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Looking at almost 2,200 cases from 2017 of Neisseria gonorrhoeae, the bacteria that causes gonorrhoea, researchers from the Doherty Institute and the Melbourne Sexual Health Clinic identified distinct transmission clusters associated with men who have sex with men, men who have sex with men and women, and heterosexuals.

The incidence of gonorrhoea has increased markedly in Australia and globally (1) over the past five years, and the emergence and spread of an antimicrobial-resistant strain has been deemed an urgent threat to public health.

In addition, the study, published today in Nature Communications, identified transmission between people living with HIV and HIV-negative individuals receiving pre-exposure prophylaxis (PrEP), antiviral drugs that prevent HIV transmission.

Untreated, gonorrhoea can lead to pelvic inflammatory disease, ectopic pregnancy and infertility in women, and can promote the transmission of HIV.

Lead author, University of Melbourne Associate Professor Deborah Williamson, Deputy Director of the Microbiological Diagnostic Unit Public Health Laboratory at the Doherty Institute, said data collected in the study highlights several groups to be targeted for interventions to improve gonorrhoea control, including returning travellers, sex workers and PrEP users.

“The incidence of bacterial sexually transmitted infections (STIs) globally is going up so we need sophisticated and innovative ways to combat this issue – the use of genomics could play a big part in this response,” Associate Professor Williamson said.

“This is the largest and most detailed genomic study of gonorrhoea worldwide, and understanding the complex transmission networks of this STI is critical in informing the response to controlling and preventing it.”

Co-author, Director of the Melbourne Sexual Health Centre and Professor of Public Health at Monash University, Kit Fairley said these insights will greatly assist our efforts to control this prevalent infection.

“For the first time we can see what we could never see before: a unique combination of new technology and detailed epidemiology has allowed us to understand how these infections may be transmitted through the Victorian population,” Professor Fairley said.

“For example, it appears travellers returning from overseas play a key role in introducing new strains of gonorrhoea into the Victorian population.”

This study was done in collaboration with Melbourne Sexual Health Centre, Melbourne Bioinformatics Group, The Victorian Department of Health and Human Services and the Harvard T.H. Chan School of Public Health.