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Plasmids are vehicles for horizontal gene transfer between bacteria, and in Neisseria gonorrhoeae plasmids can mediate high-level antimicrobial resistance (AMR). Using genomic and phylogenetic analyses, we show that plasmids are widespread in a collection of 3724 gonococcal isolates from 56 countries, and characterized the conjugative, β-lactamase and cryptic plasmids. We found that variants of the conjugative plasmid (which can mediate tetracycline resistance) and the β-lactamase plasmid expressing TEM-135 are associated with distinct gonococcal lineages. Furthermore, AMR plasmids are significantly more prevalent in gonococci from less wealthy countries, highlighting the need for further studies. More than 94% of gonococci possess the cryptic plasmid, with its absence correlated with the presence of a novel chromosomal type IV secretion system. Our results reveal the extent of plasmid-mediated AMR in the gonococcus, particularly in less wealthy countries, where diagnostic and therapeutic options can be limited, and highlight the risk of their global spread.

Original publication

DOI

10.1093/infdis/jiaa003

Type

Journal article

Journal

J Infect Dis

Publication Date

09/11/2020

Volume

222

Pages

1826 - 1836

Keywords

Neisseria gonorrhoeae , antimicrobial resistance, plasmids, whole-genome sequencing, Anti-Bacterial Agents, Drug Resistance, Bacterial, Economic Status, Gene Transfer, Horizontal, Genomics, Gonorrhea, Humans, Neisseria gonorrhoeae, Phylogeny, Plasmids, Type IV Secretion Systems, Whole Genome Sequencing, beta-Lactamases