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Establishing a Wastewater Gonococcal Isolate Surveillance Program (wwGISP) for Early Detection of Community-Level Gonorrhea Transmission and Antimicrobial Resistance

Award Number: R21AI199156
ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/08/2026
PERIOD OF PERFORMANCE END DATE: 06/30/2028

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Establishing a Wastewater Gonococcal Isolate Surveillance Program (wwGISP) for Early Detection of Community-Level Gonorrhea Transmission and Antimicrobial Resistance - Project Summary Antimicrobial-resistant (AMR) Neisseria gonorrhoeae represents a significant and escalating public health challenge, with rising cases of infections resistant to ceftriaxone—the last reliably effective antibiotic. Current surveillance systems, such as the CDC's Gonococcal Isolate Surveillance Project (GISP), have substantially contributed to understanding AMR trends, but face challenges including reporting delays, limited geographic scope, and insufficient capture of asymptomatic infections. To complement these established methods, our interdisciplinary team proposes the Wastewater Gonococcal Isolate Surveillance Program (wwGISP), a wastewater-based genomic surveillance platform that leverages the detection of gonococcal DNA shed by infected individuals into wastewater. Our team has already demonstrated substantial success in wastewater intelligence, detecting pathogens such as SARS-CoV-2, influenza, mpox, antifungal-resistant Candida auris, and drug analytes like fentanyl ahead of clinical systems, enabling actionable public health interventions. Our pilot studies in Las Vegas—a region characterized by high population density and tourism—demonstrated the effectiveness of this method by detecting key AMR mutations, including the mosaic penA60 allele, several months ahead of clinical identification. In this proposal, we aim to (1) establish and validate a robust wastewater-based genomic surveillance infrastructure across strategically selected urban sites to detect N. gonorrhoeae DNA concentrations and AMR mutations, and (2) develop computational pipelines employing Independent Component Analysis Variant (ICA-Var) and Nonnegative Matrix Factorization (NMF), and unsupervised machine learning to accurately resolve pooled AMR mutation signals from wastewater samples. This integrated, innovative approach will provide near real-time, population-level insights into gonorrhea transmission dynamics and AMR trends, thereby guiding timely public health interventions. wwGISP is designed to be readily scalable and adaptable nationwide, enhancing existing surveillance efforts and bolstering our collective capacity to respond proactively to the threat of drug-resistant gonorrhea.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $416,625 )
2026	2026	BOARD OF REGENTS OF NEVADA SYSTEM OF HIGHER EDUCATION	4505 S MARYLAND PKWY	LAS VEGAS	NV	89154	CLARK	USA	Allergy and Infectious Diseases Research	000	1	7/8/2026	NEW	$416,625
														Subtotal = $416,625

Grand Total All Awards = $416,625

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Establishing a Wastewater Gonococcal Isolate Surveillance Program (wwGISP) for Early Detection of Community-Level Gonorrhea Transmission and Antimicrobial Resistance

Award Number: R21AI199156

ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/08/2026

PERIOD OF PERFORMANCE END DATE: 06/30/2028

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