{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T14:24:30Z","timestamp":1792679070641,"version":"4.5.0"},"reference-count":76,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2017,7,26]],"date-time":"2017-07-26T00:00:00Z","timestamp":1501027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"content-domain":{"domain":["www.plosmedicine.org"],"crossmark-restriction":false},"short-container-title":["PLoS Med"],"DOI":"10.1371\/journal.pmed.1002366","type":"journal-article","created":{"date-parts":[[2017,7,26]],"date-time":"2017-07-26T17:29:33Z","timestamp":1501090173000},"page":"e1002366","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmed.corrections_policy","source":"Crossref","is-referenced-by-count":142,"title":["Multidrug-resistant gonorrhea: A research and development roadmap to discover new medicines"],"prefix":"10.1371","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8691-3991","authenticated-orcid":true,"given":"Emilie","family":"Alirol","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7640-9166","authenticated-orcid":true,"given":"Teodora E.","family":"Wi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manju","family":"Bala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luiza","family":"Bazzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang-Sheng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Deal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo-Anne R.","family":"Dillon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranmini","family":"Kularatne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jutta","family":"Heim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2261-9424","authenticated-orcid":true,"given":"Rob","family":"Hooft van Huijsduijnen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward W.","family":"Hook","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica M.","family":"Lahra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Ndowa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M.","family":"Shafer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7533-613X","authenticated-orcid":true,"given":"Liz","family":"Tayler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9918-9493","authenticated-orcid":true,"given":"Kimberly","family":"Workowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Unemo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2091-6660","authenticated-orcid":true,"given":"Manica","family":"Balasegaram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2017,7,26]]},"reference":[{"issue":"12","key":"ref1","doi-asserted-by":"crossref","first-page":"e0143304","DOI":"10.1371\/journal.pone.0143304","article-title":"Global Estimates of the Prevalence and Incidence of Four Curable Sexually Transmitted Infections in 2012 Based on Systematic Review and Global Reporting","volume":"10","author":"L Newman","year":"2015","journal-title":"PLoS ONE"},{"key":"ref2","unstructured":"Public Health England. Sexually transmitted infections and chlamydia screening in England, 2015. Health Protection Report. 2016;10(22) Available from: https:\/\/www.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/559993\/hpr2216_stis_CRRCTD4.pdf<\/ext-link>."},{"key":"ref3","unstructured":"Sant\u00e9 Publique France. Bacterial sexually transmitted infections in France: recent trends and characteristics in 2015 [French]. Bulletin \u00e9pid\u00e9miologique hebdomadaire. 2016;41-42(29 Nov) Available from: http:\/\/invs.santepubliquefrance.fr\/beh\/2016\/41-42\/_41-42_1.html<\/ext-link>."},{"key":"ref4","unstructured":"Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance. Available from: https:\/\/wwwcdcgov\/std\/stats15\/std-surveillance-2015-printpdf<\/ext-link>. 2015."},{"key":"ref5","unstructured":"The Kirby Institute for infection and immunity in society. HIV, viral hepatitis and sexually transmissible infections in Australia. Available from: http:\/\/kirbyunsweduau\/sites\/default\/files\/hiv\/resources\/SERP_2016-Annual-Surveillance-Report_UPD170116pdf<\/ext-link>. 2016;Annual Surveillance Report 2016."},{"issue":"12","key":"ref6","doi-asserted-by":"crossref","first-page":"1985","DOI":"10.1097\/QAD.0000000000001139","article-title":"Trends in condom use among MSM in the United States: the role of antiretroviral therapy and seroadaptive strategies","volume":"30","author":"G Paz-Bailey","year":"2016","journal-title":"AIDS (London, England)"},{"issue":"25","key":"ref7","doi-asserted-by":"crossref","first-page":"2504","DOI":"10.1056\/NEJMc1512757","article-title":"Failure of Dual Antimicrobial Therapy in Treatment of Gonorrhea","volume":"374","author":"H Fifer","year":"2016","journal-title":"N Engl J Med"},{"key":"ref8","unstructured":"World Health Organization. Report on global sexually transmitted infection surveillance 2013. Sexual and reproductive health. 