{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T09:12:29Z","timestamp":1787994749847,"version":"build-2784847793"},"reference-count":83,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2022,5,11]],"date-time":"2022-05-11T00:00:00Z","timestamp":1652227200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"\u00d6rebro County Council Research Committee"},{"name":"Medical Research at \u00d6rebro University Hospital"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a substantial global public health problem. Gonococcal infections acquired in or from Asia represent most verified ceftriaxone treatment failures, and several ceftriaxone-resistant strains have emerged in Asia and subsequently spread globally. Additionally, in Thailand the gonorrhoea incidence remains high. Herein, we investigate the genomic diversity, AMR and AMR determinants in gonococcal isolates cultured in 2018 in Bangkok, Thailand.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Gonococcal isolates from males (n\u200a=\u200a37) and females (n\u200a=\u200a62) were examined by Etest and WGS. AMR determinants and molecular epidemiological STs were characterized. For phylogenomic comparison, raw sequence data were included from China (432 isolates), Japan (n\u200a=\u200a270), Vietnam (n\u200a=\u200a229), Thailand (n\u200a=\u200a3), a global dataset (n\u200a=\u200a12\u200a440) and the 2016 WHO reference strains plus WHO Q (n\u200a=\u200a15).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 88, 66 and 41 different NG-MAST, NG-STAR and MLST STs, respectively, and 31 different NG-STAR clonal complexes were found. A remarkably high frequency (88%) of \u03b2-lactamase TEM genes was detected and two novel TEM alleles were found. The phylogenomic analysis divided the isolates into the previously described lineages A and B, with a large proportion of Thai isolates belonging to the novel sublineage A3.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We describe the first molecular epidemiological study using WGS on gonococcal isolates from Thailand. The high prevalence of AMR and AMR determinants for ciprofloxacin, tetracycline and benzylpenicillin, and some strains belonging to clones\/clades especially in sublineage A2 that are prone to develop resistance to extended-spectrum cephalosporins (ESCs) and azithromycin, should prompt continued and strengthened AMR surveillance, including WGS, of N. gonorrhoeae in Thailand.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkac158","type":"journal-article","created":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T19:12:00Z","timestamp":1651259520000},"page":"2171-2182","source":"Crossref","is-referenced-by-count":18,"title":["Genomic surveillance and antimicrobial resistance in <i>Neisseria gonorrhoeae<\/i> isolates in Bangkok, Thailand in 2018"],"prefix":"10.1093","volume":"77","author":[{"given":"Daniel","family":"Golparian","sequence":"first","affiliation":[{"name":"World Health Organization Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Department of Laboratory Medicine, Microbiology, Faculty of Medicine and Health, \u00d6rebro University , \u00d6rebro , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossaphorn","family":"Kittiyaowamarn","sequence":"additional","affiliation":[{"name":"Bangrak STIs Center, Division of AIDS and STIs, Department of Disease Control, Ministry of Public Health , Bangkok , Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Porntip","family":"Paopang","sequence":"additional","affiliation":[{"name":"Bangrak STIs Center, Division of AIDS and STIs, Department of Disease Control, Ministry of Public Health , Bangkok , Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pongsathorn","family":"Sangprasert","sequence":"additional","affiliation":[{"name":"Bangrak STIs Center, Division of AIDS and STIs, Department of Disease Control, Ministry of Public Health , Bangkok , Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pachara","family":"Sirivongrangson","sequence":"additional","affiliation":[{"name":"Department of Disease Control, Ministry of Public Health , Bangkok , Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Franceschi","sequence":"additional","affiliation":[{"name":"Global Antibiotic Research & Development Partnership (GARDP) , Geneva , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Jacobsson","sequence":"additional","affiliation":[{"name":"World Health Organization Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Department of Laboratory Medicine, Microbiology, Faculty of Medicine and Health, \u00d6rebro University , \u00d6rebro , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodora","family":"Wi","sequence":"additional","affiliation":[{"name":"Department of the Global HIV, Hepatitis and STI programmes, World Health Organization , Geneva , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1710-2081","authenticated-orcid":false,"given":"Magnus","family":"Unemo","sequence":"additional","affiliation":[{"name":"World Health Organization Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Department of Laboratory