Establishing a Neisseria gonorrhoeae whole-genome sequencing external quality assessment for the Antimicrobial Resistance Laboratory Network (AR Lab Network) regional laboratories

ABSTRACT Drug-resistant Neisseria gonorrhoeae (GC) is classified by the Centers for Disease Control and Prevention (CDC) as an urgent threat. Effective surveillance of antimicrobial resistance and strain types through whole-genome sequencing (WGS) is essential to preserve existing antibiotics for treatment. To ensure consistent, high-quality data, we implemented an External Quality Assessment (EQA) program within the Antimicrobial Resistance Laboratory Network in fall 2020. This biannual program distributes five blinded GC reference isolates in triplicate to four regional laboratories for antimicrobial susceptibility testing and WGS. Data were transferred to the CDC for taxonomic classification, assembly, phylogenetics, and quality evaluation. During fall 2020 (pilot)–spring (Cycle 1) 2023, five laboratories (four external; one at CDC) participated in a pilot and five EQA cycles. In the pilot cycle, all laboratories met all quality metrics. However, in 2021 Cycle 1, one laboratory scored below passing (