{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T01:00:18Z","timestamp":1793754018424,"version":"4.6.1"},"reference-count":60,"publisher":"BMJ","issue":"Suppl 4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2013,8,10]]},"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:p>Core groups contain individuals who are regularly infected with <jats:italic>Neisseria gonorrhoeae<\/jats:italic> and are able to transmit their infection to a large number of sexual partners. Classical core groups, such as sex workers and their male partners, or men who have sex with men (MSM), have contributed to the emergence and spread of antimicrobial-resistant <jats:italic>N gonorrhoeae<\/jats:italic> over many years. Sex workers and their clients were the most important core group driving the dissemination of penicillinase-producing <jats:italic>N gonorrhoeae<\/jats:italic> in the 1970s. Such individuals have continued to contribute to penicillinase-producing <jats:italic>N gonorrhoeae<\/jats:italic> outbreaks as well as to the subsequent emergence of gonococcal resistance to fluoroquinolones, macrolides, spectinomycin and cephalosporins in various settings. MSM have been a very important core group since the 1980s, first with the spread of TetM-expressing <jats:italic>N gonorrhoeae<\/jats:italic> and, second, with the dissemination of fluoroquinolone-resistant <jats:italic>N gonorrhoeae<\/jats:italic>. MSM-associated sexual networks have most recently been critical to the spread of gonococci resistant to third generation extended spectrum cephalosporins, including cefixime and ceftriaxone. Individuals within other core groups have also been linked to the transmission of antimicrobial-resistant gonorrhoea, such as military personnel, travellers, drug users, young adults, older men and members of street gangs. Understanding core behaviours and their geospatial clustering is essential for an optimal public health response to the rising prevalence of antimicrobial-resistant gonorrhoea. Furthermore, rapid and effective treatment of <jats:italic>N gonorrhoeae<\/jats:italic> infections in core individuals and their sexual partners should be a priority for gonorrhoea control programmes.<\/jats:p>","DOI":"10.1136\/sextrans-2013-051020","type":"journal-article","created":{"date-parts":[[2013,11,15]],"date-time":"2013-11-15T09:33:46Z","timestamp":1384508026000},"page":"iv47-iv51","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":94,"title":["The role of core groups in the emergence and dissemination of antimicrobial-resistant <i>N gonorrhoeae<\/i>"],"prefix":"10.1136","volume":"89","author":[{"given":"D A","family":"Lewis","sequence":"first","affiliation":[{"name":"Centre for HIV and Sexually Transmitted Infections, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa"},{"name":"Department of Internal Medicine, Faculty of Health Sciences, University of the 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