Enhanced molecular surveillance for gonococcal resistance during doxycycline post-exposure prophylaxis
Ziyuan Zhao1, Leshan Xiu2, Junping Peng1
1NHC Key Laboratory of Systems Biology of Pathogens, National Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, PR China; Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China; Key Laboratory of Pathogen Infection Prevention and Control (Ministry of Education), State Key Laboratory of Respiratory Health and Multimorbidity, National Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, PR China.
A new molecular surveillance method, HRM-doxyPEP, accurately monitors antimicrobial resistance (AMR) in Neisseria gonorrhoeae (NG) during doxycycline post-exposure prophylaxis (doxy-PEP) implementation. This tool aids in tracking resistance to tetracycline and ceftriaxone, crucial for public health.
Area of Science:
- Molecular biology
- Microbiology
- Public health
Background:
- Doxycycline post-exposure prophylaxis (doxy-PEP) is used to prevent bacterial sexually transmitted infections.
- Concerns exist regarding the potential for doxy-PEP to accelerate antimicrobial resistance (AMR) in Neisseria gonorrhoeae (NG), specifically resistance to tetracycline and ceftriaxone.
Purpose of the Study:
- To develop and validate a molecular surveillance method for monitoring AMR in NG during doxy-PEP implementation.
- To assess the accuracy and scalability of the developed assay for detecting specific resistance mechanisms.
Main Methods:
- Development of a high-resolution melting (HRM) analysis-based assay (HRM-doxyPEP).
- Validation using bacterial strains with known susceptibility profiles and clinical samples.
- Comparison of HRM results with quantitative PCR, whole-genome sequencing, and PCR-sequencing.
Main Results:
- The HRM-doxyPEP assay demonstrated high analytical specificity and a low detection limit (20 copies/reaction).
- Assay showed 84% consistency with antimicrobial susceptibility testing for known strains.
- Clinical sample testing achieved 100% sensitivity and specificity for NG detection, ceftriaxone-resistant strains, and tetM detection.
Conclusions:
- The HRM-doxyPEP assay is an accurate, affordable, and scalable tool for molecular surveillance of AMR in NG.
- This method supports monitoring AMR trends during doxy-PEP use, crucial for guiding public health strategies.
