1887
  1. Home
  2. Eurosurveillance
  3. Volume 30, Issue 46, 20/Nov/2025
  4. Article
Rapid communication Open Access
Like 0
Download

Abstract

Screening of 54,837 gonococcal genomes identified 12 new variants lacking one (n = 9) or both (n = 3) of the Xpert CT/NG assay’s gonococcal targets. In total, 17 diagnostic-escape variants occurred across five countries and multiple genomic lineages; phylogenomic analysis revealed both ancestral and strain-specific recombination events. Xpert CT/NG diagnostic escape remains rare (0.026%) but illustrates recurrent recombination in gonococci. This emphasises the necessity of continuous external quality assessments, supplementary testing of gonococcal-positive molecular screening samples, and appropriate genomic and epidemiologic surveillance.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2025.30.46.2500817
2025-11-20
2025-12-08
/content/10.2807/1560-7917.ES.2025.30.46.2500817
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/30/46/eurosurv-30-46-3.html?itemId=/content/10.2807/1560-7917.ES.2025.30.46.2500817&mimeType=html&fmt=ahah

References

  1. Jansen van Rensburg M, Pitt-Kendall R, Hincke M, Cliff PR, Shaw J, Sinka K, et al. Detection and characterisation of Xpert CT/NG assay Neisseria gonorrhoeae diagnostic escape mutants, England, June 2025. Euro Surveill. 2025;30(36):2500673.  https://doi.org/10.2807/1560-7917.ES.2025.30.36.2500673  PMID: 40937552 
  2. Persing D, Murray WE. inventors; Cepheid, assignee. Methods of detecting chlamydia and gonorrhea and of screening for infection/inflammation based on genomic copy number. Patent US 2016/0257998 A1. 2016. Available from: https://patents.google.com/patent/US20160257998A1/en?q=(genexpert+NG%2fCT+NG2a)&assignee=cepheid&oq=genexpert+NG%2fCT+cepheid+NG2a
  3. Golparian D, Bazzo ML, Ahlstrand J, Schörner MA, Gaspar PC, de Melo Machado H, et al. Recent dynamics in Neisseria gonorrhoeae genomic epidemiology in Brazil: antimicrobial resistance and genomic lineages in 2017-20 compared to 2015-16. J Antimicrob Chemother. 2024;79(5):1081-92.  https://doi.org/10.1093/jac/dkae075  PMID: 38517452 
  4. Facius D, Fussenegger M, Meyer TF. Sequential action of factors involved in natural competence for transformation of Neisseria gonorrhoeae. FEMS Microbiol Lett. 1996;137(2-3):159-64.  https://doi.org/10.1111/j.1574-6968.1996.tb08099.x  PMID: 8998979 
  5. Ison CA, Golparian D, Saunders P, Chisholm S, Unemo M. Evolution of Neisseria gonorrhoeae is a continuing challenge for molecular detection of gonorrhoea: false negative gonococcal porA mutants are spreading internationally. Sex Transm Infect. 2013;89(3):197-201.  https://doi.org/10.1136/sextrans-2012-050829  PMID: 23241969 
  6. Luijt D, Di Lorenzo C, van Loon AM, Unemo M. Most but not all laboratories can detect the recently emerged Neisseria gonorrhoeae porA mutants - results from the QCMD 2013 N. gonorrhoeae external quality assessment programme. Euro Surveill. 2014;19(8):20711.  https://doi.org/10.2807/1560-7917.ES2014.19.8.20711  PMID: 24602276 
  7. Herrmann B, Sälléber A, Kaden R. Genomic analysis of a Neisseria meningitidis patient isolate causing a false-positive result in the Abbott Alinity m STI, Sweden: a case report. ASM Case Rep. 2025;0:e00143-25.  https://doi.org/10.1128/asmcr.00143-25 
  8. Walcher M, Skvoretz R, Montgomery-Fullerton M, Jonas V, Brentano S. Description of an unusual Neisseria meningitidis isolate containing and expressing Neisseria gonorrhoeae-specific 16S rRNA gene sequences. J Clin Microbiol. 2013;51(10):3199-206.  https://doi.org/10.1128/JCM.00309-13  PMID: 23863567 
