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The sociodemographic characteristics of the patients included in the study were collected by comprehensive review of their medical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve out of 16 HL-AziR isolates belonged to the MLST ST7823\/NG-MAST ST5309 genotype and 4 to MLST ST9363\/NG-MAST ST3935. All presented the A2059G mutation in all four alleles of the 23S rRNA gene. MLST ST7823\/NG-MAST ST5309 isolates were only identified in men who have sex with women and MLST ST9363\/NG-MAST ST3935 were found in MSM. Phylogenomic analysis revealed the presence of three transmission clusters of three different NG strains independently associated with sexual behaviour.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings support the first appearance of three mild outbreaks of NG with HL-AziR in Spain. These results highlight the continuous capacity of NG to develop antimicrobial resistance and spread among sexual networks. The enhanced resolution of WGS provides valuable information for outbreak investigation, complementing the implementation of public health measures focused on the prevention and dissemination of MDR NG.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jac\/dkaa536","type":"journal-article","created":{"date-parts":[[2020,12,9]],"date-time":"2020-12-09T23:53:21Z","timestamp":1607558001000},"page":"930-935","source":"Crossref","is-referenced-by-count":16,"title":["Emergence and dissemination of three mild outbreaks of<i>Neisseria gonorrhoeae<\/i>with high-level resistance to azithromycin in Barcelona, 2016\u201318"],"prefix":"10.1093","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2115-7413","authenticated-orcid":false,"given":"P","family":"Salmer\u00f3n","sequence":"first","affiliation":[{"name":"Department of Microbiology, Vall d\u2019Hebron Hospital Universitari, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Department of Genetics and Microbiology, 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