The diagnosis of sexually transmitted infections (STIs) is a prequel to treatment. The more accurate the diagnosis, the better the treatment that can be offered. From syndromic diagnosis, through species diagnosis, to data on antimicrobial resistance (AMR) mechanisms carried by the infectious agent, higher resolution means improved treatment. The speed at which this information can be gathered is also critical to the successful administration of appropriate treatment and patient compliance. With the continuing global rise in STI diagnoses, the observed danger of diagnostic escape, and the imminence of untreatable gonorrhoea, we need to understand the evolution of STIs and the selection pressures that they are under. Whole genome sequencing can contribute a great deal towards this. Genomics has given us many insights into the lifestyles and evolution of bacterial STIs, over long and short term. Genomic surveillance will always be necessary to decipher population dynamics and to characterise novel strains. Work on genital microbiota and metagenomics can provide information on mixed infections. The pressing question is whether genomics can be used to rapidly develop point of care diagnostic tests, enabling practitioners to provide the most appropriate care for their patients.
Disclosure No significant relationships.
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