Skip to main content

Table 2 Main characteristics of the verified Neisseria gonorrhoeae superbugs and examples of sporadic gonococcal strains with ceftriaxone MIC = 0.5 mg/L

From: Current and future antimicrobial treatment of gonorrhoea – the rapidly evolving Neisseria gonorrhoeae continues to challenge

Country, year Ceftriaxone MIC (mg/L) fT>MIC (hours) with ceftriaxone 250 mg × 1 (1 g × 1)a MLST NG-MAST PBP2 sequence variant [30]
Japan, 2009 “H041” [30] 4 (Etest) 0-0 (0–5.6) ST7363 ST4220 C (X + 12 amino acid alterations; new key resistance alterations: A311V, T316P, T483S [45]) b
France, 2011 “F89” [26] 2 (Etest) 0-0 (0–20.3) ST1901 ST1407 CI (XXXIV + A501P)b
Spain, 2011 “F89” [38]c 2 (Etest) 0-0 (0–20.3) ST1901 ST1407 CI (XXXIV + A501P)b
Japan, 2000–2001 [40] 0.5 (Agar dilution) 0-19.8 (11.1-49.8) ND ND X-variant (X + N575Δ + V576A)b
China, 2007 [41] 0.5 (Agar dilution) 0-19.8 (11.1-49.8) ND ST2288 XVII
Austria, 2011 [25] 0.5 (Etest) 0-19.8 (11.1-49.8) ST1901 ST1407 XXXIV + T534Ab
Australia, 2014 “A8806” [39] 0.5 (Agar dilution) 0-19.8 (11.1-49.8) ST7363 ST4015d C-variant (including two of the three key alterations in H041: A311V and T483S)b
  1. aMonte Carlo simulation, taking into account diversity inherent within patient populations, showing 95 % confidence intervals of time (h) of free ceftriaxone above MIC (fT>MIC). Data from Chisholm et al. [52]
  2. bMosaic PBP2 sequence variant [30]
  3. cPossibly identical to the earlier identified French superbug [26] and represented the first international transmission of a high-level ceftriaxone resistant gonococcal strain
  4. dCompared to the superbug H041 [30], identical tbpB allele (10) and a porB allele (1059) that only differed by 6 %
  5. MIC minimum inhibitory concentration, MLST multilocus sequence typing, NG-MAST Neisseria gonorrhoeae multi-antigen sequence typing, PBP2 penicillin-binding protein 2, ND not determined, ST sequence type