Medicine, Microbiology, Faculty of Medicine and Health, \u00d6rebro University , \u00d6rebro , Sweden"},{"name":"Institute for Global Health, University College London , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,5,11]]},"reference":[{"key":"2022072817543509100_dkac158-B1","article-title":"Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021","author":"WHO","year":"2021"},{"key":"2022072817543509100_dkac158-B2","article-title":"Report on global 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evolution","volume":"21","author":"Golparian","year":"2020","journal-title":"BMC Genomics"},{"key":"2022072817543509100_dkac158-B6","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1128\/AAC.05665-11","article-title":"Molecular analyses of TEM genes and their corresponding penicillinase-producing Neisseria gonorrhoeae isolates in Bangkok, Thailand","volume":"56","author":"Nakayama","year":"2012","journal-title":"Antimicrob Agents Chemother"},{"key":"2022072817543509100_dkac158-B7","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1186\/1471-2334-14-454","article-title":"Characterisation of blaTEM genes and types of \u03b2-lactamase plasmids in Neisseria gonorrhoeae - the prevalent and conserved blaTEM-135 has not recently evolved and existed in the Toronto plasmid from the origin","volume":"14","author":"Muhammad","year":"2014","journal-title":"BMC Infect Dis"},{"key":"2022072817543509100_dkac158-B8","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.ijantimicag.2019.06.012","article-title":"High prevalence of TEM-135 expression from the Asian plasmid in penicillinase-producing Neisseria gonorrhoeae from Hangzhou, China","volume":"54","author":"Yan","year":"2019","journal-title":"Int J Antimicrob Agents"},{"key":"2022072817543509100_dkac158-B9","doi-asserted-by":"crossref","first-page":"e01419-18","DOI":"10.1128\/mBio.01419-18","article-title":"Azithromycin resistance through interspecific acquisition of an epistasis-dependent efflux pump component and transcriptional regulator in Neisseria gonorrhoeae","volume":"9","author":"Wadsworth","year":"2018","journal-title":"mBio"},{"key":"2022072817543509100_dkac158-B10","doi-asserted-by":"crossref","first-page":"e02281-18","DOI":"10.1128\/mBio.02281-18","article-title":"Mechanistic basis for decreased antimicrobial susceptibility in a clinical isolate of Neisseria gonorrhoeae possessing a mosaic-like mtr efflux pump locus","volume":"9","author":"Rouquette-Loughlin","year":"2018","journal-title":"mBio"},{"key":"2022072817543509100_dkac158-B11","article-title":"WHO guidelines for the treatment of Neisseria gonorrhoeae","author":"WHO","year":"2016"},{"key":"2022072817543509100_dkac158-B12","doi-asserted-by":"crossref","DOI":"10.1177\/0956462420949126","article-title":"2020 European guideline for the diagnosis and treatment of gonorrhoea in adults","author":"Unemo","year":"2020","journal-title":"Int J STD AIDS"},{"key":"2022072817543509100_dkac158-B13","article-title":"Australian STI management guidelines for use in primary care. Gonorrhoea","author":"Australasian Sexual Health Alliance (ASHA)","year":"2016"},{"key":"2022072817543509100_dkac158-B14","article-title":"Canadian guidelines on sexually transmitted infections. Gonococcal infections","author":"Romanowski","year":"2013"},{"key":"2022072817543509100_dkac158-B15","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1177\/0956462419886775","article-title":"2018 UK national guideline for the management of infection with Neisseria gonorrhoeae","volume":"31","author":"Fifer","year":"2020","journal-title":"Int J STD AIDS"},{"key":"2022072817543509100_dkac158-B16","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.15585\/mmwr.mm6950a6","article-title":"Update to CDC\u2019s Treatment Guidelines for Gonococcal Infection, 2020","volume":"69","author":"St Cyr","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022072817543509100_dkac158-B17","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/j.jiac.2019.12.001","article-title":"The JAID\/JSC guidelines to Clinical Management of Infectious Disease 2017 concerning male urethritis and related disorders","volume":"27","author":"Hamasuna","year":"2021","journal-title":"J Infect Chemother"},{"key":"2022072817543509100_dkac158-B18","volume-title":"Guidelines of Clinical Management of Sexually Transmitted Diseases","author":"Wang","year":"2020"},{"key":"2022072817543509100_dkac158-B19","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.2217\/fmb.12.117","article-title":"Emergence of multidrug-resistant, extensively drug-resistant and untreatable gonorrhea","volume":"7","author":"Unemo","year":"2012","journal-title":"Future Microbiol"},{"key":"2022072817543509100_dkac158-B20","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1071\/SH19023","article-title":"World Health Organization Global Gonococcal Antimicrobial Surveillance Program (WHO GASP): review of new data and evidence to inform international collaborative actions and research efforts","volume":"16","author":"Unemo","year":"2019","journal-title":"Sex 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