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Introduction: Gonorrhoea is a disease associated with humans and caused by Neisseria gonorrhoea. N. gonorrhoea' s ability to evolve and evade various treatment regimens can lead to untreatable gonorrhoea. In the absence of a viable vaccine and a national database on the antimicrobial resistance (AMR) and molecular characteristics of N. gonorrhoea, and with reliance on a syndromic management regime, continuous national antimicrobial resistance surveillance and molecular characterization of N. gonorrhoea remain imperative. Only two gonococcal studies have described N. gonorrhoea's molecular characteristics linked to AMR in Ghana., Methods: Secondary N. gonorrhoea isolates ( n =4) were collected from two metropolises in Ghana: Tamale in the northern sector ( n =1) and Accra in the southern sector ( n =3). The isolates were confirmed and characterized using polymerase chain reaction (PCR) targeting the por B and tbp B genes, and the disc diffusion method was used to evaluate AMR. N. gonorrhoea multi-antigen sequence typing (NG-MAST) and porin B ( por B) gene sequence analyses were employed to reveal the molecular epidemiology and evolutionary trajectory, respectively., Results: All four isolates showed resistance to at least four of the tested antibiotics. One isolate showed resistance to all seven antibiotics, i.e. ceftriaxone, azithromycin, ciprofloxacin, tetracycline, erythromycin, togamycin and penicillin. NG-MAST typing revealed isolate S3 (MZ313864) as ST211. The locus of S2 (MZ313863) (transferrin-binding protein B; tbp B) was identified as tbp B1844, and its por B locus, as por B6412, with only 4 closely related variants but with 15 nucleotide differences. However, its sequence type does not exist. The por B analysis identified isolate S3 (MZ313864) to be found globally, while S2 (MZ313863) is unique to this study., Discussion: Despite the small number of isolates tested, this study recorded multidrug resistance and previously unknown gonococcal variants based on por B gene. Additionally, the molecular typing schemes revealed a disparity between NG-MAST and the National Center for Biotechnology Information (NCBI) platforms. There is a need for continuous gonococcal AMR and molecular surveillance in Ghana to contribute to the global efforts to describe circulating strains and support proper application of the syndromic management regime to gonorrhoea., Competing Interests: The authors declare that there are no conflicts of interest., (© 2024 The Authors.)

Increasing rates of gonococcal (GC) infection and antimicrobial resistant (AMR) GC, are a serious public health concern for Canada and around the world. Previously recommended treatments are ineffective against many of the gonorrhea strains circulating today. The current recommendation for combination therapy is now being threatened by globally emerging and increasingly resistant strains. It is important that coordinated efforts be made now to ensure these new global strains do not become established in Canada. Otherwise, we will be faced with the possibility of persistent GC infection which can lead to pelvic inflammatory disease, infertility and chronic pelvic pain in women; and epididymitis in men. The presence of GC can also increase the risk of HIV acquisition and transmission. There are a number of reasons why we are facing this public health threat. GC infection is often asymptomatic and it is highly transmissible. People may hesitate to seek testing (or to offer testing). Treatment is complex: recommendations vary by site of infection and risk of resistance. Sexual contact during travel is an important source of imported emerging resistant global strains. The new screening and diagnostic Nucleic Acid Amplification Test (NAAT) is excellent but has decreased the number of cultures being done and therefore our capacity to track AMR-GC. There are four key actions that clinicians and front-line public health professionals can take to stem the increase in rates of GC and drug resistant GC. First, normalize and increase GC screening based on risk factors and emphasize the need for safer sex practices. NAAT is useful for screening, but culture is still needed for extra-genital sites. Second, conduct pretravel counselling and include a travel history as part of the risk assessment. Third, use culture along with NAAT to establish the diagnosis and follow up for test-of-cure. Finally, refer to the most current Canadian Guidelines on Sexually Transmitted Infections or provincial/territorial recommendations on combination therapies for patients and their contacts as recommendations may have changed in response to evolving AMR-GC trends. [ABSTRACT FROM AUTHOR]

Available evidence suggests MeNZB™ is not associated with a durable effect against N. gonorrhoeae.

Purpose: The aim was the assessment of the epidemiological situation of gonorrhoea in Poland in 2019 and 2020., Material and Methods: Case-based data on gonorrhoea from surveillance were used (to calculate the rate, data from the Statistics Poland on the number of population was used), which were compared with data from previous years. Data on patients treated in dermatology-venereology clinics in 2019-2020 were taken from the Statistical Bulletins of the Ministry of Health. The surveillance definition is: a confirmed case (means meeting the laboratory criteria), probable case (clinical criteria and an epidemiological link - contact with a confirmed case of gonorrhoea) and a possible case (the doctor diagnosed gonorrhoea)., Results: Year 2019 was the one with the highest number of reported gonorrhoea cases over the 2014-2020 period - 522 cases and 1.37/100,000 population. In 2020, there was a decrease in cases by 47.13% (246 cases and 0.64/100,000 inhabitants). Delays in reporting were identified - between the diagnosis and the first notification for 2019 and 2020, on average, intervened 36 and 52 days, respectively. On the other hand, in dermatologyvenereology clinics, the number of people treated for gonorrhoea did not change - 448 in 2019 and 442 in 2020., Conclusion: 1) The COVID-19 pandemic has deepened the problems of reporting good quality gonorrhoea data in epidemiological surveillance - the planning of appropriate preventive measures in central/local health policies is not possible. Improving surveillance and reporting of complete data on gonorrhoea cases is essential for reliable evaluation of the epidemiological situation. 2) Extensive prophylactic measures should be implemented (including for those under 18 years of age), targeting the source of and to cross routes of infection, including the promotion of safer sexual behaviors and informing the sexual partner., (© National Institute of Public Health NIH – National Research Institute.)

Available evidence suggests MeNZB™ is not associated with a durable effect against N. gonorrhoeae. [ABSTRACT FROM AUTHOR]