# P-1267. Neisseria gonorrhoeae in Ecuador: insights from whole-genome sequencing

## TL;DR

This study uses whole-genome sequencing to analyze Neisseria gonorrhoeae strains in Ecuador, revealing virulence and antibiotic resistance factors.

## Contribution

The study provides the first genomic insights into N. gonorrhoeae in Ecuador, identifying specific plasmid types and resistance genes.

## Key findings

- All isolates carried key virulence genes like pil, porB, and katA.
- Five strains harbored the blaTEM gene associated with plasmid variants pbla.1 and pbla.3.
- Ceftriaxone and cefixime remain effective, but other antibiotics require sensitivity testing.

## Abstract

Neisseria gonorrhoeae causes over 80 million global gonorrhea cases annually and is increasingly resistant to first-line antibiotics. In Ecuador, genomic data is scarce due to empirical treatment practices and limited culture testing. This study aims to evaluate virulence and antimicrobial resistance (AMR) factors in N. gonorrhoeae strains from Quito, Ecuador.Antimicrobial resistance profiles in Neisseria gonorrhoeae strains.Schematic representation of the pbla.1 and pbla.3 associated to blaTEM.Grey line indicates aligned regions with arrows representing ORFs colored according to their gene products; grey, hypothetical proteins; yellow, mobilization proteins; red, Tn2-derived genes including blaTEM (NEIS2357); blue, replication initiation proteins.

Antimicrobial resistance profiles in Neisseria gonorrhoeae strains.

Schematic representation of the pbla.1 and pbla.3 associated to blaTEM.

Grey line indicates aligned regions with arrows representing ORFs colored according to their gene products; grey, hypothetical proteins; yellow, mobilization proteins; red, Tn2-derived genes including blaTEM (NEIS2357); blue, replication initiation proteins.

Twenty-five genital samples from adults with suspected gonorrhea (2021–2024) were cryopreserved. Eighteen isolates were successfully cultured and fully sequenced using Oxford Nanopore MinION™ MK1B. AMR profiles were analyzed with Pathogenwatch. The blaTEM gene was identified via sequence alignment and variant analysis. Plasmid-associated genes and replication/mobilization regions were characterized, and plasmid types were classified using a pbla typing scheme.

All isolates carried key virulence genes involved in adherence, invasion, and survival, including pil, porB, katA, MsrA/B, tbpA/B, and lbpA/B. Multiple AMR mutations were detected (Figure 1). Five strains harbored the blaTEM gene, associated with plasmid variants pbla.1 (blaTEM-135) and pbla.3 (blaTEM-1B) (Figure 2).

The detection of virulence and resistance genes in N. gonorrhoeae highlights its adaptability and the need for genomic surveillance. Ceftriaxone and cefixime remain effective for empirical treatment, but other antibiotics require prior sensitivity testing. Distinct features of pbla.1 and pbla.3 plasmids may affect gene transfer, stability, and spread. The presence of blaTEM in these plasmids raises concerns about potential extended-spectrum β-lactamases (ESBL) development, emphasizing the importance of tracking plasmid diversity to manage antibiotic resistance.

All Authors: No reported disclosures