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Peer reviewedOpen accessGonorrheaGonococcal infection

Selecting candidate Neisseria gonorrhoeae strains for oropharyngeal gonorrhoea human challenge: a genomics-based analysis of clinical isolates

The Lancet Microbe·

Eloise Williams, Soo Jen Low, Georgina L Pollock, Mona L Taouk, Jacqueline Prestedge, Benjamin P Howden, Eric P F Chow, Christopher K Fairley, Kate L Seib, James S McCarthy, Shivani Pasricha, Deborah A Williamson

DOI
10.1016/j.lanmic.2025.101105
PMID
40652955
PMCID
OpenAlex
W4412424383
Study type
Journal article
Publisher
Elsevier BV
Article type
journal-article
Integrity
current

Why this research matters now

The work supports development of a controlled human infection model that could accelerate novel gonorrhoea prevention and therapeutic strategies, addressing a pathogen of major public health concern due to rising prevalence and antimicrobial resistance. The selection approach prioritizes participant safety and identifies strains relevant for evaluating current and future vaccines.

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Structured evidence summary

Research question

The study aimed to develop a systematic genomics-based approach for selecting Neisseria gonorrhoeae strains suitable for a controlled human infection model of oropharyngeal gonorrhoea.

Study design

This was a genomics-based analysis that applied predefined selection criteria to clinical isolates collected in Victoria, Australia, during 2017 and 2019-2021. The selection strategy incorporated clinical, phenotypic, and genomic characteristics to identify candidate challenge strains.

Population and setting

The primary dataset included 5,881 N. gonorrhoeae clinical isolates obtained from adult patients in Victoria, Australia, collected between January 1 and December 31, 2017, and July 1, 2019, to June 30, 2021.

Main findings

Of 5,881 isolates, 5,795 (98.6%) were excluded primarily due to clinically significant antimicrobial resistance and poor contemporary global clinical relevance. The remaining 86 candidate strains comprised five multilocus sequence types and six multiantigen sequence types. Five isolates were ultimately selected to maximize phylogenetic coverage and representation across anatomical collection sites.

Public-health relevance

The work supports development of a controlled human infection model that could accelerate novel gonorrhoea prevention and therapeutic strategies, addressing a pathogen of major public health concern due to rising prevalence and antimicrobial resistance. The selection approach prioritizes participant safety and identifies strains relevant for evaluating current and future vaccines.

Important limitations

This summary is limited to the supplied single-article abstract and metadata. The full paper is required for decision-grade interpretation, including detailed methods, validation steps, and the rationale underlying specific selection threshold choices.

GIDS interpretation

This article would be discoverable through GIDS queries combining gonorrhoea with antimicrobial resistance, transmission dynamics, or treatment, and through geographic filters for Australia. The strain selection methodology described may inform future surveillance or experimental pathogen characterization work.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 8 auditable classifier relationships to diseases, places, topics, and study design.

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