2014; Available from: http:\/\/apps.who.int\/iris\/bitstream\/10665\/112922\/1\/9789241507400_eng.pdf?ua=1<\/ext-link>."},{"issue":"10053","key":"ref9","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1016\/S0140-6736(16)31678-6","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990\u20132015: a systematic analysis for the Global Burden of Disease Study 2015","volume":"388","year":"2016","journal-title":"Lancet"},{"issue":"3","key":"ref10","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1056\/NEJM197401172900301","article-title":"Asymptomatic gonorrhea in men. Diagnosis, natural course, prevalence and significance","volume":"290","author":"HH Handsfield","year":"1974","journal-title":"N Engl J Med"},{"issue":"19","key":"ref11","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1056\/NEJM197905103001903","article-title":"A trial of minocycline given after exposure to prevent gonorrhea","volume":"300","author":"WO Harrison","year":"1979","journal-title":"N Engl J Med"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"68","DOI":"10.3109\/00365513.2014.936691","article-title":"Sexually transmitted infections in women","volume":"244","author":"B Van Der Pol","year":"2014","journal-title":"Scand J Clin Lab Invest Suppl"},{"issue":"3","key":"ref13","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1016\/0002-9378(92)91369-L","article-title":"Preterm premature rupture of membranes: results of expectant management in patients with cervical cultures positive for group B streptococcus or Neisseria gonorrhoeae","volume":"166","author":"GL Maxwell","year":"1992","journal-title":"Am J Obstet Gynecol"},{"issue":"1","key":"ref14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ajog.2016.08.008","article-title":"Sexually transmitted diseases and infertility","volume":"216","author":"DG Tsevat","year":"2017","journal-title":"Am J Obstet Gynecol"},{"issue":"8","key":"ref15","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1136\/sextrans-2013-051118","article-title":"Chlamydia and gonorrhoea infections and the risk of adverse obstetric outcomes: a retrospective cohort study","volume":"89","author":"B Liu","year":"2013","journal-title":"Sex Transm Infect"},{"issue":"2","key":"ref16","first-page":"98","article-title":"The association of gonorrhoea and syphilis with premature birth and low birthweight","volume":"69","author":"GG Donders","year":"1993","journal-title":"Genitourin Med"},{"issue":"9","key":"ref17","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1258\/ijsa.2012.011378","article-title":"The value of testing multiple anatomic sites for gonorrhoea and chlamydia in sexually transmitted infection centres in the Netherlands, 2006\u20132010","volume":"23","author":"FD Koedijk","year":"2012","journal-title":"Int J STD AIDS"},{"issue":"1","key":"ref18","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1136\/sextrans-2013-051248","article-title":"Evaluation of the anatomical site distribution of chlamydia and gonorrhoea in men who have sex with men and in high-risk women by routine testing: cross-sectional study revealing missed opportunities for treatment strategies","volume":"90","author":"GA van Liere","year":"2014","journal-title":"Sex Transm Infect"},{"issue":"12","key":"ref19","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.2217\/fmb.12.117","article-title":"Emergence of multidrug-resistant, extensively drug-resistant and untreatable gonorrhea","volume":"7","author":"M Unemo","year":"2012","journal-title":"Future Microbiol"},{"issue":"3","key":"ref20","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1128\/CMR.00010-14","article-title":"Antimicrobial resistance in Neisseria gonorrhoeae in the 21st century: past, evolution, and future","volume":"27","author":"M Unemo","year":"2014","journal-title":"Clin Microbiol Rev"},{"issue":"8","key":"ref21","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.1093\/jac\/dks162","article-title":"Molecular characterization of two high-level ceftriaxone-resistant Neisseria gonorrhoeae isolates detected in Catalonia, Spain","volume":"67","author":"J Camara","year":"2012","journal-title":"J Antimicrob Chemother"},{"issue":"7","key":"ref22","doi-asserted-by":"crossref","first-page":"3538","DOI":"10.1128\/AAC.00325-11","article-title":"Is Neisseria gonorrhoeae initiating a future era of untreatable gonorrhea?: detailed characterization of the first strain