Whole-genome sequencing of paired Neisseria co-carriage isolates from throat swabs

Neisseria meningitidis and Neisseria gonorrhoeae are two closely related yet distinct species within the genus Neisseria that exhibit distinct pathogenic characteristics and ecological niches. Inter-species genetic exchange has been documented but there are limited studies identifying the occurrence and timing of these exchanges.This study identified 47 instances of co-carriage of N. meningitidis and N. gonorrhoeae in throat swabs of high risk patients from a single Sexual Health Clinic in Sydney, Australia in 2021 and investigated evidence for genetic exchange between the species, searching for direct evidence of recent transfer of genetic material between the two isolates in each co-carriage pair.The speed and modality of genetic transfer between these Neisseria species is important in the context of changing patterns of prevalence and is pertinent in regards to antimicrobial resistance (AMR) determinants, as AMR in N. gonorrhoeae has reached a critical point, threatening our ability to treat these infections. The transmission of AMR determinants leading to similar resistance rates in N. meningitidis would have severe consequences.