were men who have sex with men (MSM), three clusters contained 87 to 100% heterosexual men and women, and one cluster was formed by equal proportions of MSM and heterosexual male and female patients. However, the various clusters differed in characteristics such as types of coinfections, numbers of sexual partners, Internet use to seek sexual partners, and locations of sexual encounters. Molecular epidemiology of gonococcal isolates in Amsterdam revealed core groups and clusters of MSM and heterosexual patients that probably indicate distinct transmission networks.

A metapopulation modelling framework for gonorrhoea and other sexually transmitted infections in heterosexual populations

“…Membership of these subpopulations was not dependent on the intensity of individual risk behaviour but on identifiable geographical and sociodemographic factors. Further evidence for the existence of such sexual networks comes from recent molecular epidemiologic studies in London and Amsterdam, which showed that distinct strains of gonorrhoea caused geographically clustered infections in individuals with significantly different sociodemographic characteristics (Choudhury et al 2006;Kolader et al 2006;Risley et al 2007). We interpret this as further support for the concept that the transmission of gonorrhoea and possibly other STIs is in essence being maintained by geographically and demographically distinct core subpopulations, with such subpopulations comprising not only the cases observed in the studies mentioned (the clinical-epidemiologic perspective), but also the uninfected individuals belonging to the same sexual network, which could be defined by a combination of sociocultural and geographical characteristics (i.e.…”

Analysis of Emergence of Quinolone-Resistant Gonococci in Greece by Combined Use of Neisseria gonorrhoeae Multiantigen Sequence Typing and Multilocus Sequence Typing

“…Molecular typing can be used to explore the basis of the emergence of QRNG strains, and several methods have been used for typing gonococci (6,9,25). In recent years, sequence-based methods have been favored for molecular typing as they allow simple interlaboratory comparisons of isolates.…”

Concordance between Neisseria gonorrhoeae Genotypes Recovered from Known Sexual Contacts

“…Typing of Neisseria gonorrhoeae isolates has provided a valuable adjunct to contact tracing for reconstructing sexual networks (3,14) and for identifying individuals predicted to be in the same sexual network (2,6). Phenotypic typing methods for gonococci-for example, the combination of auxotype and serovar-lack sufficient discrimination for this purpose, but a number of more-discriminatory molecular methods have been developed.…”