{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:30:51Z","timestamp":1787016651781,"version":"build-2736575974"},"reference-count":24,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2005,1,1]],"date-time":"2005-01-01T00:00:00Z","timestamp":1104537600000},"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":[[2005,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Of 150 clinical isolates of\n                    <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n                    recovered in 2001, we examined 55 clinical isolates of\n                    <jats:italic>N. gonorrhoeae<\/jats:italic>\n                    for which cefixime MICs were \u22650.125 \u03bcg\/ml and randomly selected 15 isolates for which cefixime MICs were \u22640.06 \u03bcg\/ml for analysis of alterations in the penicillin-binding protein 2 (PBP 2) gene. We found insertion of an extra codon (Asp-345a) in the transpeptidase domain of PBP 2, and this insertion occurred alone or in conjunction with other amino acid substitutions. We also found a mosaic PBP 2 that was composed of fragments of the PBP 2 proteins from\n                    <jats:italic>Neisseria cinera<\/jats:italic>\n                    and\n                    <jats:italic>Neisseria perflava<\/jats:italic>\n                    . This mosaic PBP 2 was significantly associated with decreased susceptibilities to penicillin and cephalosporins, especially oral cephalosporins. For most of the isolates with a mosaic PBP 2, the cefixime MICs were \u22650.5 \u03bcg\/ml and the cefdinir MICs were \u22651 \u03bcg\/ml. Analysis of chromosomal DNA restriction patterns by pulsed-field gel electrophoresis revealed that most isolates with the mosaic PBP 2 were genetically similar. The recombination events that generated the mosaic PBP 2 would likely have contributed to the decreased sensitivities to cephalosporins. Isolates with the mosaic PBP 2 appear to threaten the efficacy of the currently recommended regimen with cefixime. The emergence of such strains may be the result of the in vivo generation of clones in which interspecies recombination occurred between the\n                    <jats:italic>penA<\/jats:italic>\n                    genes of\n                    <jats:italic>N. gonorrhoeae<\/jats:italic>\n                    and commensal\n                    <jats:italic>Neisseria<\/jats:italic>\n                    species.\n                  <\/jats:p>","DOI":"10.1128\/aac.49.1.137-143.2005","type":"journal-article","created":{"date-parts":[[2004,12,23]],"date-time":"2004-12-23T04:36:20Z","timestamp":1103776580000},"page":"137-143","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":186,"title":["Emergence and Spread of\n                    <i>Neisseria gonorrhoeae<\/i>\n                    Clinical Isolates Harboring Mosaic-Like Structure of Penicillin-Binding Protein 2 in Central Japan"],"prefix":"10.1128","volume":"49","author":[{"given":"Masayasu","family":"Ito","sequence":"first","affiliation":[{"name":"Departments of Urology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Deguchi","sequence":"additional","affiliation":[{"name":"Departments of Urology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koh-Suke","family":"Mizutani","sequence":"additional","affiliation":[{"name":"Departments of Urology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Departments of Urology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeaki","family":"Yokoi","sequence":"additional","affiliation":[{"name":"Departments of Urology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-Ichi","family":"Ito","sequence":"additional","affiliation":[{"name":"Departments of Urology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshito","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Departments of Urology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Ishihara","sequence":"additional","affiliation":[{"name":"Departments of Urology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Microbiology, Gifu University School of Medicine, Gifu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Ezaki","sequence":"additional","affiliation":[{"name":"Microbiology, Gifu University School of Medicine, Gifu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s101560170034"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.46.12.3744-3749.2002"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/jb.176.2.333-337.1994"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2958.1990.tb00664.x"},{"key":"e_1_3_2_6_2","first-page":"1","volume":"51","year":"2002","unstructured":"Centers for Disease Control and Prevention. 2002. 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