{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:00:53Z","timestamp":1791525653116,"version":"4.3.4"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T00:00:00Z","timestamp":1613433600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"German Federal Ministry of Health","award":["ZMVI1-2516AUK700"],"award-info":[{"award-number":["ZMVI1-2516AUK700"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Within the German Gonococcal Resistance Network\u2019s (GORENET) Neisseria gonorrhoeae (NG) sample collection, azithromycin-resistant NG isolates increased from 4.3% in 2016 to 9.2% in 2018. We aim to understand this observed increase using whole genome sequencing of NG isolates combined with epidemiological and clinical data. Reduced susceptibility to azithromycin in 2018 was predominately clonal (NG multiantigen sequence typing G12302) and could mainly be attributed to the recently described mosaic-like mtr locus. Our data suggest that, together with horizontal gene transfer of resistance determinants and well-established point mutations, international spread of resistant lineages plays a major role regarding azithromycin resistance in Germany.<\/jats:p>","DOI":"10.1093\/infdis\/jiab091","type":"journal-article","created":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T20:47:03Z","timestamp":1613076423000},"page":"1398-1404","source":"Crossref","is-referenced-by-count":30,"title":["The Mosaic <i>mtr<\/i> Locus as Major Genetic Determinant of Azithromycin Resistance of <i>Neisseria gonorrhoeae<\/i>\u2014Germany, 2018"],"prefix":"10.1093","volume":"224","author":[{"given":"Sebastian","family":"Banhart","sequence":"first","affiliation":[{"name":"Unit of Sexually Transmitted Bacterial Pathogens, Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Selb","sequence":"additional","affiliation":[{"name":"Unit of HIV\/AIDS, STI and Blood-borne Infections, Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Oehlmann","sequence":"additional","affiliation":[{"name":"Unit of Sexually Transmitted Bacterial Pathogens, Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Bender","sequence":"additional","affiliation":[{"name":"Unit of Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Wernigerode, Germany"},{"name":"European Programme for Public Health Microbiology Training, European Centre for Disease Prevention and Control, Solna, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Buder","sequence":"additional","affiliation":[{"name":"German Reference Laboratory for Gonococci, Unit of Sexually Transmitted Bacterial Pathogens, Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Jansen","sequence":"additional","affiliation":[{"name":"Unit of HIV\/AIDS, STI and Blood-borne Infections, Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagmar","family":"Heuer","sequence":"additional","affiliation":[{"name":"Unit of Sexually Transmitted Bacterial Pathogens, Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,16]]},"reference":[{"key":"2021103113405842400_CIT0001","first-page":"548","volume-title":"Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016","author":"Rowley","year":"2019"},{"key":"2021103113405842400_CIT0002","author":"World Health Organization"},{"key":"2021103113405842400_CIT0003","author":"European Centre for Disease Prevention and Control"},{"key":"2021103113405842400_CIT0004","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s12879-018-2944-9","article-title":"Antimicrobial resistance of Neisseria gonorrhoeae in Germany: low levels of cephalosporin resistance, but high azithromycin resistance","volume":"18","author":"Buder","year":"2018","journal-title":"BMC Infect 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