with high-level resistance to ceftriaxone","volume":"55","author":"M Ohnishi","year":"2011","journal-title":"Antimicrob Agents Chemother"},{"issue":"3","key":"ref23","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1128\/AAC.05760-11","article-title":"High-level cefixime- and ceftriaxone-resistant Neisseria gonorrhoeae in France: novel penA mosaic allele in a successful international clone causes treatment failure","volume":"56","author":"M Unemo","year":"2012","journal-title":"Antimicrob Agents Chemother"},{"issue":"4","key":"ref24","doi-asserted-by":"crossref","first-page":"E557","DOI":"10.33321\/cdi.2016.40.65","article-title":"Australian Gonococcal Surveillance Programme, 1 April to 30 June 2016","volume":"40","author":"MM Lahra","year":"2016","journal-title":"Commun Dis Intell Q Rep"},{"key":"ref25","unstructured":"World Health Organization. Report on global sexually transmitted infection surveillance 2015. Available from: http:\/\/appswhoint\/iris\/bitstream\/10665\/249553\/1\/9789241565301-engpdf<\/ext-link>. 2016."},{"issue":"6","key":"ref26","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1093\/jac\/dkt034","article-title":"Phenotypic and genetic characterization of the first two cases of extended-spectrum-cephalosporin-resistant Neisseria gonorrhoeae infection in South Africa and association with cefixime treatment failure","volume":"68","author":"DA Lewis","year":"2013","journal-title":"J Antimicrob Chemother"},{"issue":"4","key":"ref27","first-page":"199","article-title":"Detection of multidrug-resistant gonorrhoea in the Gauteng province","volume":"27","author":"D Lewis","year":"2012","journal-title":"S Afr J Infect Dis"},{"issue":"30","key":"ref28","doi-asserted-by":"crossref","first-page":"20862","DOI":"10.2807\/1560-7917.ES2014.19.30.20862","article-title":"Four treatment failures of pharyngeal gonorrhoea with ceftriaxone (500 mg) or cefotaxime (500 mg), Sweden, 2013 and 2014","volume":"19","author":"D Golparian","year":"2014","journal-title":"Euro Surveill"},{"issue":"2","key":"ref29","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1001\/jama.2012.176575","article-title":"Neisseria gonorrhoeae<\/italic> treatment failure and susceptibility to cefixime in Toronto, Canada","volume":"309","author":"VG Allen","year":"2013","journal-title":"JAMA"},{"issue":"47","key":"ref30","doi-asserted-by":"crossref","first-page":"19721","DOI":"10.2807\/ese.15.47.19721-en","article-title":"Two cases of verified clinical failures using internationally recommended first-line cefixime for gonorrhoea treatment, Norway, 2010","volume":"15","author":"M Unemo","year":"2010","journal-title":"Euro Surveill"},{"issue":"14","key":"ref31","first-page":"19833","article-title":"Gonorrhoea treatment failures to cefixime and azithromycin in England, 2010","volume":"16","author":"CA Ison","year":"2011","journal-title":"Euro Surveill"},{"issue":"43","key":"ref32","doi-asserted-by":"crossref","first-page":"19998","DOI":"10.2807\/ese.16.43.19998-en","article-title":"First Neisseria gonorrhoeae<\/italic> strain with resistance to cefixime causing gonorrhoea treatment failure in Austria, 2011","volume":"16","author":"M Unemo","year":"2011","journal-title":"Euro Surveill"},{"issue":"6","key":"ref33","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1097\/OLQ.0000000000000280","article-title":"Gonorrhea Treatment Failures With Oral and Injectable Expanded Spectrum Cephalosporin Monotherapy vs Dual Therapy at 4 Canadian Sexually Transmitted Infection Clinics, 2010\u20132013","volume":"42","author":"AE Singh","year":"2015","journal-title":"Sex Transm Dis"},{"issue":"Pt 5","key":"ref34","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1099\/jmm.0.007641-0","article-title":"Two cases of failed ceftriaxone treatment in pharyngeal gonorrhoea verified by molecular microbiological methods","volume":"58","author":"J Tapsall","year":"2009","journal-title":"J Med Microbiol"},{"issue":"6","key":"ref35","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1093\/jac\/dkt017","article-title":"Failure of 500 mg of ceftriaxone to eradicate pharyngeal gonorrhoea, Australia","volume":"68","author":"MY Chen","year":"2013","journal-title":"J Antimicrob Chemother"},{"issue":"5","key":"ref36","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1071\/SH13077","article-title":"One confirmed and one suspected case of pharyngeal gonorrhoea treatment failure following 500mg ceftriaxone in Sydney, Australia","volume":"10","author":"PJ Read","year":"2013","journal-title":"Sexual health"},{"issue":"25","key":"ref37","doi-asserted-by":"crossref","first-page":"20200","DOI":"10.2807\/ese.17.25.20200-en","article-title":"Treatment