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.