{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T01:00:20Z","timestamp":1793754020559,"version":"4.6.1"},"reference-count":12,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2026,6]]},"abstract":"\n Background<\/jats:title>\n \n The global emergence of antimicrobial-resistant\n Neisseria gonorrhoeae<\/jats:italic>\n represents a major public health concern. In particular, strains carrying the mosaic\n penA<\/jats:italic>\n -60.001 allele have been associated with resistance to extended-spectrum cephalosporins and high-level resistance to azithromycin, threatening current treatment strategies. We describe an extensively drug-resistant\n Neisseria gonorrhoeae<\/jats:italic>\n (XDR-NG) strain belonging to sequence type (ST) 16406, detected in Northern Italy in April 2025.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n The\n N<\/jats:italic>\n .\n gonorrhoeae<\/jats:italic>\n strain was recovered from a urethral swab collected from a 28-year-old male at the Microbiology Unit of IRCCS Azienda Ospedaliero-Universitaria di Bologna. Antimicrobial susceptibility testing was performed using E-test strips and interpreted according to EUCAST breakpoints. Whole-genome sequencing (WGS) was conducted using Illumina technology, and genomic characterization included MLST, NG-MAST, NG-STAR typing, resistance gene detection, and phylogenetic analysis with publicly available ST16406 genomes.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The isolate exhibited high-level resistance to tetracycline (MIC = 16\u00a0mg\/L) and ciprofloxacin (MIC = 4\u00a0mg\/L), very high azithromycin MIC (>256\u00a0mg\/L), and resistance to both injectable and oral ESCs (ceftriaxone MIC = 0.25\u00a0mg\/L, cefixime MIC = 1\u00a0mg\/L). WGS assigned the isolate to MLST ST16406 and identified the mosaic\n penA<\/jats:italic>\n -60.001 allele, the A2059G mutation in all four 23S rRNA alleles, mutations in\n gyrA<\/jats:italic>\n and\n parC<\/jats:italic>\n associated with fluoroquinolone resistance, and tetracycline resistance determinants including\n tet(M)<\/jats:italic>\n . The A39T mutation was identified in the\n mtrR<\/jats:italic>\n repressor gene. No plasmids were detected using PlasmidFinder. Phylogenetic analysis demonstrated close genetic relatedness to previously reported ST16406 isolates from Europe and Asia.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n This study reports the first detection in Italy of an XDR\n N<\/jats:italic>\n .\n gonorrhoeae<\/jats:italic>\n ST16406 isolate carrying the\n penA<\/jats:italic>\n -60.001 allele. The finding highlights the ongoing international dissemination of this resistant lineage and underscores the importance of maintaining culture-based diagnostics to ensure effective antimicrobial resistance surveillance.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/09564624261435841","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T15:01:56Z","timestamp":1773673316000},"page":"788-793","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Detection and genomic characterization of an extensively drug-resistant\n Neisseria gonorrhoeae<\/i>\n ST16406 isolate identified in Italy, 2025"],"prefix":"10.1177","volume":"37","author":[{"given":"Raul","family":"Cetatean","sequence":"first","affiliation":[{"name":"University of Pavia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetti","family":"Secci","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliero-Universitaria of Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Lazzarotto","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliero-Universitaria of Bologna"},{"name":"Alma Mater Studiorum - University of Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7253-8799","authenticated-orcid":false,"given":"Claudio","family":"Foschi","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliero-Universitaria of Bologna"},{"name":"Alma Mater Studiorum - University of Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Ambretti","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliero-Universitaria of Bologna"},{"name":"Alma Mater Studiorum - University of Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"e_1_3_6_2_2","volume-title":"ECDC","author":"European Centre for Disease Prevention and Control","year":"2025","unstructured":"European Centre for Disease Prevention and Control. Gonorrhoea. In: ECDC. Annual epidemiological report for 2023. ECDC, 2025."},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2023.1308550"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(21)00171-3"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2022.27.18.2100611"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2024-056405"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid3009.240557"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkae369"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1586\/eri.09.63"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2023.28.37.2300456"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2021.0483"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01542-21"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00010-14"}],"container-title":["International Journal of STD & AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624261435841","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09564624261435841","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624261435841","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T04:08:10Z","timestamp":1779250090000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09564624261435841"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,16]]},"references-count":12,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1177\/09564624261435841"],"URL":"https:\/\/doi.org\/10.1177\/09564624261435841","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,16]]}}}