Introduction: The aim of this study was to molecularly characterize Neisseria gonorrhoeae on non-cultured specimens collected from multiple anatomic sites. N. gonorrhoeae multiantigen sequence typing (NG-MAST) together with the gene sequence analysis of antimicrobial resistance (AMR) target genes were used.
Materials and methods: Seventeen genital and extra-genital samples from eight patients (7 were men who have sex with men, MSM, and 1 women who have sex with men, WSM) with gonorrhoea symptoms were analyzed. For 7, of the 8 patients, conventional culture method has been used to identify gonorrhoea. All the samples were tested with the rapid molecular method CEPHEID. Amplification and sequencing of porB and tbpB, to identify the Sequence Type (ST) by NG-MAST, and penA, mtrR, porB1b, ponA genes were also performed. Antimicrobial susceptibility by Etest, for the available culture positive samples, was carried out.
Results: For 7 patients the ST was obtained and for 6 the complete sequence analysis of the AMR target genes was also defined. For the majority of them, samples collected from multiple sites (oropharynx, rectum, vaginal and urethra) confirm the presence of the same gonorrhoea strain. In particular, for 5 patients the same STs and changes in the AMR target genes were identified.
Conclusion: Molecular characterization on non-cultured or culture negative specimens for gonorrhoea can successfully be applied directly to genital and extra-genital samples. Thus permit to identify the presence of the same strain in patients with gonorrhoea infection in multiple anatomic sites and to predict the antimicrobial susceptibility pattern.