Emergence and Characterization of a Ceftriaxone-Resistant Neisseria gonorrhoeae FC428 Clone Evolving Moderate-Level Resistance to Azithromycin in Shenzhen, China

Figures & data

Table 1 Phenotypic Characteristics and Molecular Characteristics of Isolates Related to the FC428 Clone

Isolate	Country	Patient Gender	Sexual Orientation	Sampling Site	MIC (mg/L)						PPNG	blaTEM Type	Reference
					CRO	TET	SPT	AZM	CIP	PEN
YL201	China	Male	Hetero	Urethral	0.75	4	12	12	32	1.5	Yes	1	This study
BJ16148	China	Male	Hetero	Urethral	0.5	4	16	0.25	>32	NA	NA	NA	[^Citation12]
GC185	China	NA	NA	Urethral	1	NA	NA	0.5	NA	NA	Yes	135	[^Citation6]
GC250	China	Male	hetero	Urethral	0.5	NA	NA	2	NA	NA	Yes	1	[^Citation6]
SC18-25	China	Male	Hetero	Urethral	≥0.5	NA	16.0	0.5	≥16.0	2	No	No	[^Citation13]
SC18-26	China	Male	Hetero	Urethral	≥0.5	NA	16.0	1.0	≥16.0	≥8.0	Yes	1	[^Citation13]
SC18-68	China	Male	Hetero	Urethral	≥0.5	NA	16.0	0.5	≥16.0	4.0	No	No	[^Citation13]
SRRSH214	China	NA	NA	Urethral or vaginal	1	NA	NA	0.1	NA	NA	NA	NA	[^Citation7]
SRRSH229	China	NA	NA	Urethral or vaginal	1	NA	NA	0.3	NA	NA	NA	NA	[^Citation7]
SZ2017191	China	NA	NA	Urethral	0.5	8	16	0.5	16	1	NA	NA	[^Citation14]
FC428	Japan	Male	NA	Urethral	0.5	0.5	8	0.25	>32	>32	Yes	135	[^Citation15]
FC460	Japan	Male	NA	Urethral	0.5	0.5	8	0.25	>32	>32	Yes	NA	[^Citation15]
FC498	Japan	Male	NA	Urethral	0.75	NA	8	0.5	>32	1.5	NO	NO	[^Citation16]
KU16054	Japan	Male	NA	Urethral	0.5	NA	8	0.19	>32	0.5	NO	NO	[^Citation16]
KM383	Japan	Male	NA	Urethral	0.5	NA	12	0.125	>32	1	NO	NO	[^Citation16]
A7846	Australia	Male	Hetero	Urethral	0.5	2	8	0.25	>32	≥32	Yes	NA	[^Citation17]
A7536	Australia	Male	Hetero	Urethral	0.5	4	8	0.25	>32	≥32	Yes	NA	[^Citation17]
GK124	Denmark	Male	Hetero	Urethral	0.5	NA	8	0.5	>32	>256	NA	NA	[^Citation3]
47707	Canada	Female	Hetero	NA	1	4	16	0.5	32	≥256	Yes	NA	[^Citation18]
IR72	Ireland	Male	Hetero	Urethral	0.5	0.5	16	0.38–0.5	>32	NA	NA	NA	[^Citation2]
A2543	Australia	Female	NA	NA	0.5	NA	NA	>256	NA	NA	NA	NA	[^Citation5]
H18-502	UK	Female	Hetero	Vaginal	1	2	8	0.5	>32	2	No	No	[^Citation4]
51742	Canada	Male	Hetero	Urethral	0.5	2	16	0.25	32	2	NA	NA	[^Citation19]

Abbreviations: CRO, ceftriaxone; TET, tetracycline; SPT, spectinomycin; AZM, azithromycin; CIP, ciprofloxacin; PEN, penicillin; PPNG, penicillinase producing Neisseria gonorrhoeae; NA, not available.

Figure 1 Maximum-likelihood tree based on 13,236 SNPs extracted from whole-genome sequences. FA1090 was placed as the outgroup. STs, antimicrobial resistance determinants and antimicrobial susceptibility are also shown. For YL201 and A2543, they contain four copies of the 23S rRNA C2611T and A2059G mutation respectively. Isolate YL201 described in this study is shown in red. The color coding of AMR phenotype and AMR-related alleles are indicated in the columns on the bottom left.

Abbreviations: R, resistance; S susceptibility; HLR, High-level resistance; WT, Wild type.

Figure 2 Comparison of YL201 and other 14 strains genomes in the phylogenetic tree. FA1090 (GenBank: AE004969.1) genome was used as the reference. The outermost ring indicates YL201. BLASTn matches with less than 30% identity appear as blank spaces (gaps) in each ring.

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