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Spread, clonality, and characteristics of 202 isolates were examined using antibiograms, conventional<jats:italic>penA<\/jats:italic>mosaic gene PCR, and<jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">N. gonorrhoeae<\/jats:named-content>multiple-locus variable-number tandem repeat analysis (NG-MLVA). A strictly defined subset was further characterized by<jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">N. gonorrhoeae<\/jats:named-content>multiantigen sequence typing (NG-MAST) and sequencing of ESC resistance determinants (<jats:italic>penA<\/jats:italic>,<jats:italic>mtrR<\/jats:italic>, and<jats:italic>porB1b<\/jats:italic>). Seventy-four<jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">N. gonorrhoeae<\/jats:named-content>isolates with a cefotaxime MIC of &gt;0.125 \u03bcg\/ml (group A), 54 with a cefotaxime MIC of 0.125 \u03bcg\/ml (group B), and a control group of 74 with a cefotaxime MIC of &lt;0.125 \u03bcg\/ml (group C) were included. Fifty-three clonally related<jats:italic>penA<\/jats:italic>mosaic-positive isolates (penicillin-binding protein 2 type XXXIV) were identified in group A (<jats:italic>n<\/jats:italic>= 47 isolates; 64%) and B (<jats:italic>n<\/jats:italic>= 6 isolates; 11%). The 53<jats:italic>penA<\/jats:italic>mosaic-positive isolates were predominantly NG-MAST ST1407 (87%) and contained an<jats:italic>mtrR<\/jats:italic>promoter A deletion (98%) and<jats:italic>porB1b<\/jats:italic>alterations G101K\/A102N. All were assigned to the same NG-MLVA cluster that comprised in total 56 isolates. A correlation was found between decreased cefotaxime susceptibility and ST1407 that was highly prevalent among visitors of the Amsterdam STI clinic. The rapid spread of this strain, which also has been identified in many other countries, might be facilitated by high-risk sexual behavior and should be monitored closely to identify potential treatment failure. Quality-assured surveillance of ESC susceptibility on the national and international levels and exploration of new drugs and\/or strategies for treatment of gonorrhea are crucial.<\/jats:p>","DOI":"10.1128\/aac.05481-11","type":"journal-article","created":{"date-parts":[[2012,1,4]],"date-time":"2012-01-04T07:55:10Z","timestamp":1325663710000},"page":"1516-1522","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":25,"title":["Clonally Related Neisseria gonorrhoeae Isolates with Decreased Susceptibility to the Extended-Spectrum Cephalosporin Cefotaxime in Amsterdam, the Netherlands"],"prefix":"10.1128","volume":"56","author":[{"given":"Raymond","family":"Heymans","sequence":"first","affiliation":[{"name":"Public Health Laboratory, Cluster of Infectious Diseases, Health Service of Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvia M.","family":"Bruisten","sequence":"additional","affiliation":[{"name":"Public Health Laboratory, Cluster of Infectious Diseases, Health Service of Amsterdam, the Netherlands"},{"name":"University of Amsterdam, Department of Experimental Virology, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Golparian","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Clinical Microbiology, \u00d6rebro University Hospital, \u00d6rebro, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magnus","family":"Unemo","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Clinical Microbiology, \u00d6rebro University Hospital, \u00d6rebro, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry J. 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