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In this paper, we describe the prevalence of antimicrobial resistance and molecular characteristics of<jats:italic>N. gonorrhoeae<\/jats:italic>isolates from India, Pakistan, and Bhutan in 2007\u20132011.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Antimicrobial susceptibility and \u03b2-lactamase production were tested for 65<jats:italic>N<\/jats:italic>.<jats:italic>gonorrhoeae<\/jats:italic>isolates from India (n=40), Pakistan (n=18) and Bhutan (n=7) using Etest methodology (eight antimicrobials) and nitrocefin solution, respectively. Resistance determinants, i.e.<jats:italic>penA<\/jats:italic>,<jats:italic>mtrR<\/jats:italic>,<jats:italic>porB1b<\/jats:italic>,<jats:italic>gyrA<\/jats:italic>, and<jats:italic>parC<\/jats:italic>, were sequenced.<jats:italic>N<\/jats:italic>.<jats:italic>gonorrhoeae<\/jats:italic>multiantigen sequence typing (NG-MAST) was performed for molecular epidemiology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The highest resistance level was observed for ciprofloxacin (94%), followed by penicillin G (68%), erythromycin (62%), tetracycline (55%), and azithromycin (7.7%). All the isolates were susceptible to ceftriaxone, cefixime, and spectinomycin. Thirty-four (52%) of the isolates were producing \u03b2-lactamase. No<jats:italic>penA<\/jats:italic>mosaic alleles or A501-altered alleles of penicillin-binding protein 2 were identified. Forty-nine NG-MAST STs were identified, of which 42 STs have not been previously described worldwide.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on this study, ceftriaxone, cefixime, and spectinomycin can be used as an empirical first-line therapy for gonorrhoea in India, Pakistan, and Bhutan, whereas ciprofloxacin, penicillin G, tetracycline, erythromycin, and azithromycin should not be. It is imperative to strengthen the laboratory infrastructure in this region, as well as to expand the phenotypic and genetic surveillance of antimicrobial resistance, emergence of new resistance, particularly, to extended-spectrum cephalosporins, and molecular epidemiology.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1471-2334-13-35","type":"journal-article","created":{"date-parts":[[2013,1,24]],"date-time":"2013-01-24T15:43:29Z","timestamp":1359042209000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Antimicrobial susceptibility and genetic characteristics of Neisseria gonorrhoeae isolates from India, Pakistan and Bhutan in 2007\u20132011"],"prefix":"10.1186","volume":"13","author":[{"given":"Sunil","family":"Sethi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Golparian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manju","family":"Bala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorji","family":"Dorji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kausar","family":"Jabeen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magnus","family":"Unemo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2013,1,24]]},"reference":[{"key":"2226_CR1","volume-title":"Global incidence and prevalence of selected curable sexually transmitted infections - 2008","author":"World Health Organization (WHO)","year":"2012","unstructured":"World Health Organization (WHO): Global incidence and prevalence of selected curable sexually transmitted infections - 2008. 2012, Geneva: World Health Organization, Available at: http:\/\/www.who.int\/reproductivehealth\/publications\/rtis\/2008_STI_estimates.pdf (Accessed: December 20, 2012)"},{"key":"2226_CR2","volume-title":"Prevalence and incidence of selected sexually transmitted infections: Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis and Trichomonas vaginalis. 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