{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:56:36Z","timestamp":1791294996940,"version":"4.1.0"},"reference-count":22,"publisher":"American Society for Microbiology","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"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":["Microbiol Spectr"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      CLSI M100, 36th edition (2026), lowered the ceftriaxone susceptible MIC breakpoint for\n                      <jats:italic toggle=\"yes\">Neisseria gonorrhoeae<\/jats:italic>\n                      from \u22640.25 mg\/L to \u22640.12 mg\/L, classified 0.25 mg\/L as intermediate, and removed ceftriaxone disk diffusion interpretive criteria. We conducted a single-center, retrospective method-comparison study of 111 consecutive, nonduplicate, culture-confirmed isolates with paired ceftriaxone gradient strip MICs, agar dilution MICs, and archived 30-\u00b5g disk diffusion zone diameters. Gradient strip readings were prespecified to be rounded upward to the next nominal twofold dilution for comparison with agar dilution. Standardized essential agreement within \u00b11 dilution was 111\/111 (100.0%); because upward rounding can increase apparent essential agreement, essential agreement based on the original continuous readings was also assessed and was 102\/111 (91.9%). Using a binary interpretation based on the revised susceptible breakpoint (\u22640.125 mg\/L, displayed by CLSI as \u22640.12 mg\/L, vs &gt;0.125 mg\/L), gradient strip and agar dilution classifications agreed for all 111 isolates (100.0%). Complete CLSI 2026 S\/I\/R categorical agreement was 105\/111 (94.6%). The six discrepancies were all minor errors in which gradient strip testing classified an isolate as intermediate, whereas agar dilution classified it as resistant; no major or very major errors occurred. Gradient strip testing identified 12 of 18 isolates classified as resistant by agar dilution, corresponding to 66.7% sensitivity for the resistant category. Both methods classified 28 of 111 isolates (25.2%) as having MICs above the revised susceptible breakpoint; this proportion represents a classification frequency in a method-comparison data set, not a regional prevalence estimate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>\n                      Clinical laboratories need practical approaches when antimicrobial susceptibility breakpoints change. For\n                      <jats:italic toggle=\"yes\">Neisseria gonorrhoeae<\/jats:italic>\n                      , the 2026 CLSI revision lowered the ceftriaxone susceptible MIC breakpoint and removed ceftriaxone disk diffusion interpretive criteria. Using paired isolate-level results, this study evaluated a product-specific ceftriaxone gradient strip workflow against agar dilution and examined archived disk diffusion results using the former 2025 CLSI susceptible-zone threshold of 35 mm. After prespecified upward rounding to the reference twofold scale, standardized essential agreement was 100.0% and complete CLSI 2026 S\/I\/R categorical agreement was 94.6%; all six categorical discrepancies involved gradient strip intermediate results and agar dilution resistant results. The former disk diffusion threshold showed limited specificity in this historical exploratory analysis. These data provide a single-center assessment to inform local verification of gradient strip MIC testing and transition toward MIC-based ceftriaxone surveillance.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.02569-26","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:00:36Z","timestamp":1791291636000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Local verification of ceftriaxone gradient strip MIC testing for\n                    <i>Neisseria gonorrhoeae<\/i>\n                    after CLSI 2026 breakpoint changes"],"prefix":"10.1128","author":[{"given":"Li","family":"Li","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/027a61038","id-type":"ROR","asserted-by":"publisher"}],"name":"Nantong Center for Disease Control and Prevention","place":["Nantong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zijie","family":"Tang","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/001rahr89","id-type":"ROR","asserted-by":"publisher"}],"name":"Laboratory Medicine Center, Affiliated Hospital of Nantong University","place":["Nantong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1942-5960","authenticated-orcid":true,"given":"Jiang","family":"Pu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/001rahr89","id-type":"ROR","asserted-by":"publisher"}],"name":"Laboratory Medicine Center, Affiliated Hospital of Nantong University","place":["Nantong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_3_5_2_2","unstructured":"World Health Organization. 2024. Enhanced gonococcal antimicrobial surveillance programme (EGASP): surveillance report 2023. World Health Organization. Geneva Switzerland"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0128-6"},{"key":"e_1_3_5_4_2","volume-title":"Updated recommendations for the treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum (syphilis) and new recommendations on syphilis testing and partner services","author":"Organization WH","year":"2024","unstructured":"Organization WH. 2024. Updated recommendations for the treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum (syphilis) and new recommendations on syphilis testing and partner services. World Health Organization, Geneva, Switzerland."