ArticleAntimicrobial agents and chemotherapy2012
High-level cefixime- and ceftriaxone-resistant Neisseria gonorrhoeae in France: novel penA mosaic allele in a successful international clone causes treatment failure.
Article in Antimicrobial agents and chemotherapy, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 294 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
294 citing papers in PubMed, 2 syntheses or guidelines pooled it, 635 citations in OpenAlex.
- Antimicrobial resistance of Neisseria gonorrhoeae in Latin American countries: a systematic review.The Journal of antimicrobial chemotherapy · 2023Pooled it
- Sexually Transmitted Infections Treatment Guidelines, 2021.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2021Guideline
- App-Based Training Module on Guiding Physicians' Prescription for Antibiotic Treatment of Gonorrhea: Cluster Randomized Controlled Trial.JMIR mHealth and uHealth · 2026Trial
- Gepotidacin for the Treatment of Uncomplicated Urogenital Gonorrhea: A Phase 2, Randomized, Dose-Ranging, Single-Oral Dose Evaluation.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Trial
- Gentamicin versus ceftriaxone for the treatment of gonorrhoea (G-TOG trial): study protocol for a randomised trial.Trials · 2016Trial
- Molecular epidemiology and pharmacokinetic-pharmacodynamic analysis of Neisseria gonorrhoeae strains in Northern Spain.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Rise ofAntimicrobial agents and chemotherapy · 2026Article
- A penicillin-binding protein inhibitor series to target drug-resistant Neisseria gonorrhoeae.Nature microbiology · 2026Article
- Article
- Plasmid-mediated resistance in Neisseria gonorrhoeae clinical strains from South Poland, 2014-2021.Folia microbiologica · 2026Article
- Biology of novel LpxC inhibitors forMicrobiology spectrum · 2026Article
- Repurposing epetraborole to combatAntimicrobial agents and chemotherapy · 2026Article
- Pre-clinical efficacy of a C4BP hexameric IgG Fc fusion protein against Neisseria gonorrhoeae.PloS one · 2026Article
- Genomic diversity of Neisseria gonorrhoeae Isolates in Kenya revealed by MLST, NG-MAST, and NG-STAR typing.PloS one · 2026Article
- Review
- Clonal Expansion ofInfection and drug resistance · 2026Article
- High prevalence and emerging cephalosporin resistance of penicillinase-producing Neisseria gonorrhoeae in Meizhou, China (2022-2024).BMC infectious diseases · 2025Article
- Antibiotic-resistance mutations in penicillin-binding protein 2 from the ceftriaxone-resistantbioRxiv : the preprint server for biology · 2025Article
- Global genomic and antimicrobial resistance profiling of Neisseria gonorrhoeae: Insights from whole genome sequencing and minimum inhibitory concentration analysis.PLoS neglected tropical diseases · 2025Article
- Oxydifficidin, a potenteLife · 2025Article
234 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
6 authors at 5 institutions in 4 countries.
Funding
Abstract
Recently, the first Neisseria gonorrhoeae strain (H041) highly resistant to the expanded-spectrum cephalosporins (ESCs) ceftriaxone and cefixime, which are the last remaining options for first-line gonorrhea treatment, was isolated in Japan. Here, we confirm and characterize a second strain (F89) with high-level cefixime and ceftriaxone resistance which was isolated in France and most likely caused a treatment failure with cefixime. F89 was examined using six species-confirmatory tests, antibiograms (33 antimicrobials), porB sequencing, N. gonorrhoeae multiantigen sequence typing (NG-MAST), multilocus sequence typing (MLST), and sequencing of known gonococcal resistance determinants (penA, mtrR, penB, ponA, and pilQ). F89 was assigned to MLST sequence type 1901 (ST1901) and NG-MAST ST1407, which is a successful gonococcal clone that has spread globally. F89 has high-level resistance to cefixime (MIC = 4 μg/ml) and ceftriaxone (MIC = 1 to 2 μg/ml) and resistance to most other antimicrobials examined. A novel penA mosaic allele (penA-CI), which was penA-XXXIV with an additional A501P alteration in penicillin-binding protein 2, was the primary determinant for high-level ESC resistance, as determined by transformation into a set of recipient strains. N. gonorrhoeae appears to be emerging as a superbug, and in certain circumstances and settings, gonorrhea may become untreatable. Investigations of the biological fitness and enhanced understanding and monitoring of the ESC-resistant clones and their international transmission are required. Enhanced disease control activities, antimicrobial resistance control and surveillance worldwide, and public health response plans for global (and national) perspectives are also crucial. Nevertheless, new treatment strategies and/or drugs and, ideally, a vaccine are essential to develop for efficacious gonorrhea management.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.