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Genomic Characterization of Emerging Bacterial Uropathogen Neisseria meningitidis, Which Was Misidentified as Neisseria gonorrhoeae by Nucleic Acid Amplification Testing
Journal of Clinical Microbiology ( IF 6.1 ) Pub Date : 2021-01-21 , DOI: 10.1128/jcm.01699-20
Kimberley V Sukhum 1, 2 , Sophonie Jean 2, 3 , Meghan Wallace 2 , Neil Anderson 2 , C A Burnham 4, 5, 6, 7 , Gautam Dantas 2, 7, 8, 9
Affiliation  

Neisseria meningitidis and Neisseria gonorrhoeae are pathogenic bacteria that can cause human infections. While N. meningitidis infections are associated with bacterial meningitis and bacteremia, a strain of N. meningitidis, isolated from the urogenital system, has recently been associated with urethritis. As this strain is becoming prominent as an emerging pathogen, it is essential to assess identification tools for N. meningitidis and N. gonorrhoeae urogenital isolates. Consecutive N. meningitidis isolates recovered from urogenital cultures of symptomatic patients with presumptive diagnoses of gonorrhea and a random selection of N. gonorrhoeae isolates recovered from the same population within the same time frame were characterized with routine identification systems, antimicrobial susceptibility testing, and whole-genome sequencing. Matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS), multilocus sequence typing, 16S rRNA gene sequence, and average nucleotide identity methods accurately identified 95% (18/19) of N. meningitidis and N. gonorrhoeae isolates. With the Aptima Combo 2 CT/NG test, 30% (3/10) of N. meningitidis isolates were misidentified as N. gonorrhoeae, but no misidentifications were found with the Xpert CT/NG nucleic acid amplification test (NAAT). Phylogenetic core genome and single nucleotide polymorphism (SNP)-based grouping analyses showed that urogenital N. meningitidis isolates were highly related and phylogenetically distinct from N. gonorrhoeae and respiratory N. meningitidis isolates but similar to urogenital N. meningitidis isolates from patients with urethritis in the United States. Urogenital N. meningitidis isolates were predominantly azithromycin resistant, while N. gonorrhoeae isolates were azithromycin susceptible. These data indicate that urogenital isolates of N. meningitidis can cause false-positive detections with N. gonorrhoeae diagnostic assays. Misidentification of urogenital N. meningitidis isolates may confound public health-related activities for gonorrhea, and future studies are needed to understand the impact on clinical outcome of N. meningitidis urogenital infection.

中文翻译:


新型细菌性尿路病原体脑膜炎奈瑟菌的基因组特征,该菌被核酸扩增检测误认为是淋病奈瑟菌



脑膜炎奈瑟菌淋病奈瑟菌是可引起人类感染的致病菌。虽然脑膜炎奈瑟氏菌感染与细菌性脑膜炎和菌血症有关,但从泌尿生殖系统中分离出的脑膜炎奈瑟氏菌菌株最近与尿道炎有关。由于该菌株作为一种新兴病原体正变得越来越突出,因此有必要评估脑膜炎奈瑟菌淋病奈瑟菌泌尿生殖分离株的鉴定工具。从推定诊断为淋病的有症状患者的泌尿生殖培养物中连续回收的脑膜炎奈瑟氏菌分离株,以及在同一时间范围内从同一人群中随机选择的淋病奈瑟氏菌分离株,通过常规鉴定系统、抗菌药物敏感性测试和整体鉴定进行了表征。基因组测序。基质辅助激光解吸电离-飞行时间质谱 (MALDI-TOF MS)、多位点序列分型、16S rRNA 基因序列和平均核苷酸同一性方法准确鉴定了 95% (18/19) 的脑膜炎奈瑟菌淋病奈瑟菌隔离。通过 Aptima Combo 2 CT/NG 测试,30% (3/10) 的脑膜炎奈瑟菌分离株被误识别为淋病奈瑟菌,但通过 Xpert CT/NG 核酸扩增测试 (NAAT) 未发现错误识别。系统发育核心基因组和基于单核苷酸多态性 (SNP) 的分组分析表明,泌尿生殖脑膜炎奈瑟氏球菌分离株与脑膜炎奈瑟氏球菌高度相关,并且在系统发育上截然不同。 淋病和呼吸道脑膜炎奈瑟菌分离株,但与美国尿道炎患者的泌尿生殖道脑膜炎奈瑟菌分离株相似。泌尿生殖道脑膜炎奈瑟菌分离株主要对阿奇霉素耐药,而淋病奈瑟菌分离株对阿奇霉素敏感。这些数据表明,泌尿生殖道脑膜炎奈瑟菌分离株可导致淋病奈瑟菌诊断检测出现假阳性检测。泌尿生殖道脑膜炎奈瑟菌分离株的错误识别可能会混淆淋病的公共卫生相关活动,需要未来的研究来了解泌尿生殖道脑膜炎奈瑟氏菌感染对临床结果的影响。
更新日期:2021-01-21
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