{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T18:29:56Z","timestamp":1787941796799,"version":"build-2784847793"},"reference-count":35,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2007,6,1]],"date-time":"2007-06-01T00:00:00Z","timestamp":1180656000000},"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":[[2007,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n The recent emergence and transmission of\n Neisseria gonorrhoeae<\/jats:italic>\n isolates with reduced susceptibility to expanded-spectrum cephalosporins such as cefixime and ceftriaxone have been reported. The aim of this study was to determine the correlation of different polymorphisms in the\n penA<\/jats:italic>\n ,\n mtrR<\/jats:italic>\n ,\n porB1b<\/jats:italic>\n (\n penB<\/jats:italic>\n ), and\n ponA<\/jats:italic>\n genes of\n N. gonorrhoeae<\/jats:italic>\n with reduced susceptibility to cefixime and ceftriaxone. Eighteen gonococcal isolates with reduced cefixime and ceftriaxone susceptibility (Cef\n i<\/jats:sup>\n ) and two susceptible isolates were characterized using serovar determination, antibiograms,\n N. gonorrhoeae<\/jats:italic>\n multiantigen sequence typing (NG-MAST), and sequencing of\n penA<\/jats:italic>\n ,\n mtrR<\/jats:italic>\n ,\n porB1b<\/jats:italic>\n , and\n ponA<\/jats:italic>\n alleles. For the Cef\n i<\/jats:sup>\n isolates (\n n<\/jats:italic>\n = 18), the MICs of cefixime and ceftriaxone ranged between 0.032 to 0.38 \u03bcg\/ml and 0.064 to 0.125 \u03bcg\/ml, respectively. These isolates were assigned five different serovars and six divergent NG-MAST sequence types. Eleven isolates (61%) with higher MICs of cefixime and ceftriaxone contained a nearly identical\n penA<\/jats:italic>\n mosaic allele and previously described polymorphisms in\n mtrR<\/jats:italic>\n (a single nucleotide [A] deletion in the promoter),\n penB<\/jats:italic>\n (mutations in\n porB1b<\/jats:italic>\n encoding loop 3 of PorB1b), and\n ponA<\/jats:italic>\n (\n ponA1<\/jats:italic>\n polymorphism). The remaining seven Cef\n i<\/jats:sup>\n isolates (39%), which had somewhat lower MICs of cefixime and ceftriaxone, contained an aspartic acid insertion (Asp-345a) in PBP 2 in conjunction with alterations of 4 to 10 amino acid residues in the C-terminal region of the transpeptidase domain of\n penA<\/jats:italic>\n . In conclusion, an unambiguous association between\n penA<\/jats:italic>\n mosaic alleles, in conjunction with genetic polymorphisms in\n mtrR<\/jats:italic>\n ,\n porB1b<\/jats:italic>\n , and\n ponA<\/jats:italic>\n , and greater reduced susceptibility to cefixime and ceftriaxone was identified.\n <\/jats:p>","DOI":"10.1128\/aac.01604-06","type":"journal-article","created":{"date-parts":[[2007,4,9]],"date-time":"2007-04-09T20:34:03Z","timestamp":1176150843000},"page":"2117-2122","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":184,"title":["Neisseria gonorrhoeae<\/i>\n Isolates with Reduced Susceptibility to Cefixime and Ceftriaxone: Association with Genetic Polymorphisms in\n penA<\/i>\n ,\n mtrR<\/i>\n ,\n porB1b<\/i>\n , and\n ponA<\/i>"],"prefix":"10.1128","volume":"51","author":[{"given":"Robert","family":"Lindberg","sequence":"first","affiliation":[{"name":"National Reference Laboratory for Pathogenic Neisseria, Department of Clinical Microbiology, O\u0308rebro University Hospital, O\u0308rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Fredlund","sequence":"additional","affiliation":[{"name":"National Reference Laboratory for Pathogenic Neisseria, Department of Clinical Microbiology, O\u0308rebro University Hospital, O\u0308rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Nicholas","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Unemo","sequence":"additional","affiliation":[{"name":"National Reference Laboratory for Pathogenic Neisseria, Department of Clinical Microbiology, O\u0308rebro University Hospital, O\u0308rebro, Sweden"}],"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","first-page":"205","volume":"30","year":"2006","unstructured":"Australian Gonococcal Surveillance Programme. 2006. 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