Exploring the Prevalence of Neisseria gonorrhoeae in Women with Genitourinary Symptoms in Tehran, Iran

Narjes Noori  Goodarzi; Shaghayegh  Zafar; Naghmeh  Pourmand; Soheila  Ajdary; Mir Saeed  Yekaninejad; Mohammad Reza  Pourmand; Farzad  Badmasti

doi:10.18502/ijph.v54i4.18424

Narjes Noori Goodarzi Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Shaghayegh Zafar Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Naghmeh Pourmand Department of Infertility, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Soheila Ajdary Department of Immunology, Pasteur Institute of Iran, Tehran, Iran
Mir Saeed Yekaninejad Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences,Tehran, Iran
Mohammad Reza Pourmand Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Farzad Badmasti Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran

DOI: https://doi.org/10.18502/ijph.v54i4.18424

Keywords: Neisseria gonorrhoeae; Prevalence; Gonorrhea

Abstract

Background: Neisseria gonorrhoeae, the second most common sexually transmitted infection (STI) worldwide, affects one million people daily. We aimed to investigate the prevalence of gonorrhea in females with genital infections in Tehran, Iran.

Methods: First, a bioinformatic study was conducted to identify a conserved and high-prevalent gene marker for detection of N. gonorrhoeae. One desirable marker was selected and a pair of specific primers was designed to amplify it. The reliability of the primer pair was evaluated in silico and in vitro. Subsequently, 172 patients with genitourinary symptoms were enrolled and an endocervical swab specimen was obtained from each patient to evaluate the presence of N. gonorrhoeae in clinical specimens using the specific primers.

Results: Restriction endonuclease subunit S (resS, WP_003687768.1) was selected as a specific detection marker. The designed primer pair targeting resS showed specific and reliable detection of N. gonorrhoeae in silico and in vitro. Out of 172 clinical samples, seven (4.06%) cases were infected by N. gonorrhoeae. Statistical analysis of clinical manifestations showed that there was a significant association between the occurrence of N. gonorrhoeae and dysuria (P= 0.043), pelvic pain (P= 0.017), and fever (P = 0.045).

Conclusion: Three promising markers were introduced for development of point-of-care testing approaches. Moreover, this study highlights a 4% prevalence of gonorrhea among women with genitourinary symptoms in Iran, which reminds the urgent need for routine surveillance and new policies in management of STIs, particularly gonorrhea.