{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:28:59Z","timestamp":1777922939546,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T00:00:00Z","timestamp":1554076800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2019,4,1]]},"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Neisseria gonorrhoeae<\/jats:italic>\n                    is a principal pathogen for sexually transmitted infections, especially for male urethritis. Currently, the prevalence of multidrug resistance is increasing. Carbapenems are broad-spectrum antimicrobials that are widely used in the clinical setting, especially for multidrug-resistant Gram-negative bacteria. However, susceptibility to carbapenems has not been well evaluated for cephalosporin-resistant\n                    <jats:italic toggle=\"yes\">N. gonorrhoeae<\/jats:italic>\n                    isolates. In this study, we determined the susceptibility to a series of carbapenems (meropenem, imipenem, doripenem, and biapenem) and faropenem against cephalosporin-resistant (resistant to cefixime, but susceptible to ceftriaxone) and cephalosporin-susceptible\n                    <jats:italic toggle=\"yes\">N. gonorrhoeae<\/jats:italic>\n                    clinical isolates. The gene mutations associated with \u03b2-lactam resistance were evaluated. All cephalosporin-resistant\n                    <jats:italic toggle=\"yes\">N. gonorrhoeae<\/jats:italic>\n                    isolates possessed mosaic mutation alleles in\n                    <jats:italic toggle=\"yes\">penA<\/jats:italic>\n                    (NG-STAR\n                    <jats:italic toggle=\"yes\">penA<\/jats:italic>\n                    -10.001, 27.001, or 108.001). They exhibited a low minimum inhibitory concentration (MIC) (\u22640.125\u2009mg\/L) for meropenem and markedly high MICs (0.5\u20132\u2009mg\/L) for other carbapenems and faropenem. The strongest association was observed between the mosaic alleles in\n                    <jats:italic toggle=\"yes\">penA<\/jats:italic>\n                    and decreased susceptibility to carbapenems and faropenem compared with mutations in\n                    <jats:italic toggle=\"yes\">mtrR<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">porB<\/jats:italic>\n                    , and\n                    <jats:italic toggle=\"yes\">ponA<\/jats:italic>\n                    . These results suggest that meropenem may serve as an alternative therapeutic agent for cephalosporin-resistant\n                    <jats:italic toggle=\"yes\">N. gonorrhoeae<\/jats:italic>\n                    with a mosaic allele in\n                    <jats:italic toggle=\"yes\">penA<\/jats:italic>\n                    , whereas other carbapenems and faropenem may be ineffective.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2018.0263","type":"journal-article","created":{"date-parts":[[2019,1,24]],"date-time":"2019-01-24T11:18:53Z","timestamp":1548328733000},"page":"427-433","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Evaluation of Susceptibilities to Carbapenems and Faropenem Against Cephalosporin-Resistant\n                    <i>Neisseria gonorrhoeae<\/i>\n                    Clinical Isolates with\n                    <i>penA<\/i>\n                    Mosaic Alleles"],"prefix":"10.1177","volume":"25","author":[{"given":"Yoshiki","family":"Hiyama","sequence":"first","affiliation":[{"name":"Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan."},{"name":"Department of Infection Control and Laboratory Medicine, and Sapporo Medical University School of Medicine, Sapporo, Japan."},{"name":"Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Infection Control and Laboratory Medicine, and Sapporo Medical University School of Medicine, Sapporo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toyotaka","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaaki","family":"Shinagawa","sequence":"additional","affiliation":[{"name":"Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukari","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chie","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan."},{"name":"Global Station for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiko","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan."},{"name":"Global Station for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoya","family":"Masumori","sequence":"additional","affiliation":[{"name":"Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shin-ichi","family":"Yokota","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,4,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/iju.13044"},{"key":"e_1_3_3_3_2","first-page":"85","volume":"24","author":"Bignell C.","year":"2013","unstructured":"Bignell C., , and Unemo M.. 2013. European STI Guidelines Editorial Board. 2012 European guideline on the diagnosis and treatment of gonorrhoea in adults. Int. J. STD AIDS, 24:85\u201392.","journal-title":"European STI Guidelines Editorial Board. 2012 European guideline on the diagnosis and treatment of gonorrhoea in adults. Int. J. STD AIDS"},{"key":"e_1_3_3_4_2","unstructured":"CDC. 2015. Sexually Transmitted Diseases Treatment Guidelines. Available at www.cdc.gov\/mmwr\/pdf\/rr\/rr6403.pdf"},{"key":"e_1_3_3_5_2","unstructured":"WHO Guidelines for the Treatment of Neisseria gonorrhoeae. 2016. Geneva: World Health Organization. Available at www.ncbi.nlm.nih.gov\/books\/NBK379221"},{"key":"e_1_3_3_6_2","unstructured":"Centers for Disease Control and Prevention. 2013. Antibiotic resistance threats in the United States 2013. Centers for Disease Control and Prevention Atlanta GA. 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