},{"key":"e_1_3_5_5_2","volume-title":"Gonococcal infections among adolescents and adults: STI treatment guidelines","author":"Centers for Disease Control and Prevention","year":"2024","unstructured":"Centers for Disease Control and Prevention. 2024. Gonococcal infections among adolescents and adults: STI treatment guidelines"},{"key":"e_1_3_5_6_2","volume-title":"Gonococcal Isolate Surveillance Project (GISP) profiles","author":"Centers for Disease Control and Prevention","year":"2026","unstructured":"Centers for Disease Control and Prevention. 2026. Gonococcal Isolate Surveillance Project (GISP) profiles"},{"key":"e_1_3_5_7_2","unstructured":"European Centre for Disease Prevention and Control. 2026. Gonorrhoea and Euro-GASP resources"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2020.08.013"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkz530"},{"key":"e_1_3_5_10_2","series-title":"CLSI Supplement M100","volume-title":"Performance standards for antimicrobial susceptibility testing","author":"Clinical and Laboratory Standards Institute","year":"2026","unstructured":"Clinical and Laboratory Standards Institute. 2026. Performance standards for antimicrobial susceptibility testing. 36th ed. CLSI Supplement M100. CLSI, Wayne, PA.","edition":"36"},{"key":"e_1_3_5_11_2","series-title":"CLSI Standard M07","volume-title":"Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically","author":"Clinical and Laboratory Standards Institute","year":"2024","unstructured":"Clinical and Laboratory Standards Institute. 2024. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. 12th ed. CLSI Standard M07. CLSI, Wayne, PA.","edition":"12"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S340074"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1099\/acmi.0.000116"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.002088"},{"key":"e_1_3_5_15_2","series-title":"CLSI Standard M02","volume-title":"Performance standards for antimicrobial disk susceptibility tests","author":"Clinical and Laboratory Standards Institute","year":"2024","unstructured":"Clinical and Laboratory Standards Institute. 2024. In Performance standards for antimicrobial disk susceptibility tests, 14th ed. CLSI Standard M02. CLSI, Wayne, PA.","edition":"14"},{"key":"e_1_3_5_16_2","series-title":"CLSI Supplement M100","volume-title":"Performance standards for antimicrobial susceptibility testing","author":"Clinical and Laboratory Standards Institute","year":"2025","unstructured":"Clinical and Laboratory Standards Institute. 2025. Performance standards for antimicrobial susceptibility testing. 35th ed. CLSI Supplement M100. CLSI, Wayne, PA.","edition":"35"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002499"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S335252"},{"key":"e_1_3_5_19_2","unstructured":"National Health Commission of the People\u2019s Republic of China. 2019. WS\/T 268-2019: Gonorrhea diagnosis. Beijing China"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.35541\/cjd.20190808"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7312a2"},{"key":"e_1_3_5_22_2","series-title":"CLSI Guideline M52","volume-title":"Verification of commercial microbial identification and antimicrobial susceptibility testing systems","author":"Clinical and Laboratory Standards Institute","year":"2015","unstructured":"Clinical and Laboratory Standards Institute. 2015. In Verification of commercial microbial identification and antimicrobial susceptibility testing systems, 1st ed. CLSI Guideline M52. CLSI, Wayne, PA.","edition":"1"},{"key":"e_1_3_5_23_2","volume-title":"Clinical laboratory testing and in vitro diagnostic test systems\u2014susceptibility testing of infectious agents and evaluation of performance of antimicrobial susceptibility testing devices\u2014part 2: evaluation of performance of antimicrobial susceptibility testing devices","author":"International Organization for Standardization","year":"2021","unstructured":"International Organization for Standardization. 2021. Clinical laboratory testing and in vitro diagnostic test systems\u2014susceptibility testing of infectious agents and evaluation of performance of antimicrobial susceptibility testing devices\u2014part 2: evaluation of performance of antimicrobial susceptibility testing devices"}],"container-title":["Microbiology Spectrum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.02569-26","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.02569-26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:00:39Z","timestamp":1791291639000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/spectrum.02569-26"}},"subtitle":[],"editor":[{"given":"Wendy A.","family":"Szymczak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":22,"alternative-id":["10.1128\/spectrum.02569-26"],"URL":"https:\/\/doi.org\/10.1128\/spectrum.02569-26","relation":{},"ISSN":["2165-0497"],"issn-type":[{"value":"2165-0497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"assertion":[{"value":"2026-07-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e02569-26"}}