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Journal of Clinical Microbiology, December 2003, p. 5609-5614, Vol. 41, No. 12
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.12.5609-5614.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Persistence of Two Genotypes of Neisseria gonorrhoeae during Transmission

Departments of Infectious Diseases and Microbiology,¹ Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London,² Department of Genitourinary Medicine, Royal Hallamshire Hospital, Sheffield, United Kingdom³

Received 15 May 2003/ Returned for modification 8 July 2003/ Accepted 1 September 2003

Isolates of Neisseria gonorrhoeae were tested using a highly discriminatory typing method, opa typing, to examine the genetic diversity over a 2-year study period of isolates from all consecutive patients with gonorrhea attending the Genitourinary Medicine clinic in Sheffield, United Kingdom. Two opa genotypes were detected throughout the 2-year time period and comprised 41% of all strains tested. The persistence of two opa types was investigated further to determine the apparent genetic stability, by examining the ability of isolates to undergo intragenic and intergenic recombination and mutation in vitro. Intragenic recombination or mutation involving the opa genes of N. gonorrhoeae in the selected isolates was not detected, but intergenic recombination did occur. opa genes of N. gonorrhoeae in vivo appear to diversify primarily through intergenic recombination. Intergenic recombination in vivo would require the presence of a mixed gonococcal infection, in which an individual is concurrently colonized with more than one strain of N. gonorrhoeae. We propose that the level of diversity of opa genotypes in a population is linked to the degree of sexual mixing of individuals and the incidence of mixed infections of N. gonorrhoeae.

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