Transmission dynamics of Neisseria gonorrhoeae in Greenland: A 55-year retrospective observational genomic study

Andrea Sánchez-Serrano; Daniel Golparian; Thomas Roland Pedersen; Steen Hoffmann; Michael Lynge Pedersen; Marc Stegger; Leonor Sánchez-Busó; Magnus Unemo; Jørgen Skov Jensen

doi:10.1016/j.jgar.2026.08.018

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Transmission dynamics of Neisseria gonorrhoeae in Greenland: A 55-year retrospective observational genomic study

Journal article

Open access

Peer reviewed

Transmission dynamics of Neisseria gonorrhoeae in Greenland: A 55-year retrospective observational genomic study

Andrea Sánchez-Serrano, Daniel Golparian, Thomas Roland Pedersen, Steen Hoffmann, Michael Lynge Pedersen, Marc Stegger, Leonor Sánchez-Busó, Magnus Unemo and Jørgen Skov Jensen

Journal of global antimicrobial resistance, Vol.51, pp.35-44

2026

DOI: https://doi.org/10.1016/j.jgar.2026.08.018

PMID: 42660293

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Abstract

Antimicrobial resistance

Gonorrhoea

Greenland

Neisseria gonorrhoeae

Surveillance

Whole-genome sequencing

Background Greenland has high gonorrhoea rates, yet the antimicrobial resistance (AMR) and especially genomic epidemiology and dynamics of gonococcal lineages remain unexplored. We characterized circulating gonococcal lineages in Greenland over 55 years, their AMR determinants and importation of AMR lineages. Methods We analyzed 463 gonococcal isolates collected from five municipalities in Greenland across 1960–1990 and 2012–2015. Antimicrobial susceptibility was determined using Etest, and whole-genome sequencing performed using Illumina NextSeq 550. Comparative genomic analysis included isolates from Denmark and other European and global datasets. Results Tetracycline resistance was the most prevalent, while high-level resistance to benzylpenicillin, ciprofloxacin, azithromycin and ceftriaxone remained rare or absent. Genomic analysis revealed two major clades, with lineage-specific AMR determinants. Most lineages were unique to Greenland or shared exclusively with Denmark, but globally-circulating AMR high-risk clonal complexes have also been introduced in Greenland, e.g., NG-STAR CC20, ST20 and NG-STAR CC158, ST158; with decreased susceptibility to ceftriaxone, and resistance to ciprofloxacin and tetracycline. Conclusion The importation of the first AMR high-risk lineage (NG-STAR CC158, ST158) into Greenland threatened historical high antimicrobial susceptibility. Re-established gonococcal AMR surveillance, with genomic surveillance, improved clinical management of gonorrhoea, targeted public health interventions, and enhanced tailored sexual health education are imperative in Greenland.

Details

Title: Transmission dynamics of Neisseria gonorrhoeae in Greenland: A 55-year retrospective observational genomic study
Authors/Creators: Andrea Sánchez-Serrano - Universitat de València
Daniel Golparian - Örebro University
Thomas Roland Pedersen - Statens Serum Institut
Steen Hoffmann - Statens Serum Institut
Michael Lynge Pedersen - Ilisimatusarfik
Marc Stegger - Murdoch University
Leonor Sánchez-Busó - Universitat de València
Magnus Unemo - Örebro University
Jørgen Skov Jensen - Department of Bacteria, Parasites and Fungi, Research Unit for Reproductive Microbiology, Statens Serum Institut, Copenhagen, Denmark
Publication Details: Journal of global antimicrobial resistance, Vol.51, pp.35-44
Publisher: Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy.
Number of pages: 10
Identifiers: 991005927417307891
Murdoch Affiliation: Harry Butler Institute
Language: English
Resource Type: Journal article

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