Europe-wide expansion and eradication of multidrug-resistant Neisseria gonorrhoeae lineages: a genomic surveillance study

Centre for Genomic Pathogen Surveillance and the Euro-GASP study group: Sonja Pleininger, Alexander Indra, Irith De Baetselier, Wim Vanden Berghe, Blaženka Hunjak, Tatjana Nemeth Blažić, Panayiota Maikanti-Charalambous, Despo Pieridou, Hana Zákoucká, Helena Žemličková, Steen Hoffmann, Susan Cowan, Lasse Jessen Schwartz, Rita Peetso, Jevgenia Epstein, Jelena Viktorova, Ndeindo Ndeikoundam, Beatrice Bercot, Cécile Bébéar, Florence Lot, Susanne Buder, Klaus Jansen, Vivi Miriagou, Georgios Rigakos, Vasilios Raftopoulos, Eszter Balla, Mária Dudás, Lena Rós Ásmundsdóttir, Guðrún Sigmundsdóttir, Guðrún Svanborg Hauksdóttir, Thorolfur Gudnason, Aoife Colgan, Brendan Crowley, Sinéad Saab, Paola Stefanelli, Anna Carannante, Patrizia Parodi, Gatis Pakarna, Raina Nikiforova, Antra Bormane, Elina Dimina, Monique Perrin, Tamir Abdelrahman, Joël Mossong, Jean-Claude Schmit, Friedrich Mühlschlegel, Christopher Barbara, Francesca Mifsud, Alje Van Dam, Birgit Van Benthem, Maartje Visser, Ineke Linde, Hilde Kløvstad, Dominique Caugant, Beata Młynarczyk-Bonikowska, Jacinta Azevedo, Maria-José Borrego, Marina Lurdes Ramos Nascimento, Peter Pavlik, Irena Klavs, Andreja Murnik, Samo Jeverica, Tanja Kustec, Julio Vázquez Moreno, Asuncion Diaz, Raquel Abad, Inga Velicko, Magnus Unemo, Helen Fifer, Jill Shepherd, Lynsey PattersonBackground: Genomic surveillance using quality-assured whole-genome sequencing (WGS) together with epidemiological and antimicrobial resistance (AMR) data is essential to characterise the circulating Neisseria gonorrhoeae lineages and their association to patient groups (defined by demographic and epidemiological factors). In 2013, the European gonococcal population was characterised genomically for the first time. We describe the European gonococcal population in 2018 and identify emerging or vanishing lineages associated with AMR and epidemiological characteristics of patients, to elucidate recent changes in AMR and gonorrhoea epidemiology in Europe. Methods: We did WGS on 2375 gonococcal isolates from 2018 (mainly Sept 1-Nov 30) in 26 EU and EEA countries. Molecular typing and AMR determinants were extracted from quality-checked genomic data. Association analyses identified links between genomic lineages, AMR, and epidemiological data. Findings: Azithromycin-resistant N gonorrhoeae (8·0% [191/2375] in 2018) is rising in Europe due to the introduction or emergence and subsequent expansion of a novel N gonorrhoeae multi-antigen sequence typing (NG-MAST) genogroup, G12302 (132 [5·6%] of 2375; N gonorrhoeae sequence typing for antimicrobial resistance [NG-STAR] clonal complex [CC]168/63), carrying a mosaic mtrR promoter and mtrD sequence and found in 24 countries in 2018. CC63 was associated with pharyngeal infections in men who have sex with men. Susceptibility to ceftriaxone and cefixime is increasing, as the resistance-associated lineage, NG-MAST G1407 (51 [2·1%] of 2375), is progressively vanishing since 2009-10. Interpretation: Enhanced gonococcal AMR surveillance is imperative worldwide. WGS, linked to epidemiological and AMR data, is essential to elucidate the dynamics in gonorrhoea epidemiology and gonococcal populations as well as to predict AMR. When feasible, WGS should supplement the national and international AMR surveillance programmes to elucidate AMR changes over time. In the EU and EEA, increasing low-level azithromycin resistance could threaten the recommended ceftriaxone-azithromycin dual therapy, and an evidence-based clinical azithromycin resistance breakpoint is needed. Nevertheless, increasing ceftriaxone susceptibility, declining cefixime resistance, and absence of known resistance mutations for new treatments (zoliflodacin, gepotidacin) are promising.This study was supported by the European Centre for Disease Prevention and Control, the Centre for Genomic Pathogen Surveillance, the Li Ka Shing Foundation (Big Data Institute, University of Oxford), the Wellcome Genome Campus, the Foundation for Medical Research at Örebro University Hospital, and grants from Wellcome (098051 and 099202). LSB was funded by Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana (Plan GenT CDEI-06/20-B), Valencia, Spain, and Ministry of Science, Innovation and Universities (PID2020–120113RA-I00), Spain, at the time of analysing and writing this manuscript.info:eu-repo/semantics/publishedVersio