  9. Sukhum KV, Jean S, Wallace M, Anderson N, Burnham CA, Dantas G. Genomic characterization of emerging bacterial uropathogen Neisseria meningitidis, which was misidentified as Neisseria gonorrhoeae by nucleic acid amplification testing. J Clin Microbiol. 2021;59(2):e01699-20.  https://doi.org/10.1128/JCM.01699-20  PMID: 33177123 
  10. Unemo M, Ross J, Serwin AB, Gomberg M, Cusini M, Jensen JS. 2020 European guideline for the diagnosis and treatment of gonorrhoea in adults. Int J STD AIDS. 2020;956462420949126:956462420949126.  https://doi.org/10.1177/0956462420949126  PMID: 33121366 
  11. Unemo M, Lahra MM, Cole MJ, Marcano Zamora D, Jacobsson S, Galarza P, et al. WHO global gonococcal antimicrobial surveillance programmes, 2019-22: a retrospective observational study. Lancet Microbe. 2025;6(10):101181.  https://doi.org/10.1016/j.lanmic.2025.101181  PMID: 41015046 
  12. Lan PT, Phan Nguyen TT, Anh VT, Golparian D, Thuy Van NT, Maatouk I, et al. The World Health Organization (WHO) Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) reports continuously high levels of ceftriaxone resistance across Viet Nam, 2024. Lancet Reg Health West Pac. 2025;63:101709.  https://doi.org/10.1016/j.lanwpc.2025.101709  PMID: 41140782 
  13. Golparian D, Cole MJ, Sánchez-Busó L, Day M, Jacobsson S, Uthayakumaran T, et al. Antimicrobial-resistant Neisseria gonorrhoeae in Europe in 2020 compared with in 2013 and 2018: a retrospective genomic surveillance study. Lancet Microbe. 2024;5(5):e478-88.  https://doi.org/10.1016/S2666-5247(23)00370-1  PMID: 38614111 
  14. Jolley KA, Maiden MC. Using multilocus sequence typing to study bacterial variation: prospects in the genomic era. Future Microbiol. 2014;9(5):623-30.  https://doi.org/10.2217/fmb.14.24  PMID: 24957089 
  15. Demczuk W, Sidhu S, Unemo M, Whiley DM, Allen VG, Dillon JR, et al. Neisseria gonorrhoeae sequence typing for antimicrobial resistance, a novel antimicrobial resistance multilocus typing scheme for tracking global dissemination of N. gonorrhoeae strains. J Clin Microbiol. 2017;55(5):1454-68.  https://doi.org/10.1128/JCM.00100-17  PMID: 28228492 
  16. Croucher NJ, Page AJ, Connor TR, Delaney AJ, Keane JA, Bentley SD, et al. Rapid phylogenetic analysis of large samples of recombinant bacterial whole genome sequences using Gubbins. Nucleic Acids Res. 2015;43(3):e15.  https://doi.org/10.1093/nar/gku1196  PMID: 25414349 
Global distribution of Xpert CT/NG assay Neisseria gonorrhoeae escape variants indicates sporadic emergence with limited clonality between 2016 and 2025
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Daniel+Golparian&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Golparian Daniel</a>, <a href="/search?value1=Maria+Luiza+Bazzo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bazzo Maria Luiza</a>, <a href="/search?value1=Pamela+Cristina+Gaspar&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gaspar Pamela Cristina</a>, <a href="/search?value1=Magnus+Unemo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Unemo Magnus</a></span>. Global distribution of Xpert CT/NG assay Neisseria gonorrhoeae escape variants indicates sporadic emergence with limited clonality between 2016 and 2025. <a href="/content/ecdc">Euro Surveill.</a> 2025;30(46):pii=2500817. <a href="https://doi.org/10.2807/1560-7917.ES.2025.30.46.2500817" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2025.30.46.2500817</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 29 Oct 2025;&nbsp;&nbsp; <span class="generated">Accepted</span>: 17 Nov 2025 </span> </p>
/content/10.2807/1560-7917.ES.2025.30.46.2500817
/content/10.2807/1560-7917.ES.2025.30.46.2500817
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error