ArticleAntimicrobial agents and chemotherapy2010
High-level azithromycin resistance occurs in Neisseria gonorrhoeae as a result of a single point mutation in the 23S rRNA genes.
Article in Antimicrobial agents and chemotherapy, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 92 papers.
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92 citing papers in PubMed, 200 citations in OpenAlex.
- Antimicrobial Resistance in Neisseria gonorrhoeae: Proceedings of the STAR Sexually Transmitted Infection-Clinical Trial Group Programmatic Meeting.Sexually transmitted diseases · 2019Trial
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- Put your money where your mouth is: surveillance of antibiotic resistance within the commensalMicrobiology spectrum · 2026Article
- Plasmids inClinical microbiology reviews · 2026Review
- Antimicrobial resistance crisis in STIs: Gonorrhea andNew microbes and new infections · 2026Review
- Laboratory evaluation of the Allplex NG & DR assay for detection ofSexually transmitted infections · 2026Article
- The Synergistic Armory: A Global Genome-Wide Association Study Reveals the Integrated Mechanisms of Azithromycin Resistance inInternational journal of molecular sciences · 2026Article
- Put your money where your mouth is: Surveillance of antibiotic resistance within the commensalbioRxiv : the preprint server for biology · 2026Article
- World Health Organization-Recommended Periodic Presumptive Treatment Versus Doxycycline Post-Exposure Prophylaxis for Sexually Transmitted Infection Control Among Men Who Have Sex With Men in Kenya: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2026Article
- A novel commensalJournal of clinical microbiology · 2025Article
- CommensalAnnual review of microbiology · 2025Review
- Molecular Detection of Mutations in theTropical medicine and infectious disease · 2025Article
- Evaluation of the Allplex NG & DR assay for molecular prediction of ciprofloxacin and azithromycin resistance in Neisseria gonorrhoeae.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Antimicrobial Resistance in Curable Sexually Transmitted Infections.Current HIV/AIDS reports · 2025Review
- Local emergence and global evolution ofAntimicrobial agents and chemotherapy · 2024Article
- The novel 2024 WHO Neisseria gonorrhoeae reference strains for global quality assurance of laboratory investigations and superseded WHO N. gonorrhoeae reference strains-phenotypic, genetic and reference genome characterization.The Journal of antimicrobial chemotherapy · 2024Article
- Rolling the evolutionary dice:Microbiology spectrum · 2024Article
- Impact of mutations in the mtrR, rpdlVD and rrl genes on azithromycin resistance in Neisseria gonorrhoeae.PloS one · 2024Article
- Antimicrobial resistance and molecular characteristics ofAccess microbiology · 2024Article
- Microevolution and Its Impact on Hypervirulence, Antimicrobial Resistance, and Vaccine Escape inMicroorganisms · 2023Review
32 more citing papers are in PubMed but not listed here.
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3 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
High-level azithromycin resistance (AZM-HR), defined as a MIC of > or = 256 mg/liter, emerged in Neisseria gonorrhoeae in the United Kingdom in 2004. To determine the mechanism of this novel phenotype, isolates from the United Kingdom that were AZM-HR (n, 19), moderately AZM resistant (MICs, 2 to 8 mg/liter) (n, 26), or sensitive (MICs, 0.12 to 0.25 mg/liter) (n, 4) were screened for methylase (erm) genes and for mutations in the mtrR promoter region, associated with efflux pump upregulation. All AZM-resistant isolates and 12 sensitive isolates were screened for mutations in domain V of each 23S rRNA allele. All AZM-HR isolates contained the A2059G mutation (Escherichia coli numbering) in three (3 isolates) or four (16 isolates) 23S rRNA alleles. Most (22/26) moderately AZM resistant isolates contained the C2611T mutation in at least 3/4 alleles. The remainder contained four wild-type alleles, as did 8/12 sensitive isolates, while one allele was mutated in the remaining four sensitive isolates. Serial passage of AZM-sensitive colonies on an erythromycin-containing medium selected AZM-HR if the parent strain already contained mutation A2059G in one 23S rRNA allele. The resultant AZM-HR strains contained four mutated alleles. Eight isolates (five moderately AZM resistant and three AZM-HR) contained mutations in the mtrR promoter. No methylase genes were detected. This is the first evidence that AZM-HR in gonococci may result from a single point mutation (A2059G) in the peptidyltransferase loop in domain V of the 23S rRNA gene. Mutation of a single allele is insufficient to confer AZM-HR, but AZM-HR can develop under selection pressure. The description of a novel resistance mechanism will aid in screening for the AZM-HR phenotype.
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