Introduction. The aim was to characterize Neisseria gonorrheae collected from multiple sites in the same patient without a cultured strain. The use of N. gonorrhoeae multiantigen sequence typing (NG-MAST) together with the gene sequence analysis of antimicrobial resistance (AMR) target genes permit to depict these samples.
Materials and methods. Seventeen genital and extra-genital samples from eight patients (7 were men who have sex with men, MSM, and 1 women who have sex with men, WSM) with gonorrhoea symptoms were analyzed.
For 7, of the 8 patients, conventional culture method has been used to identify gonorrhoea. All the samples were tested with the rapid molecular method CEPHEID. Amplification and sequencing of porB and tbpB, to identify the Sequence Type (ST) by NG-MAST, and penA, mtrR, porB1b, ponA genes were also performed.
Antimicrobial susceptibility by Etest, for the available culture positive samples, was carried out.
Results. For 7 patients it was obtained the ST (Sequence Type) and for 6 the complete sequence analysis of the antimicrobial resistance target genes. For the majority of them, samples collected from multiple sites confirm the presence of the same gonorrhoea strain. In particular, for 5 patients the same STs and changes in the AMR target genes were identified.
Conclusion. Molecular characterization on non-cultured or culture negative specimens for gonorrhoea permit to predict the presence of the same strain in the patients with infection in multiple anatomic sites and the genetic antimicrobial susceptibility pattern .