{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T14:49:46Z","timestamp":1766760586079,"version":"build-2065373602"},"reference-count":12,"publisher":"BMJ","issue":"7","funder":[{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["No. 2022A1515111148"],"award-info":[{"award-number":["No. 2022A1515111148"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Medical Science and Technology Research Foundation of Guangdong Province","award":["A2022106"],"award-info":[{"award-number":["A2022106"]}]},{"name":"Shanghai Municipal Health Commission Health Industry Clinical Research Project","award":["20244Y0232"],"award-info":[{"award-number":["20244Y0232"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No. 82302578"],"award-info":[{"award-number":["No. 82302578"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020084","name":"Guangzhou Municipal Science and Technology Bureau","doi-asserted-by":"publisher","award":["No. 202201010917"],"award-info":[{"award-number":["No. 202201010917"]}],"id":[{"id":"10.13039\/501100020084","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2025,4,23]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>\n                     <jats:italic>Neisseria gonorrhoeae<\/jats:italic> (NG), a bacterium characterised by multidrug resistance, is traditionally treated with ceftriaxone, either as a monotherapy or in conjunction with azithromycin. However, the emergence of strains resistant to these antibiotics presents a considerable challenge to current therapeutic approaches, which necessitates the exploration of alternative treatment strategies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Agar dilution and broth microdilution to determine the minimum inhibitory concentrations (MICs) of antibiotics and 7,8-dihydroxyflavone. The development of 7,8-dihydroxyflavone drug resistance was detected under the treatment of sublethal concentration for 30 passages. Genotypic analysis was conducted to examine <jats:italic>penA<\/jats:italic>, <jats:italic>23S rRNA<\/jats:italic> alleles and multilocus sequence typing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>55 clinical NG isolates emphasised the high-level rates of the current antimicrobial resistance, with a notable prevalence of the <jats:italic>penA<\/jats:italic>-60.001 FC428 clone and high-level azithromycin-resistant clones characterised by the <jats:italic>23S rRNA<\/jats:italic>-1 (A2059G) and <jats:italic>23S rRNA<\/jats:italic>-2 (C2611T) alleles. Among the strains that are representative of clinical circulation, 7,8-dihydroxyflavone demonstrated inhibitory activity, with MIC<jats:sub>50<\/jats:sub> and MIC<jats:sub>90<\/jats:sub> values of 10\u2009mg\/L and 20\u2009mg\/L, respectively, which are unlikely to induce drug resistance in NG.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>7,8-dihydroxyflavone may represent a promising antimicrobial agent in the context of escalating antibiotic resistance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/sextrans-2024-056362","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T12:55:51Z","timestamp":1747313751000},"page":"483-486","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Exploring alternative therapeutic options for multidrug-resistant <i>N. Gonorrhoeae<\/i>: the potential of 7,8-dihydroxyflavone"],"prefix":"10.1136","volume":"101","clinical-trial-number":[{"clinical-trial-number":"nct03959527","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04010539","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Yuqiu","family":"Qi","sequence":"first","affiliation":[{"name":"Department of Pharmacy, The First Affiliated Hospital of Naval Medical University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qinghui","family":"Xie","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Medicine, Shanghai Skin Diseases Hospital, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingxia","family":"Lin","sequence":"additional","affiliation":[{"name":"Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ran","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The First Affiliated Hospital of Naval Medical University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingxian","family":"Tang","sequence":"additional","affiliation":[{"name":"Qingyuan People\u2019s Hospital, Qingyuan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The First Affiliated Hospital of Naval Medical University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaomian","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The First Affiliated Hospital of Naval Medical University, Shanghai, China"},{"name":"Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"2025101602151357000_101.7.483.1","unstructured":"Sarah JQ , Seifert HS . Neisseria gonorrhoeae host adaptation and pathogenesis. Nat Rev Microbiol 2018."},{"key":"2025101602151357000_101.7.483.2","unstructured":"Nan B , et al . 7,8-Dihydroxyflavone attenuates the virulence of Staphylococcus aureus by inhibiting alpha-hemolysin. World J Microbiol Biotechnol 2022."},{"key":"2025101602151357000_101.7.483.3","doi-asserted-by":"crossref","DOI":"10.1126\/sciadv.adg4205","article-title":"Natural flavonoids disrupt bacterial iron homeostasis to potentiate colistin efficacy","volume":"9","author":"Zhong","year":"2023","journal-title":"Sci Adv"},{"key":"2025101602151357000_101.7.483.4","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1080\/22221751.2020.1773325","article-title":"Impact of the gonococcal FC428 penA allele 60.001 on ceftriaxone resistance and biological fitness","volume":"9","author":"Zhou","year":"2020","journal-title":"Emerg Microbes Infect"},{"key":"2025101602151357000_101.7.483.5","doi-asserted-by":"crossref","first-page":"e154","DOI":"10.1016\/S2666-5247(20)30059-8","article-title":"Azithromycin susceptibility of Neisseria gonorrhoeae in the USA in 2017: a genomic analysis of surveillance data","volume":"1","author":"Gernert","year":"2020","journal-title":"Lancet Microbe"},{"key":"2025101602151357000_101.7.483.6","unstructured":"Magnus Unemo RB , Ison C , Lewis D , et al . Laboratory diagnosis of sexually transmitted infections, including human immunodeficiency virus. World Health Organization, 2013."},{"key":"2025101602151357000_101.7.483.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2018.06.004"},{"key":"2025101602151357000_101.7.483.8","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiad258"},{"key":"2025101602151357000_101.7.483.9","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.3201\/eid3008.240139","article-title":"Surge in Ceftriaxone-Resistant Neisseria gonorrhoeae FC428-Like Strains, Asia-Pacific Region, 2015-2022","volume":"30","author":"Xiu","year":"2024","journal-title":"Emerg Infect Dis"},{"key":"2025101602151357000_101.7.483.10","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00309-10"},{"key":"2025101602151357000_101.7.483.11","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky438"},{"key":"2025101602151357000_101.7.483.12","doi-asserted-by":"crossref","DOI":"10.1128\/spectrum.01570-22","article-title":"Emergence and Genomic Characterization of Neisseria gonorrhoeae Isolates with High Levels of Ceftriaxone and Azithromycin Resistance in Guangdong, China, from 2016 to 2019","volume":"10","author":"Lin","year":"2022","journal-title":"Microbiol Spectr"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2024-056362","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T09:15:36Z","timestamp":1760606136000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2024-056362"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,13]]},"references-count":12,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,10,16]]},"published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1136\/sextrans-2024-056362"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2024-056362","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"type":"print","value":"1368-4973"},{"type":"electronic","value":"1472-3263"}],"subject":[],"published":{"date-parts":[[2025,5,13]]}}}