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Reviewed 03 Aug 2007

MicrobiologyThis page summarises the role and activities of the microbiology section of the ESSTI network.

During the first phase of ESSTI (2001-2004), the microbiology section aimed to make a rapid but comprehensive assessment of reference and specialist centres for gonorrhoea across Europe. It also investigated diagnostic methods in use for gonorrhoea, syphilis and chlamydia in laboratories in Europe, and the quality of antimicrobial susceptibility testing for Neisseria gonorrhoeae.


The microbiology objectives of ESSTI (2006-2008) are:

  • To implement molecular outbreak typing
  • To provide an annual quality assurance programme by the exchange of N. gonorrhoeae strains
  • To develop a panel of N. gonorrhoeae control strains
  • To implement a European Gonococcal Antimicrobial Surveillance Programme (Euro_GASP) network
Molecular Outbreak Typing

Outbreaks have successfully been identified using ESSTI_ALERT. Molecular typing of outbreak strains may add considerably to outbreak investigations.  We will use a multi-locus antigen sequencing method (NG-MAST;, which examines variation in two genes, por and tbpB. NG-MAST is highly discriminatory in identifying clusters, and can be applied to a large number of strains. This data can be provided within a 2 – 4 week period from receiving the gonococcal isolates, and will therefore help inform outbreak control.

N. gonorrhoeae isolate panel exchange

A panel of 30 isolates will be exchanged by all participating laboratories and susceptibility testing will be performed using each laboratory’s routine methodology. The strains will have a range of susceptibilities and will be tested with a minimum of penicillin, ciprofloxacin, tetracycline and a cephalosporin. MIC or zone size results will be reported, along with susceptibility/resistance category. The results will be returned centrally for analysis. This will allow laboratories to identify reproducibility problems and offer a comparison between laboratories. Further analysis will examine the effect of the different methods on concordance of results, with the aim of clarifying best practice.


Panel of control strains

The panel of control strains will be available to all European reference and specialist centres in the first instance. The panel will be chosen from strains that have previously been tested in all laboratories through the QA programme to achieve a consensus result. This will ensure a common reference point to which laboratories can control their methodology.

European Gonococcal Antimicrobial Surveillance Programme (Euro_GASP)

A representative sample of N. gonorrhoeae strains will be collected from each country. The strains will be tested against a range of antimicrobials, including penicillin, ciprofloxacin, tetracycline, azithromycin and a cephalosporin . The results will determine the prevalence of antimicrobial resistance across Europe and help inform treatment guidelines.

ESSTI Training Course on STI laboratory methods
A one-week training course on STI laboratory methods has been developed by ESSTI. The first such course was held at the Health Protection Agency Centre for Infections, London in April 2007. Ten participants from laboratories that are part of the ESSTI network attended the week of seminars and practical sessions. A second course will be held at a later date.
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