The remote sensing monitoring of the environment

W pracy podano pewne sugestie zastosowania metod teledetekcyjnych w monitoringu środowiska (przyrodniczego i antropogenicznego). Przedstawiono również krótkie wprowadzenie historyczne do problemu monitoringu. Zestawiono podstawowe metody teledetekcyjne (bierne i czynne). Opisano ponadto zasadnicze różnice między monitoringiem in situ a teledetekcyjnym wspomaganym technikami GPS i GIS. Zwrócono uwagę na konieczność stosowania komplementarnych systemów monitoringu w celu dokładniejszej interpretacji pozyskiwanych wyników obserwacji i pomiarów komponentów środowiska. Określono trzy podstawowe, istotne komponenty środowiska: atmosferę, hydrosferę i litosferę wraz z biosferą. Dla potrzeb monitoringu teledetekcyjnego - zwłaszcza dla zdjęć lotniczych, zobrazowań satelitarnych i obserwacji radiometrycznych - wprowadzono pojęcie morfostruktur antropogenicznych i przyrodniczych ekosystemów. Podkreślono ważność stosowania metod teledetekcyjnych w monitoringu środowiska w związku z przystąpieniem Polski do Wspólnoty Europejskiej.The paper presents some suggestions of an applictaion of remote sensing methods for the monitoring of envirnonment (natural and antropogenic). It contains also a short historical introduction to the problem of monitoring. As next it have been listed fundamental remote sensing methods (passive and active). Moreover, it is described principial differences between an in situ and remote sensing monitoring supported by the GPS and GIS technics. The neccesity of an application of complementar monitoring systems for more precise interpretation of obtained results of observations and measurements of environmental components is taken into consideration. Three fundamental, substantial components of environment have been defined such as: atmosphere, hydrosphere and litosphere together with biosphere. For the need of the remote sensing monitoring - especially for aerial photographs, satellite images and radiometrie observations - an idea of morfostructures of antropogenic and natural ecosystems have been introduced. The importance of using remote sensing methods in the environmental monitoring according to the accession of Poland to the European Union, at most was emphasized

Why Immigrant Background Matters for University Participation: A Comparison of Switzerland and Canada

This article extends our understanding of the difference in university participation between students with and without immigrant backgrounds by contrasting outcomes in Switzerland and Canada and by the use of new longitudinal data that are comparable between the countries. The research includes family socio-demographic characteristics, family aspirations regarding university education, and the student's secondary school performance as explanatory variables of university attendance patterns. In Switzerland, compared with students with Swiss-born parents, those with immigrant backgrounds are disadvantaged regarding university participation, primarily due to poor academic performance in secondary school. In comparison, students with immigrant backgrounds in Canada display a significant advantage regarding university attendance, even among some who performed poorly in secondary school. The included explanatory variables can only partly account for this advantage, but family aspirations regarding university attendance play a significant role, while traditional variables such as parental educational attainment are less important. In both countries, source region background is important. Possible reasons for the cross-country differences are discussed