Table 2

Resistance mechanisms in isolates with mosaic penA alleles

Couple	Partner	Site	NG-MAST	MLST	PEN MIC (mg/L)	CRO MIC (mg/L)	CIP MIC (mg/L)	TET MIC (mg/L)	SP MIC (mg/L)	AZI MIC (mg/L)	Phenotypic bla	penA	mtr promoter	mtrR	ponA	gyrA	parC	23S (WT:Alt)
24	A	Urethra	1407	1901	2	0.06	16	≤4	≤64	0.25	ND	Mosaic XXXIV	–A	WT	L421P	S91F, D95G	S87R	4:0
24	B	Rectal	1407	1901	2	0.06	16	≤4	≤64	0.25	ND	Mosaic XXXIV	–A	WT	L421P	S91F, D95G	S87R	4:0
23	B	Urethra	359	8126	1	0.016	≤0.03	≤4	≤64	0.125	ND	Novel Mosaic XLI	WT	G45D	WT	WT	WT	4:0
23	B	Rectal	359	8126	1	0.016	≤0.03	≤4	≤64	0.125	ND	Novel Mosaic XLI	WT	G45D	WT	WT	WT	4:0
23	A	Pharyngeal	359	8126	1	0.016	≤0.03	≤4	≤64	0.125	ND	Novel Mosaic XLI	WT	G45D	WT	WT	WT	4:0
3	A	Urethra	4822	1901	0.5	0.03	4	≤4	≤64	≤0.06	ND	Mosaic XXXIV	–A	WT	L421P	S91F, D95G	S87R	4:0
3	B	Rectal	4822	1901	0.5	0.03	4	≤4	≤64	≤0.06	ND	Mosaic XXXIV	–A	WT	L421P	S91F, D95G	S87R	4:0
3	B	Pharyngeal	4822	1901	1	0.03	4	≤4	≤64	≤0.06	ND	Mosaic XXXIV	–A	WT	L421P	S91F, D95G	S87R	4:0
6	A	Urethra	4822	1901	2	0.06	16	≤4	≤64	0.25	ND	Mosaic XXXIV	–A	WT	L421P	S91F, D95G	S87R	4:0
6	B	Pharyngeal	4822	1901	2	0.06	8	≤4	≤64	0.125	ND	Mosaic XXXIV	–A	WT	L421P	S91F, D95G	S87R	4:0
6	B	Rectal	4822	1901	2	0.06	8	≤4	≤64	0.125	ND	Mosaic XXXIV	–A	WT	L421P	S91F, D95G	S87R	4:0
33	A	Urethra	1407	7360	1	0.03	8	≤4	≤64	0.25	ND	Mosaic XXXIV	–A	WT	L421P	S91F, D95G	S87R	4:0
33	B	Rectal	1407	7360	1	0.06	8	≤4	≤64	0.25	ND	Mosaic XXXIV	–A	WT	L421P	S91F, D95G	S87R	4:0

Alt, alternate allele; AZI, azithromycin; CIP, ciprofloxacin; CRO, ceftriaxone; MIC, minimum inhibitory concentration; MLST, multilocus sequence typing; ND, not detected; NG-MAST, Neisseria gonorrhoeae multiantigen sequence typing; PEN, penicillin; SP, spectinomycin; TET, tetracycline; WT, wild-type.