failure of pharyngeal gonorrhoea with internationally recommended first-line ceftriaxone verified in Slovenia, September 2011","volume":"17","author":"M Unemo","year":"2012","journal-title":"Euro Surveill"},{"issue":"6","key":"ref38","doi-asserted-by":"crossref","first-page":"19792","DOI":"10.2807\/ese.16.06.19792-en","article-title":"Ceftriaxone treatment failure of pharyngeal gonorrhoea verified by international recommendations, Sweden, July 2010","volume":"16","author":"M Unemo","year":"2011","journal-title":"Euro Surveill"},{"issue":"10","key":"ref39","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1093\/infdis\/jiw420","article-title":"Genomic Epidemiology of Gonococcal Resistance to Extended-Spectrum Cephalosporins, Macrolides, and Fluoroquinolones in the United States, 2000\u20132013","volume":"214","author":"YH Grad","year":"2016","journal-title":"J Infect Dis"},{"issue":"10","key":"ref40","doi-asserted-by":"crossref","first-page":"3772","DOI":"10.1128\/JCM.01502-14","article-title":"Using crude whole-genome assemblies of Neisseria gonorrhoeae<\/italic> as a platform for strain analysis: clonal spread of gonorrhea infection in Saskatchewan, Canada","volume":"52","author":"S Vidovic","year":"2014","journal-title":"J Clin Microbiol"},{"issue":"12","key":"ref41","doi-asserted-by":"crossref","first-page":"4208","DOI":"10.1128\/JCM.01175-11","article-title":"Molecular characterization of quinolone-resistant Neisseria gonorrhoeae<\/italic> isolates from Brazil","volume":"49","author":"AA Uehara","year":"2011","journal-title":"J Clin Microbiol"},{"issue":"1","key":"ref42","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1128\/AAC.49.1.137-143.2005","article-title":"Emergence and spread of Neisseria gonorrhoeae clinical isolates harboring mosaic-like structure of penicillin-binding protein 2 in Central Japan","volume":"49","author":"M Ito","year":"2005","journal-title":"Antimicrob Agents Chemother"},{"issue":"12","key":"ref43","doi-asserted-by":"crossref","first-page":"3744","DOI":"10.1128\/AAC.46.12.3744-3749.2002","article-title":"Mosaic-like structure of penicillin-binding protein 2 Gene (penA) in clinical isolates of Neisseria gonorrhoeae with reduced susceptibility to cefixime","volume":"46","author":"S Ameyama","year":"2002","journal-title":"Antimicrob Agents Chemother"},{"issue":"3","key":"ref44","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/s10156-008-0610-7","article-title":"Analysis of amino acid sequences of penicillin-binding protein 2 in clinical isolates of Neisseria gonorrhoeae with reduced susceptibility to cefixime and ceftriaxone","volume":"14","author":"K Osaka","year":"2008","journal-title":"J Infect Chemother"},{"issue":"12","key":"ref45","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1093\/infdis\/jis277","article-title":"Impact of fluoroquinolone resistance mutations on gonococcal fitness and in vivo selection for compensatory mutations","volume":"205","author":"AN Kunz","year":"2012","journal-title":"J Infect Dis"},{"issue":"2","key":"ref46","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1111\/j.1365-2958.2008.06424.x","article-title":"Clinically relevant mutations that cause derepression of the Neisseria gonorrhoeae<\/italic> MtrC-MtrD-MtrE Efflux pump system confer different levels of antimicrobial resistance and in vivo<\/italic> fitness","volume":"70","author":"DM Warner","year":"2008","journal-title":"Mol Microbiol"},{"issue":"12","key":"ref47","doi-asserted-by":"crossref","first-page":"1804","DOI":"10.1086\/522964","article-title":"Regulation of the MtrC-MtrD-MtrE efflux-pump system modulates the in vivo fitness of Neisseria gonorrhoeae<\/italic>","volume":"196","author":"DM Warner","year":"2007","journal-title":"J Infect Dis"},{"issue":"7","key":"ref48","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1586\/eri.09.63","article-title":"Meeting the public health challenge of multidrug- and extensively drug-resistant Neisseria gonorrhoeae<\/italic>","volume":"7","author":"JW Tapsall","year":"2009","journal-title":"Expert Rev Anti Infect Ther"},{"issue":"3","key":"ref49","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1503\/cmaj.081721","article-title":"Multidrug-resistant Neisseria gonorrhoeae<\/italic>","volume":"180","author":"J Tapsall","year":"2009","journal-title":"CMAJ"},{"key":"ref50","unstructured":"World Health Organization. Global strategy for the prevention and control of sexually transmitted infections: 2006\u20132015. Available from: http:\/\/appswhoint\/iris\/bitstream\/10665\/43853\/1\/9789241563475_engpdf<\/ext-link>. 