{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:50:24Z","timestamp":1789775424128,"version":"4.0.1"},"reference-count":17,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2008,10,1]],"date-time":"2008-10-01T00:00:00Z","timestamp":1222819200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2008,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p><jats:italic>Neisseria gonorrhoeae<\/jats:italic>infections have been empirically treated in Hong Kong with a single oral 400-mg dose of ceftibuten since 1997. Following anecdotal reports of the treatment failure of gonorrhea with oral extended-spectrum cephalosporins, the current study was undertaken to determine the antimicrobial susceptibility pattern and molecular characteristics of isolates of<jats:italic>N. gonorrhoeae<\/jats:italic>among patients with putative treatment failure in a sexually transmitted disease clinic setting. Between October 2006 and August 2007, 44 isolates of<jats:italic>N. gonorrhoeae<\/jats:italic>were studied from patients identified clinically to have treatment failure with empirical ceftibuten. The ceftibuten MICs for three strains were found to have been 8 mg\/liter. These strains were determined by<jats:italic>N. gonorrhoeae<\/jats:italic>multiantigen sequence typing to belong to sequence type 835 (ST835) or the closely related ST2469. The testing of an additional eight archived ST835 strains revealed similarly elevated ceftibuten MICs. The<jats:italic>penA<\/jats:italic>gene sequences of these 11 isolates all had the mosaic pattern previously described as pattern X. Of note is that the ceftriaxone susceptibility results of these strains all fell within the susceptible range. It is concluded that ceftibuten resistance may contribute to the empirical treatment failure of gonorrhea caused by strains harboring the mosaic<jats:italic>penA<\/jats:italic>gene, which confers reduced susceptibility to oral extended-spectrum cephalosporins. Screening for such resistance in the routine clinical laboratory may be undertaken by the disk diffusion test. The continued monitoring of antimicrobial resistance and molecular characteristics of<jats:italic>N. gonorrhoeae<\/jats:italic>isolates is important to ensure that control and prevention strategies remain effective.<\/jats:p>","DOI":"10.1128\/aac.00198-08","type":"journal-article","created":{"date-parts":[[2008,7,29]],"date-time":"2008-07-29T00:44:55Z","timestamp":1217292295000},"page":"3564-3567","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":50,"title":["Ceftibuten Resistance and Treatment Failure of<i>Neisseria gonorrhoeae<\/i>Infection"],"prefix":"10.1128","volume":"52","author":[{"given":"Janice Y. C.","family":"Lo","sequence":"first","affiliation":[{"name":"Microbiology Division, Public Health Laboratory Services Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. M.","family":"Ho","sequence":"additional","affiliation":[{"name":"Social Hygiene Service, Public Health Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna O. C.","family":"Leung","sequence":"additional","affiliation":[{"name":"Microbiology Division, Public Health Laboratory Services Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felisa S. T.","family":"Tiu","sequence":"additional","affiliation":[{"name":"Microbiology Division, Public Health Laboratory Services Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grand K. L.","family":"Tsang","sequence":"additional","affiliation":[{"name":"Microbiology Division, Public Health Laboratory Services Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angus C. T.","family":"Lo","sequence":"additional","affiliation":[{"name":"Microbiology Division, Public Health Laboratory Services Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W.","family":"Tapsall","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.46.12.3744-3749.2002"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/0732-8893(91)90096-X","volume":"14","year":"1991","unstructured":"Barr, W. H., C. C. Lin, E. Radwanski, J. Lim, S. Symchowicz, and M. Affrime. 1991. The pharmacokinetics of ceftibuten in humans. Diagn. Microbiol. Infect. Dis.14:93-100.","journal-title":"Diagn. Microbiol. Infect. 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Sloots. 2007. Use of a novel screening PCR indicates presence of Neisseria gonorrhoeae isolates with a mosaic penA gene sequence in Australia. Pathology39:445-446.","journal-title":"Pathology"},{"key":"e_1_3_2_16_2","unstructured":"Laboratory diagnosis of gonorrhoea. 1999"},{"key":"e_1_3_2_17_2","first-page":"430","volume":"30","year":"2006","unstructured":"WHO Western Pacific Gonococcal Antimicrobial Surveillance Programme. 2006. Surveillance of antibiotic resistance in Neisseria gonorrhoeae in the WHO Western Pacific Region, 2005. Commun. Dis. Intell.30:430-433.","journal-title":"Commun. Dis. Intell."},{"key":"e_1_3_2_18_2","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.3201\/eid1308.060948","volume":"13","year":"2007","unstructured":"Yokoi, S., T. Deguchi, T. Ozawa, M. Yasuda, S.-I. Ito, Y. Kubota, M. Tamaki, and S.-I. Maeda. 2007. Threat to cefixime treatment for gonorrhea. Emerg. Infect. Dis.13:1275-1277.","journal-title":"Emerg. Infect. 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