Neisseria gonorrhoeae molecular typing for understanding sexual networks and antimicrobial resistance transmission: A systematic review

Katy Town*, Hikaru Bolt, Sara Croxford, Michelle Cole, Simon Harris, Nigel Field, Gwenda Hughes

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

13 Citations (Scopus)


Objectives: Neisseria gonorrhoeae (NG) is a significant global public health concern due to rising diagnoses rates and antimicrobial resistance. Molecular combined with epidemiological data have been used to understand the distribution and spread of NG, as well as relationships between cases in sexual networks, but the public health value gained from these studies is unclear. We conducted a systematic review to examine how molecular epidemiological studies have informed understanding of sexual networks and NG transmission, and subsequent public health interventions. Methods: Five research databases were systematically searched up to 31st March 2017 for studies that used sequence-based DNA typing methods, including whole genome sequencing, and linked molecular data to patient-level epidemiological data. Data were extracted and summarised to identify common themes. Results: Of the 49 studies included, 82% used NG Multi-antigen Sequence Typing. Gender and sexual orientation were commonly used to characterise sexual networks that were inferred using molecular clusters; clusters predominantly of one patient group often contained a small number of isolates from other patient groups. Suggested public health applications included using these data to target interventions at specific populations, confirm outbreaks, and inform partner management, but these were mainly untested. Conclusions: Combining molecular and epidemiological data has provided insight into sexual mixing patterns, and dissemination of NG, but few studies have applied these findings to design or evaluate public health interventions. Future studies should focus on the application of molecular epidemiology in public health practice to provide evidence for how to prevent and control NG.

Original languageEnglish
Pages (from-to)507-514
Number of pages8
JournalJournal of Infection
Issue number6
Publication statusPublished - Jun 2018

Bibliographical note

Funding Information:
Dr. Cole reports grants from The European Centre for Disease Prevention and Control Grant number Framework Contract No. ECDC/2013/015 which included funding for molecular typing, outside the submitted work.

Funding Information:
Dr. Harris reports grants from Wellcome Trust , grant number 098051 during the conduct of the study.

Funding Information:
The research was funded by the National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with Public Health England and in collaboration with the London School of Hygiene and Tropical Medicine. The funder of the study had no role in study design, data collection, data analysis, data interpretation, writing of the report or decision to submit the manuscript for publication. The corresponding author (KT) had full access to all the data in the study and had final responsibility for the decision to submit for publication.

Publisher Copyright:
© 2018 The Authors


  • Gonorrhoea
  • Molecular epidemiology
  • Molecular typing
  • Multi-Locus Sequence Typing
  • Neisseria Gonorrhoeae Multi-Antigen Sequence Typing
  • Neisseria gonorrhoeae
  • Public health
  • Sexual health
  • Sexually transmitted infection
  • Whole genome sequencing


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