2007."},{"issue":"1","key":"ref51","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.annemergmed.2012.10.014","article-title":"Update on Emerging Infections: news from the Centers for Disease Control and Prevention. Update to the CDC's Sexually Transmitted Diseases Treatment Guidelines, 2010: Oral cephalosporins no longer a recommended treatment for gonococcal infections","volume":"61","author":"NG Maldonado","year":"2013","journal-title":"Ann Emerg Med"},{"issue":"2","key":"ref52","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1177\/0956462412472837","article-title":"European STIGEB. 2012 European guideline on the diagnosis and treatment of gonorrhoea in adults","volume":"24","author":"C Bignell","year":"2013","journal-title":"Int J STD AIDS"},{"issue":"4","key":"ref53","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1136\/sextrans-2014-051730","article-title":"Will use of combination cephalosporin\/azithromycin therapy forestall resistance to cephalosporins in Neisseria gonorrhoeae<\/italic>?","volume":"91","author":"LB Rice","year":"2015","journal-title":"Sex Transm Infect"},{"issue":"5","key":"ref54","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1097\/OLQ.0b013e318248a85f","article-title":"Emergence of fluoroquinolone resistance in Neisseria gonorrhoeae<\/italic> isolates from four clinics in three regions of Kenya","volume":"39","author":"PR Lagace-Wiens","year":"2012","journal-title":"Sex Transm Dis"},{"issue":"5","key":"ref55","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1097\/00007435-199705000-00002","article-title":"Fluoroquinolone treatment failure in gonorrhea. Emergence of a Neisseria gonorrhoeae<\/italic> strain with enhanced resistance to fluoroquinolones","volume":"24","author":"T Deguchi","year":"1997","journal-title":"Sex Transm Dis"},{"issue":"Suppl 4","key":"ref56","first-page":"iv36","article-title":"Two decades of the gonococcal antimicrobial surveillance program in South America and the Caribbean: challenges and opportunities","volume":"89","author":"JA Dillon","year":"2013","journal-title":"."},{"issue":"10","key":"ref57","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1097\/OLQ.0b013e3182631c9f","article-title":"Retrospective analysis of antimicrobial susceptibility trends (2000\u20132009) in Neisseria gonorrhoeae<\/italic> isolates from countries in Latin America and the Caribbean shows evolving resistance to ciprofloxacin, azithromycin and decreased susceptibility to ceftriaxone","volume":"39","author":"S Starnino","year":"2012","journal-title":"Sex Transm Dis"},{"issue":"12","key":"ref58","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1086\/648428","article-title":"Pharyngeal gonorrhea: an important reservoir of infection?","volume":"49","author":"H Weinstock","year":"2009","journal-title":"Clin Infect Dis"},{"issue":"1","key":"ref59","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/00007435-199501000-00007","article-title":"Treating uncomplicated Neisseria gonorrhoeae<\/italic> infections: is the anatomic site of infection important?","volume":"22","author":"JS Moran","year":"1995","journal-title":"Sex Transm Dis"},{"key":"ref60","unstructured":"World Health Organization. Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics. Available from: http:\/\/wwwwhoint\/medicines\/publications\/WHO-PPL-Short_Summary_25Feb-ET_NM_WHOpdf?ua=1<\/ext-link>. 2017."},{"key":"ref61","unstructured":"Centers for Disease Control and Prevention. Antibiotic resistance trends in the United States, 2013. Available from: https:\/\/wwwcdcgov\/drugresistance\/pdf\/ar-threats-2013-508pdf<\/ext-link>. 2013."},{"issue":"3","key":"ref62","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1128\/AAC.01343-09","article-title":"In vitro<\/italic> activity of CEM-101, a new fluoroketolide antibiotic, against Chlamydia trachomatis<\/italic> and Chlamydia<\/italic> (Chlamydophila<\/italic>) pneumoniae","volume":"54","author":"PM Roblin","year":"2010","journal-title":"Antimicrob Agents Chemother"},{"issue":"5","key":"ref63","doi-asserted-by":"crossref","first-page":"2139","DOI":"10.1128\/AAC.00090-09","article-title":"Comparative in vitro susceptibilities of human mycoplasmas and ureaplasmas to a new investigational ketolide, CEM-101","volume":"53","author":"KB Waites","year":"2009","journal-title":"Antimicrob Agents Chemother"},{"issue":"5","key":"ref64","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.1128\/AAC.00036-12","article-title":"In vitro activity of the new fluoroketolide solithromycin (CEM-101) against a large collection of clinical Neisseria