{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:31:50Z","timestamp":1777923110503,"version":"3.51.4"},"reference-count":16,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"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":[[2022,1,1]]},"abstract":"<jats:p>\n                    The aim of this study was to characterize the evolution of gonorrhea in the general population by correlating epidemiological, genotypic, and antimicrobial resistance data of\n                    <jats:italic toggle=\"yes\">Neisseria gonorrhoeae<\/jats:italic>\n                    isolates collected in northern Spain from 2014 to 2018. One hundred ninety-four strains underwent antimicrobial susceptibility testing and were genetically analyzed by\n                    <jats:italic toggle=\"yes\">N. gonorrhoeae<\/jats:italic>\n                    multiantigen sequence typing.\n                  <\/jats:p>\n                  <jats:p>\n                    Increasing cases of gonococcal infections have been observed after 2015. Most occurred in male with urethritis. Sequence type (ST)-9972 and ST-1576, the predominant genotypes identified, have not been previously described as epidemic clones. Of great concern was the significant increase in azithromycin-resistant\n                    <jats:italic toggle=\"yes\">N. gonorrhoeae<\/jats:italic>\n                    . More than 30% of these isolates were obtained from men who have sex with men (MSM). ST-12302 was the most prevalent clone among the azithromycin-resistant strains, and was also resistant to penicillin, ciprofloxacin, and tetracycline. This multidrug-resistant clone was exclusively isolated from MSM during 2018. The incidence rates of gonorrhea and azithromycin-resistant\n                    <jats:italic toggle=\"yes\">N. gonorrhoeae<\/jats:italic>\n                    have significantly increased due to the emergence of new clones. ST-12302 has recently been recognized as an epidemic clone; therefore, its surveillance could be the key in controlling further dissemination of azithromycin resistance. These data highlight the need to perform local studies to update treatment guidelines and reinforce preventive measures against gonorrhea.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2020.0594","type":"journal-article","created":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T11:39:24Z","timestamp":1629200364000},"page":"81-86","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Large Increase in Azithromycin-Resistant\n                    <i>Neisseria gonorrhoeae<\/i>\n                    in Northern Spain"],"prefix":"10.1177","volume":"28","author":[{"given":"Raquel","family":"Carballo","sequence":"first","affiliation":[{"name":"Microbiology Laboratory, Complexo Hospitalario Universitario de Vigo, Vigo, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Clara","family":"Povoa","sequence":"additional","affiliation":[{"name":"Group of Microbiology and Infectology, Fundaci\u00f3n Biom\u00e9dica Galicia Sur, Vigo, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Abad","sequence":"additional","affiliation":[{"name":"Reference and Research Laboratory for Vaccine Preventable Bacterial Diseases, Instituto de Salud Carlos III, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Navarro","sequence":"additional","affiliation":[{"name":"Reference and Research Laboratory for Vaccine Preventable Bacterial Diseases, Instituto de Salud Carlos III, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Martin","sequence":"additional","affiliation":[{"name":"Reference and Research Laboratory for Vaccine Preventable Bacterial Diseases, Instituto de Salud Carlos III, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximiliano","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Complexo Hospitalario Universitario de Vigo, Vigo, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angel","family":"Salgado","sequence":"additional","affiliation":[{"name":"Methodology and Statistics Unit, Fundaci\u00f3n Biom\u00e9dica Galicia Sur, Vigo, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Potel","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Complexo Hospitalario Universitario de Vigo, Vigo, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,1,13]]},"reference":[{"key":"e_1_3_5_2_2","article-title":"Epidemiological trends of antibiotic resistant gonorrhoea in the United Kingdom","volume":"13","author":"Whittles L.K.","year":"2018","unstructured":"Whittles L.K., , White P.J, , Paul J., , and Didelot X.. 2018. Epidemiological trends of antibiotic resistant gonorrhoea in the United Kingdom. Antibiotics (Basel), 13:7.e60.","journal-title":"Antibiotics (Basel)"},{"key":"e_1_3_5_3_2","article-title":"European guideline for the diagnosis and treatment of gonorrhoea in adults","volume":"29","author":"Unemo M.","year":"2020","unstructured":"Unemo M., , Ross J.D.C, , Serwin A.B, , Gomberg M., , Cusini M., , and Jensen J.S.. 2020. European guideline for the diagnosis and treatment of gonorrhoea in adults. Int. J. STD AIDS, 29:956462420949126.","journal-title":"Int. J. STD AIDS"},{"key":"e_1_3_5_4_2","unstructured":"GESIDA. Consensus document on diagnostic and treatment of adult and teenage\/adolescent sexually transmitted infections [in Spanish]. Available at http:\/\/gesida-seimc.org\/category\/guias-clinicas\/otras-guias-vigentes (accessed July9 2019)."},{"key":"e_1_3_5_5_2","first-page":"23","article-title":"Persistence of an outbreak of gonorrhoeae with high level resistance to azithromycin in England, November 2014-May 2018","volume":"23","author":"Smolarchuck C.","year":"2018","unstructured":"Smolarchuck C., , Wensley A., , Padfield S., , Fifer H., , Lee A., , and Hughes G.. 2018. Persistence of an outbreak of gonorrhoeae with high level resistance to azithromycin in England, November 2014-May 2018. Euro Surveill. 23:23.","journal-title":"Euro Surveill"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2019.24.8.1900118"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6950a6"},{"key":"e_1_3_5_8_2","unstructured":"The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 11.0 2021. Available at www.eucast.org (accessed July19 2021)."},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1017\/S095026881600234X"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1086\/383047"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eimc.2019.05.002"},{"key":"e_1_3_5_12_2","unstructured":"European Centre for Disease Prevention and Control. 2020. Surveillance and disease data for gonorrhoea. ECDC Stockholm."},{"key":"e_1_3_5_13_2","first-page":"137","article-title":"Is there a future for the ongoing use of azithromycin for the treatment of Neisseria gonorrhoeae? Clin","volume":"26","author":"Kong F.Y.S.","year":"2020","unstructured":"Kong F.Y.S., , Hocking J.S, , and Fairley C.K.. 2020. Is there a future for the ongoing use of azithromycin for the treatment of Neisseria gonorrhoeae? Clin. Microbiol. Infect. 26:137\u2013139.","journal-title":"Microbiol. Infect"},{"key":"e_1_3_5_14_2","first-page":"165","article-title":"Gibert","volume":"36","author":"Fuertes de Vega I.","year":"2018","unstructured":"Fuertes de Vega I., , Baliu-Pique C., , Bosch J., , Vergara-Gomez A., , Valles X., and M.A. 2018. Gibert. Risk factors for antimicrobial-resistant Neisseria gonorrhoeae and characteristics of patients infected with gonorrhea. Enferm. Infecc. Microbiol. Clin. 36:165\u2013168.","journal-title":"Risk factors for antimicrobial-resistant Neisseria gonorrhoeae and characteristics of patients infected with gonorrhea. Enferm. Infecc. Microbiol. Clin"},{"key":"e_1_3_5_15_2","unstructured":"European Centre for Disease Prevention and Control. 2018. Molecular typing of Neisseria gonorrhoeae\u2014a study of 2013 isolates. ECDC Stockholm."},{"key":"e_1_3_5_16_2","first-page":"1660","volume-title":"Emerg. Infect. 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