| Autor: |
Smith AC; STD Laboratory Reference and Research Branch, Division of STD Prevention, NCHHSTP, CDC, Atlanta, Georgia, USA., Shrivastava A; STD Laboratory Reference and Research Branch, Division of STD Prevention, NCHHSTP, CDC, Atlanta, Georgia, USA.; Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, Oak Ridge, Tennessee, USA., Cartee JC; STD Laboratory Reference and Research Branch, Division of STD Prevention, NCHHSTP, CDC, Atlanta, Georgia, USA., Bélanger M; STD Laboratory Reference and Research Branch, Division of STD Prevention, NCHHSTP, CDC, Atlanta, Georgia, USA., Sharpe S; STD Laboratory Reference and Research Branch, Division of STD Prevention, NCHHSTP, CDC, Atlanta, Georgia, USA., Lewis J; STD Laboratory Reference and Research Branch, Division of STD Prevention, NCHHSTP, CDC, Atlanta, Georgia, USA.; Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, Oak Ridge, Tennessee, USA., Budionno S; City of Milwaukee Health Department Laboratory, Milwaukee, Wisconsin, USA., Gomez R; City of Milwaukee Health Department Laboratory, Milwaukee, Wisconsin, USA., Khubbar MK; City of Milwaukee Health Department Laboratory, Milwaukee, Wisconsin, USA., Pham CD; STD Laboratory Reference and Research Branch, Division of STD Prevention, NCHHSTP, CDC, Atlanta, Georgia, USA., Gernert KM; STD Laboratory Reference and Research Branch, Division of STD Prevention, NCHHSTP, CDC, Atlanta, Georgia, USA., Schmerer MW; STD Laboratory Reference and Research Branch, Division of STD Prevention, NCHHSTP, CDC, Atlanta, Georgia, USA., Raphael BH; STD Laboratory Reference and Research Branch, Division of STD Prevention, NCHHSTP, CDC, Atlanta, Georgia, USA., Learner ER; STD Laboratory Reference and Research Branch, Division of STD Prevention, NCHHSTP, CDC, Atlanta, Georgia, USA., Kersh EN; STD Laboratory Reference and Research Branch, Division of STD Prevention, NCHHSTP, CDC, Atlanta, Georgia, USA., Joseph SJ; STD Laboratory Reference and Research Branch, Division of STD Prevention, NCHHSTP, CDC, Atlanta, Georgia, USA. |
| Abstrakt: |
Neisseria meningitidis (Nm) and Neisseria gonorrhoeae (Ng) are human pathogens that sometimes occupy the same anatomical niche. Ng, the causative agent of gonorrhea, infects 87 million individuals annually worldwide and is an urgent threat due to increasing drug resistance. Ng is a pathogen of the urogenital tract and may infect the oropharyngeal or rectal site, often asymptomatically. Conversely, Nm is an opportunistic pathogen. While often a commensal in the oropharyngeal tract, it is also the leading cause of bacterial meningitis with 1.2 million cases globally, causing significant morbidity and mortality. Horizontal gene transfer (HGT) is likely to occur between Ng and Nm due to their shared anatomical niches and genetic similarity, which poses challenges for accurate detection and treatment. Routine surveillance through the Gonococcal Isolate Surveillance Project and Strengthening the U.S. Response to Resistant Gonorrhea detected six concerning urogenital Neisseria isolates with contradicting species identification in Milwaukee (MIL). While all six isolates were positive for Ng using nucleic acid amplification testing (NAAT) and matrix-assisted laser desorption/ionization time of flight identified the isolates as Ng, two biochemical tests, Gonochek-II and API NH, classified them as Nm. To address this discrepancy, we performed whole-genome sequencing (WGS) using Illumina MiSeq on all isolates and employed various bioinformatics tools. Species detection analysis using BMScan, which uses WGS data, identified all isolates as Ng. Furthermore, Kraken revealed over 98% of WGS reads mapped to the Ng genome and <1% to Nm. Recombination analysis identified putative HGT in all MIL isolates within the γ-glutamyl transpeptidase ( ggt ) gene, a key component in the biochemical tests used to differentiate between Nm and Ng. Further analysis identified Nm as the source of HGT event. Specifically, the active Nm ggt gene replaced the Ng pseudogenes, ggt1 and ggt2 . Together, this study demonstrates that closely related Neisseria species sharing a niche underwent HGT, which led to the misidentification of species following biochemical testing. Importantly, NAAT accurately detected Ng. The misidentification highlights the importance of using WGS to continually evaluate diagnostic or bacterial identification tests. |
