Genomic surveillance meets clinical practice: rule-based individualized treatment prediction for gonorrhoea using SensiTyper.

SensiTyper predicts antimicrobial susceptibility from Neisseria gonorrhoeae whole-genome data with 98.9–100% sensitivity and specificity for ceftriaxone, ciprofloxacin, spectinomycin, and zoliflodacin across 13,701 genomes from 68 countries (1928–2024).

• Why it matters: XDR Neisseria gonorrhoeae strains threaten empirical gonorrhoea treatment, creating a need for genomic tools that can guide individualized therapy and stewardship in real-world clinical and molecular sampling.
• What they did: The rule-based SensiTyper framework was analytically validated and benchmarked by applying it to 13,701 gonococcal genomes from 68 countries, using cultured isolates and clinical molecular samples and comparing predictions with prior genomic and phenotypic data.
• The result: SensiTyper enabled susceptibility-guided individualized treatment recommendations via SensiTreat, while azithromycin showed 92.5% sensitivity and 97.1% specificity and gepotidacin showed 100% sensitivity but 0% specificity, supporting XDR flagging for follow-up, test-of-cure, and contact tracing.

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