{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:57:03Z","timestamp":1790701023108,"version":"4.1.0"},"reference-count":61,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82572622"],"award-info":[{"award-number":["82572622"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82272382"],"award-info":[{"award-number":["82272382"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82150610507"],"award-info":[{"award-number":["82150610507"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004731","name":"Zhejiang Province Natural Science Foundation","doi-asserted-by":"publisher","award":["LZ24H190001"],"award-info":[{"award-number":["LZ24H190001"]}],"id":[{"id":"10.13039\/501100004731","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The emergence of ceftriaxone-resistant Neisseria gonorrhoeae threatens the effectiveness of this last-line empirical therapy for gonorrhoea. Zoliflodacin and gepotidacin are novel oral gyrase\/topoisomerase inhibitors with distinct mechanisms of action, recently US FDA-approved for treatment of uncomplicated urogenital gonorrhoea. We evaluated their in vitro activity against contemporary multidrug-resistant N. gonorrhoeae isolates from Hangzhou, China, a region with high ceftriaxone resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MICs of zoliflodacin and gepotidacin were determined by agar dilution for 340 clinical N. gonorrhoeae isolates collected in Hangzhou (2020\u20132025). Sequencing of gyrA, parC and gyrB quinolone resistance-determining regions (QRDRs) was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All isolates were ciprofloxacin-resistant, and 23.2% were ceftriaxone-resistant. Zoliflodacin demonstrated potent activity (MIC range, 0.008\u20130.25\u2005mg\/L; MIC90, 0.06\u2005mg\/L). No isolate carried known GyrB target substitutions associated with increased zoliflodacin MICs (in D429 or K450), but GyrA S91F\/D95G with ParC S87R was associated with slightly higher zoliflodacin wild-type MICs (P\u200a=\u200a0.0004). Gepotidacin MICs ranged from 0.06\u2005mg\/L to 4\u2005mg\/L (MIC90, 2\u2005mg\/L); 42 isolates (12.4%) had non-susceptible MICs \u22652\u2005mg\/L. GyrA S91F\/D95Y with ParC S87N and GyrA S91F\/D95A with ParC D86N were associated with slightly higher gepotidacin MICs (P\u200a&amp;lt;\u200a0.0001). No Spearman's rank correlation was observed between ciprofloxacin and zoliflodacin (R\u200a=\u200a0.059) or gepotidacin (R\u200a=\u200a0.0077) MICs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Zoliflodacin demonstrated potent in vitro activity and all isolates in this high-ceftriaxone-resistance setting were categorized as susceptible. Gepotidacin also showed potent activity, but 12% of isolates displayed non-susceptible MICs (\u22652\u2005mg\/L). Continuous surveillance (phenotypic and genomic susceptibility) is essential when these two novel oral therapies enter clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkag330","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:14:17Z","timestamp":1789672457000},"source":"Crossref","is-referenced-by-count":0,"title":["Activity of the novel oral antimicrobials zoliflodacin and gepotidacin against ceftriaxone-resistant and\/or multidrug-resistant\n                    <i>Neisseria gonorrhoeae<\/i>\n                    isolates from Hangzhou, China"],"prefix":"10.1093","volume":"81","author":[{"given":"Wenyan","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases of the Second Affiliated Hospital of Zhejiang University School of Medicine, Department of Microbiology, School of Medicine, Zhejiang University , Hangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Sir Run Shaw Hospital, School of Medicine, Zhejiang University , Hangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu\u2019ai","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases of the Second Affiliated Hospital of Zhejiang University School of Medicine, Department of Microbiology, School of Medicine, Zhejiang University , Hangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuefeng","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Unemo","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for Sexually Transmitted Infections, Department of Laboratory Medicine, Faculty of Medicine and Health, \u00d6rebro University , \u00d6rebro ,","place":["Sweden"]},{"name":"Institute for Global Health, University College London (UCL) , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8176-391X","authenticated-orcid":false,"given":"Stijn","family":"van der Veen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases of the Second Affiliated Hospital of Zhejiang University School of Medicine, Department of Microbiology, School of Medicine, Zhejiang University , Hangzhou ,","place":["China"]},{"name":"State Key Laboratory for Diagnosis and Treatment of 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