I had to read this study a couple of times to get to grips with the maths (!), but the message is clear.

We all know that gonorrhea is getting more and more resistant to antibiotics, and so most coutries now have some kind of monitoring systme to detect the emergence of resistant strains.

In this study, the wanted to compare (using statistical models) if we can best detect resistant strains with the current system used in the US (called GISP, it looks mostly at urethral and vaginal samples) or by including throat and rectal samples too.

It clearly showed that looking at samples from people who have oral and anal sex helsp detect the most resistant types of gonorrhea.

The reason for this, is that gonorrhea is in closer contact with other bacteria in the throat and rectum than when the infection in “genital”, and it can use a special mechanism to steal DNA that is “resistant to antibiotics” from those other bacteria.

Sofya Prakhova. Evaluating Efficiency of the US Surveillance Systems for Monitoring Antimicrobial Resistant Gonorrhea: An Agent Based Modelling Study; 2023, doi: 10.20944/preprints202310.0814.v1