✅ Say: "My manuscript has been metropolised"
❌ Don't say: "My manuscript has been rejected and so I've sent it to MDPI"

www.nature.com/articles/s41...

(10/10) Work with @tatumdmortimer.bsky.social & @yhgrad.bsky.social

(9/10) As N. gonorrhoeae strains carrying high-level cephalosporin resistance on a tetM positive background have been emerging globally wwwnc.cdc.gov/eid/article/..., the evident strength of selection for tetM may have created a favorable environment for their expansion in the US.

(8/10) This raises concern for genetic hitchhiking, whereby alleles that may be neutral or deleterious on their own actually increase in frequency due to their presence in lineages that carry another gene or allele that’s beneficial.

(7/10) The number of major N. gonorrhoeae lineages carrying tetM also increased from one before 2020 that accounted for ~40% of all tetM+ isolates to 4 after 2020 that collectively accounted for ~80% of all tetM+ isolates. Two of these lineages carry penA variants that increase cephalosporin MICs.

(6/10) This is consistent with a recent report out of Seattle, showing an increase in resistance in N. gonorrhoeae and an increase in S. aureus tetracycline resistance in those on doxy-PEP: academic.oup.com/cid/advance-... and www.thelancet.com/journals/lan...

(5/10) By May 2024, the estimated proportion of isolates carrying tetM skyrocketed to ~35%, suggesting a large selective pressure for doxycycline resistance. The rise seems most pronounced in HHS regions 9 and 10.

(4/10) To investigate the impact of the increased doxy use, we analyzed a collection of over 14000 N. gonorrhoeae genomes spanning 2018-mid 2024, collected and sequenced through CDC surveillance efforts -- GISP, eGISP, SURRG www.cdc.gov/gonorrhea/hc....

(3/10) This is especially relevant for N. gonorrhoeae. In 2018, an estimated 10% of isolates carried the plasmid-borne gene tetM, which confers high-level tetracycline resistance (MIC ≥ 16 µg/mL) pmc.ncbi.nlm.nih.gov/articles/PMC....

(2/10) Over the past few years, the use of doxycycline to treat bacterial STIs has gone up in the US. Doxy became the recommended treatment for chlamydia (2020), it was used for syphilis treatment during bicillin shortages, and doxy-PEP was rolled out. What’s the impact on resistance?

Work with @tatumdmortimer.bsky.social & @yhgrad.bsky.social

(9/10) As N. gonorrhoeae strains carrying high-level cephalosporin resistance on a tetM positive background have been emerging globally wwwnc.cdc.gov/eid/article/..., the evident strength of selection for tetM may have created a favorable environment for their expansion in the US.

(8/10) This raises concern for genetic hitchhiking, whereby alleles that may be neutral or deleterious on their own actually increase in frequency due to their presence in lineages that carry another gene or allele that’s beneficial.

(7/10) The number of major N. gonorrhoeae lineages carrying tetM also increased from one before 2020 that accounted for ~40% of all tetM+ isolates to 4 after 2020 that collectively accounted for ~80% of all tetM+ isolates. Two of these lineages carry penA variants that increase cephalosporin MICs.

(6/10) This is consistent with a recent report out of Seattle, showing an increase in resistance in N. gonorrhoeae and an increase in S. aureus tetracycline resistance in those on doxy-PEP: www.thelancet.com/journals/lan... and academic.oup.com/cid/advance-...

(5/10) By May 2024, the estimated proportion of isolates carrying tetM skyrocketed to ~35%, suggesting a large selective pressure for doxycycline resistance. The rise seems most pronounced in HHS regions 9 and 10.

(4/10) To investigate the impact of the increased doxy use, we analyzed a collection of over 14000 N. gonorrhoeae genomes spanning 2018-mid 2024, collected and sequenced through CDC surveillance efforts -- GISP, eGISP, SURRG www.cdc.gov/gonorrhea/hc....

(3/10) This is especially relevant for N. gonorrhoeae. In 2018, an estimated 10% of isolates carried the plasmid-borne gene tetM, which confers high-level tetracycline resistance (MIC ≥ 16 µg/mL).