Whole Genome Sequencing Analysis of Neisseria gonorrhoeae Isolates From Turkey: An Observational Study.

Introduction: Neisseria gonorrhoea, the agent of sexually transmitted infections, remains a major public health concern. Whole genome sequencing (WGS) of the agent can provide insights on antimicrobial resistance, pathogenicity, and epidemiology of the bacteria, among others. The aim of this study is to sequence and characterize the whole genome of nine Neisseria gonorrhoeae strains and to understand their epidemiological origins, and the resistance determinant genes. Method: N. gonorrhoeae strains were obtained from different clinical microbiology laboratories. The isolates were cultured on Thayer-Martin medium and antimicrobial susceptibility test was done using disk diffusion method. DNA was extracted from bacterial suspensions using the DNA Kit and WGS sequencing was done. Genes involved in antimicrobial resistance were detected using various bioinformatics tools. Phylogenetic analysis based on 50S ribosomal protein L6 was carried out to determine the evolutionary origin of the isolates. Basic Local Alignment Search Tool search with the protein identified close homologs, which were aligned for maximum likelihood tree generation (bootstrap of 100). Results: Six of the N. gonorrhoeae isolates were susceptible to ceftriaxone and three of them were resistant or intermediate to penicillin. All N. gonorrhoeae isolates possessed norm, mtrC, mtrR, mtrF, mtrA, farB, DfrA42, macA, and macB genes as genetic resistance determinants. Only one isolate contained tetM gene, a tetracyclineresistant determinant. Phylogenetic analysis revealed that our strains formed a statistically significant clade with isolates from Korea, Canada, USA and Russia. Conclusion: The nine N. gonorrhoeae strains circulating in Turkey do not appear to pose a significant threat to public health since they do not have any novel antimicrobial resistance features. Phylogenetic analysis revealed that our clinical strains share common origin with isolates from diverse regions of the world. [ABSTRACT FROM AUTHOR]