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Genomic epidemiology of syphilis reveals independent emergence of macrolide resistance across multiple circulating lineages.

Beale, MA; Marks, M; Sahi, SK; Tantalo, LC; Nori, AV; French, P; Lukehart, SA; Marra, CM; Thomson, NR (2019) Genomic epidemiology of syphilis reveals independent emergence of macrolide resistance across multiple circulating lineages. Nat Commun, 10 (1). p. 3255. ISSN 2041-1723 https://doi.org/10.1038/s41467-019-11216-7
SGUL Authors: Nori, Achyuta Vithal

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Abstract

Syphilis is a sexually transmitted infection caused by Treponema pallidum subspecies pallidum and may lead to severe complications. Recent years have seen striking increases in syphilis in many countries. Previous analyses have suggested one lineage of syphilis, SS14, may have expanded recently, indicating emergence of a single pandemic azithromycin-resistant cluster. Here we use direct sequencing of T. pallidum combined with phylogenomic analyses to show that both SS14- and Nichols-lineages are simultaneously circulating in clinically relevant populations in multiple countries. We correlate the appearance of genotypic macrolide resistance with multiple independently evolved SS14 sub-lineages and show that genotypically resistant and sensitive sub-lineages are spreading contemporaneously. These findings inform our understanding of the current syphilis epidemic by demonstrating how macrolide resistance evolves in Treponema subspecies and provide a warning on broader issues of antimicrobial resistance.

Item Type: Article
Additional Information: Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2019
Keywords: Anti-Bacterial Agents, Azithromycin, Drug Resistance, Bacterial, Genome, Bacterial, Genomics, Genotype, Humans, Macrolides, Molecular Epidemiology, Pandemics, Phylogeny, Sequence Analysis, DNA, Species Specificity, Syphilis, Treponema pallidum, Humans, Treponema pallidum, Syphilis, Macrolides, Azithromycin, Anti-Bacterial Agents, Sequence Analysis, DNA, Genomics, Phylogeny, Drug Resistance, Bacterial, Species Specificity, Genotype, Genome, Bacterial, Molecular Epidemiology, Pandemics, MD Multidisciplinary
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Nat Commun
ISSN: 2041-1723
Language: eng
Dates:
DateEvent
22 July 2019Published
1 July 2019Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
R01 AI042143NIAID NIH HHSUNSPECIFIED
R01 AI123196NIAID NIH HHSUNSPECIFIED
R01 AI063940NIAID NIH HHSUNSPECIFIED
P01 AI034616NIAID NIH HHSUNSPECIFIED
102807Wellcome Trusthttp://dx.doi.org/10.13039/100004440
098051Wellcome Trusthttp://dx.doi.org/10.13039/100004440
R01 NS034235NINDS NIH HHSUNSPECIFIED
PubMed ID: 31332179
Web of Science ID: WOS:000476721900003
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/113815
Publisher's version: https://doi.org/10.1038/s41467-019-11216-7

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