{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T01:14:34Z","timestamp":1775870074945,"version":"3.50.1"},"reference-count":8,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2018,9,11]],"date-time":"2018-09-11T00:00:00Z","timestamp":1536624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/doi.org\/10.1128\/AuthorWarrantyLicense.v1"},{"start":{"date-parts":[[2018,11,7]],"date-time":"2018-11-07T00:00:00Z","timestamp":1541548800000},"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":["mBio"],"published-print":{"date-parts":[[2018,11,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n In a previous\n mBio<\/jats:italic>\n article, Wadsworth and colleagues (mBio 9:e01419-18, 2018,\n https:\/\/doi.org\/10.1128\/mBio.01419-18<\/jats:ext-link>\n ) described\n Neisseria gonorrhoeae<\/jats:named-content>\n isolates that express low levels of azithromycin (Azi) resistance. Whole-genome sequencing and bioinformatic analysis suggested that the isolates had acquired DNA from commensal\n Neisseria<\/jats:italic>\n spp. that caused numerous nucleotide changes in the\n mtr<\/jats:italic>\n locus, which contains genes for a transcriptional repressor (MtrR) and three proteins (MtrC-MtrD-MtrE) that form a multidrug efflux pump known to export macrolides. Strong regions of linkage disequilibrium mapped to the overlapping\n mtrR<\/jats:italic>\n and\n mtrCDE<\/jats:italic>\n promoters and\n mtrD.<\/jats:italic>\n Genetic analyses revealed that these mosaic-like sequences increased transcription of\n mtrCDE<\/jats:italic>\n and MtrD function, respectively. These changes also had strong epistatic effects that collectively were responsible for decreased susceptibility to MtrCDE substrates, including Azi. The report emphasizes the importance of gene exchange among neisserial species and development of antibiotic resistance in gonococci, both of which have ramifications for detection of resistance markers and efficacy of antibiotic treatment regimens for gonorrhea.\n <\/jats:p>","DOI":"10.1128\/mbio.01747-18","type":"journal-article","created":{"date-parts":[[2018,9,10]],"date-time":"2018-09-10T11:30:04Z","timestamp":1536579004000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":26,"title":["Mosaic Drug Efflux Gene Sequences from Commensal\n Neisseria<\/i>\n Can Lead to Low-Level Azithromycin Resistance Expressed by\n Neisseria gonorrhoeae<\/i>\n Clinical Isolates"],"prefix":"10.1128","volume":"9","author":[{"given":"William M.","family":"Shafer","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia, USA"},{"name":"The Emory Antibiotic Resistance Center, Emory University School of Medicine, Atlanta, Georgia, USA"},{"name":"The Laboratories of Bacterial Pathogenesis, Medical Research Service, Veterans Affairs Medical Center, Decatur, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","first-page":"213","volume-title":"Emerging Infections","author":"Unemo M","year":"2016","unstructured":"Unemo M, del Rio C, Shafer WM. 2016. Antimicrobial resistance expressed by Neisseria gonorrhoeae: a major global public health problem in the 21st century, p 213\u2013237. In Emerging Infections, vol 10, Chapter 12. ASM Press, Washington, DC."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0143304"},{"key":"e_1_3_3_4_2","first-page":"161","volume-title":"Pathogenic Neisseria: genomics, molecular biology and disease intervention.","author":"Unemo M","year":"2014","unstructured":"Unemo M, Nicholas RA, Jerse AE, Davies C, Shafer WM. 2014. Molecular mechanisms of antibiotic resistance expressed by the pathogenic Neisseria, p 161\u2013192. In Davies J, Kahler C, (ed), Pathogenic Neisseria: genomics, molecular biology and disease intervention. Horizon Scientific Press, Poole, United Kingdom."},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.01419-18"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiw420"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/128.3.321"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.074286-0"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0097903"}],"container-title":["mBio"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/mBio.01747-18","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/mBio.01747-18","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T02:20:05Z","timestamp":1646706005000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/mBio.01747-18"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,7]]},"references-count":8,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,11,7]]}},"alternative-id":["10.1128\/mBio.01747-18"],"URL":"https:\/\/doi.org\/10.1128\/mbio.01747-18","relation":{},"ISSN":["2161-2129","2150-7511"],"issn-type":[{"value":"2161-2129","type":"print"},{"value":"2150-7511","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,7]]},"assertion":[{"value":"2018-09-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01747-18"}}