Photoinactivation of Neisseria gonorrhoeae: A Paradigm-Changing Approach for Combating Antibiotic-Resistant Gonococcal Infection

J Infect Dis. 2019 Jul 31;220(5):873-881. doi: 10.1093/infdis/jiz018.


Antimicrobial resistance in Neisseria gonorrhoeae is a major issue of public health, and there is a critical need for the development of new antigonococcal strategies. In this study, we investigated the effectiveness of antimicrobial blue light (aBL; wavelength, 405 nm), an innovative nonpharmacological approach, for the inactivation of N. gonorrhoeae. Our findings indicated that aBL preferentially inactivated N. gonorrhoeae, including antibiotic-resistant strains, over human vaginal epithelial cells in vitro. Furthermore, no aBL-induced genotoxicity to the vaginal epithelial cells was observed at the radiant exposure used to inactivate N. gonorrhoeae. aBL also effectively inactivated N. gonorrhoeae that had attached to and invaded into the vaginal epithelial cells in their cocultures. No gonococcal resistance to aBL developed after 15 successive cycles of inactivation induced by subtherapeutic exposure to aBL. Endogenous aBL-activatable photosensitizing porphyrins in N. gonorrhoeae were identified and quantified using ultraperformance liquid chromatography, with coproporphyrin being the most abundant species in all N. gonorrhoeae strains studied. Singlet oxygen was involved in aBL inactivation of N. gonorrhoeae. Together, these findings show that aBL represents a potential potent treatment for antibiotic-resistant gonococcal infection.

Keywords: Neisseria gonorrhoeae; antibiotic resistance; antimicrobial blue light; endogenous porphyrins; gonorrhea.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Abetalipoproteinemia
  • Anti-Bacterial Agents / pharmacology
  • Drug Resistance, Multiple, Bacterial / radiation effects
  • Epithelial Cells / microbiology
  • Female
  • Gonorrhea / drug therapy
  • Gonorrhea / radiotherapy*
  • Humans
  • Light
  • Microbial Sensitivity Tests
  • Neisseria gonorrhoeae / drug effects
  • Neisseria gonorrhoeae / growth & development
  • Neisseria gonorrhoeae / radiation effects*
  • Oxygen
  • Sodium Azide
  • Vagina / microbiology


  • Anti-Bacterial Agents
  • Sodium Azide
  • Oxygen