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.