Increased diversity and introduction of multi-drug resistant strains of Neisseria gonorrhoeae following cessation of COVID-19 pandemic-related travel restrictions: an observational genomic epidemiological study.

Abstract

National and international travel drives the spread of antimicrobial resistance in high-priority pathogens, including Neisseria gonorrhoeae. Border closures and travel restrictions in response to the COVID-19 pandemic had wide-reaching impacts on infectious disease epidemiology, including the transmission and genomic diversity of N. gonorrhoeae. However, less is known about N. gonorrhoeae population structures in the years following lifting of pandemic restrictions. This study analysed N. gonorrhoeae genomic data collected for routine public health surveillance in South Australia, Australia, and contextual sequences from Victoria, Australia, before and after the cessation of COVID-19 interstate and international travel restrictions. N. gonorrhoeae was highly clonal during periods with restricted travel, and genomic diversity markedly increased after restrictions were removed, possibly driven by increased transmission and the introduction of new strains. Routine genomic surveillance is an important public health tool for the monitoring of N. gonorrhoeae, especially the introduction and spread of antimicrobial resistant strains.