gonorrhoeae isolates and international reference strains, including those with high-level antimicrobial resistance: potential treatment option for gonorrhea?","volume":"56","author":"D Golparian","year":"2012","journal-title":"Antimicrob Agents Chemother"},{"issue":"7","key":"ref65","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1093\/cid\/civ478","article-title":"A Phase 2 Trial of Oral Solithromycin 1200 mg or 1000 mg as Single-Dose Oral Therapy for Uncomplicated Gonorrhea","volume":"61","author":"EW Hook 3rd","year":"2015","journal-title":"Clin Infect Dis"},{"issue":"1","key":"ref66","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1128\/AAC.04124-14","article-title":"In vitro<\/italic> antibacterial activity of AZD0914, a new spiropyrimidinetrione DNA gyrase\/topoisomerase inhibitor with potent activity against Gram-positive, fastidious Gram-Negative, and atypical bacteria","volume":"59","author":"MD Huband","year":"2015","journal-title":"Antimicrob Agents Chemother"},{"issue":"12","key":"ref67","doi-asserted-by":"crossref","first-page":"7595","DOI":"10.1128\/AAC.03920-14","article-title":"In vitro activity of AZD0914, a novel DNA gyrase inhibitor, against Chlamydia trachomatis and Chlamydia pneumoniae","volume":"58","author":"SA Kohlhoff","year":"2014","journal-title":"Antimicrob Agents Chemother"},{"issue":"9","key":"ref68","doi-asserted-by":"crossref","first-page":"5220","DOI":"10.1128\/AAC.00786-15","article-title":"High in vitro<\/italic> susceptibility to the novel spiropyrimidinetrione ETX0914 (AZD0914) among 873 contemporary clinical Neisseria gonorrhoeae<\/italic> isolates from 21 European countries from 2012 to 2014","volume":"59","author":"M Unemo","year":"2015","journal-title":"Antimicrob Agents Chemother"},{"issue":"3","key":"ref69","doi-asserted-by":"crossref","first-page":"1918","DOI":"10.1128\/AAC.02820-15","article-title":"In Vitro<\/italic> Activity of Gepotidacin, a Novel Triazaacenaphthylene Bacterial Topoisomerase Inhibitor, against a Broad Spectrum of Bacterial Pathogens","volume":"60","author":"DJ Biedenbach","year":"2016","journal-title":"Antimicrob Agents Chemother"},{"issue":"7","key":"ref70","doi-asserted-by":"crossref","first-page":"e1002344","DOI":"10.1371\/journal.pmed.1002344","article-title":"Antimicrobial resistance in Neisseria gonorrhoeae<\/italic>: Global surveillance and a call for international collaborative action","volume":"14","author":"T Wi","year":"2017","journal-title":"PLoS Med"},{"issue":"3","key":"ref71","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1038\/nrurol.2016.268","article-title":"Antimicrobial-resistant sexually transmitted infections: gonorrhoea and Mycoplasma genitalium<\/italic>","volume":"14","author":"M Unemo","year":"2017","journal-title":"Nat Rev Urol"},{"issue":"6","key":"ref72","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1056\/NEJMp1112456","article-title":"The emerging threat of untreatable gonococcal infection","volume":"366","author":"GA Bolan","year":"2012","journal-title":"N Engl J Med"},{"key":"ref73","unstructured":"The Global Antibiotic Research and Development Partnership (GARDP) www.gardp.org<\/ext-link>. 2016."},{"issue":"5","key":"ref74","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1056\/NEJM198707303170504","article-title":"Effect of spectinomycin use on the prevalence of spectinomycin-resistant and of penicillinase-producing Neisseria gonorrhoeae","volume":"317","author":"JW Boslego","year":"1987","journal-title":"N Engl J Med"},{"issue":"8254","key":"ref75","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/S0140-6736(81)91227-7","article-title":"Spectinomycin-resistant penicillinase-producing Neisseria gonorrhoeae","volume":"2","author":"WA Ashford","year":"1981","journal-title":"Lancet"},{"issue":"4","key":"ref76","first-page":"257","article-title":"Activity of eight antimicrobial agents in vitro against N. Gonorrhoeae","volume":"51","author":"E Stolz","year":"1975","journal-title":"Brit J Vener Dis"}],"container-title":["PLOS Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/dx.plos.org\/10.1371\/journal.pmed.1002366","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T18:12:55Z","timestamp":1750788775000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pmed.1002366"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,26]]},"references-count":76,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2017,7,26]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pmed.1002366","relation":{},"ISSN":["1549-1676"],"issn-type":[{"value":"1549-1676","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,26]]}}}