1887

Abstract

) is a bacterial pathogen responsible for invasive meningococcal disease. Though typically colonizing the nasopharynx, multiple outbreaks of meningococcal urethritis were first reported in 2015–2016; outbreaks originally presumed to be caused by (). Genomic analysis revealed that the isolates causing these outbreaks were a distinct clade, and had integrated gonococcal DNA at multiple genomic sites, including the gonococcal denitrification apparatus , a partial gonococcal operon of five genes containing D, and the acetylglutamate kinase gene with the adjacent gonococcal locus . The urethritis isolates had also deleted the group C capsule biosynthesis genes and , resulting in loss of capsule. Collectively, these isolates form the urethritis clade (UC). Genomic analysis of recent (2016–2022) UC isolates revealed that the genomic features have been maintained in the clade, implying that they are important for UC’s status as a urogenital pathogen. Furthermore, the analysis revealed the emergence of a sub-clade, designated UC-B, phylogenetically separated from the earlier UC-A. This sub-clade has integrated additional gonococcal alleles into the genome, including alleles associated with antimicrobial resistance. UC continues to adapt to a urethral niche and evolve as a urogenital pathogen.

Funding
This study was supported by the:
  • Division of Intramural Research, National Institute of Allergy and Infectious Diseases (Award R01AI127863)
    • Principle Award Recipient: NotApplicable
  • Division of Intramural Research, National Institute of Allergy and Infectious Diseases (Award R21AI164733)
    • Principle Award Recipient: Yih-LingTzeng
  • Division of Intramural Research, National Institute of Allergy and Infectious Diseases (Award R21AI128313)
    • Principle Award Recipient: Yih-LingTzeng
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License.
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2023-10-18
2024-10-03
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