Estimating the prevalence of mixed-type gonococcal infections in Queensland, Australia
Ella Trembizki A B , Christine Doyle C , Cameron Buckley A B , Amy Jennison C , Helen Smith C , John Bates C , Theo Sloots A B D , Michael Nissen A B D , Monica M. Lahra E and David Whiley A B FA Queensland Paediatric Infectious Diseases Laboratory, Queensland Children’s Health Services, Block 28, Royal Children’s Hospital, Herston Road, Herston, Qld 4029, Australia.
B Queensland Children’s Medical Research Institute, The University of Queensland, Qld 4029, Australia.
C Public Health Microbiology, Queensland Health Forensic and Scientific Services, Archerfield, Qld 4108, Australia.
D Microbiology Division, Pathology Queensland Central, Royal Brisbane and Women’s Hospital Campus, Qld 4029, Australia.
E WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, NSW 2031, Australia.
F Corresponding author. Email: d.whiley@uq.edu.au
Sexual Health 12(5) 439-444 https://doi.org/10.1071/SH15009
Submitted: 20 January 2015 Accepted: 7 May 2015 Published: 6 July 2015
Abstract
Background: Mixed gonococcal infections within the one anatomical site have been recognised but questions remain over how often they occur. In this study, the aim was to estimate the prevalence of mixed gonococcal infections using novel real-time polymerase chain reaction (PCR) methods that were developed and validated, targeting the gonococcal porB gene. Methods: Neisseria gonorrhoeae strains were categorised into three different porB groups, based on sequence data derived from N. gonorrhoeae multi-antigen sequence typing (NG-MAST) analyses of local isolates. Specific PCR methods for each group were then developed and these PCR methods were used to test clinical samples (n = 350) that were positive for gonorrhoea as determined by nucleic acid amplification test (NAAT) diagnostic screening. Results: Initial validation using isolates showed the group PCR methods proved 100% sensitive and 100% specific for their respective porB groups. When applied to the clinical specimens, 298/350 (85%) provided positive results by the group PCR methods. Of these, four specimens showed evidence of mixed infections, supported by subsequent DNA sequencing of the PCR products. Conclusions: The data provide further evidence of mixed gonococcal infections at the same anatomical site, but show that such infections may be relatively infrequent (1.3%; 95% confidence interval 0.01–2.6%) in a general screening population.
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