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Table 2 Characteristics of N. gonorrhoeae isolates with AZM-R and CROD identified in Guangzhou in 2009-2013

From: Azithromycin-resistant Neisseria gonorrhoeae isolates in Guangzhou, China (2009–2013): coevolution with decreased susceptibilities to ceftriaxone and genetic characteristics

  AZM-LLR (n = 33) AZM-MLR (n = 44)  
  Totalc CROD Totalc CROD  
  n (%) n (%) n (%) n (%) P
Antimicrobial resistance 33 (100.0) 6 (18.2) 44 (100) 19 (43.2) b < 0.05
23 S rRNA
 WT 32 (97.0) 5 (15.2) 38 (86.3) 13 (29.5) a, b > 0.05
 C2611TS 1 (3.0) 1 (3.0) 1 (2.3) 1 (2.3)  
 C2611TAll 0 (0.0) 0 (0.0) 5 (11.4) 5 (11.4)  
mtrR      
 Deletiona      
  Yes 29 (87.9) 6 (18.2) 42 (95.5) 19 (43.3) a > 0.05, b: ND
  No 4 (12.1) 0 (0.0) 2 (4.5) 0 (0.0)  
 Mutations      
  WTb 2 (6.1) 0 (0.0) 2 (4.5) 0 (0.0) a, b > 0.05
  A39T 7 (21.2) 4 (12.1) 6 (13.6) 4 (9.1)  
  G45D 8 (24.2) 1 (3.0) 5 (11.3) 2 (4.5)  
  H105Y 16 (48.5) 1 (3.0) 26 (59.1) 11 (25.0)  
  A39T/ F62L 0 (0.0) 0 (0.0) 1 (2.3) 0 (0.0)  
  A40D/T86A 0 (0.0) 0 (0.0) 1 (2.3) 0 (0.0)  
  A40D/T86A/H105Y 0 (0.0) 0 (0.0) 1 (2.3) 1 (2.3)  
  D79N/T86A/H105Y 0 (0.0) 0 (0.0) 1 (2.3) 1 (2.3)  
  T86A/ H105Y 0 (0.0) 0 (0.0) 1 (2.3) 0 (0.0)  
Mutation patterns in PBP2      
  II or XIV 3 (9.1) 0 (0.0) 4 (9.1) 0 (0.0) a, b > 0.05
  V 6 (18.2) 1 (3.0) 8 (18.2) 3 (6.8)  
  VII 0 (0.0) 0 (0.0) 1 (2.3) 0 (0.0)  
  VIII 0 (0.0) 0 (0.0) 1 (2.3) 1 (2.3)  
  XII 2 (6.1) 0 (0.0) 2 (4.6) 1 (2.3)  
  XIII 2 (6.1) 0 (0.0) 0 (0.0) 0 (0.0)  
  XVII 2 (6.1) 1 (3.0) 0 (0.0) 0 (0.0)  
  XVIII 5 (15.2) 2 (6.1) 13 (29.4) 10 (22.6)  
  XXI 7 (21.2) 1 (3.0) 8 (18.2) 3 (6.8)  
  XXVII 4 (12.2) 0 (0.0) 6 (13.6) 1 (2.3)  
  New 1d 1 (3.0) 0 (0.0) 0 (0.0) 0 (0.0)  
  New 2d 1 (3.0) 1 (3.0) 0 (0.0) 0 (0.0)  
  New 3d 0 (0.0) 0 (0.0) 1 (2.3) 0 (0.0)  
23rRNA/mtrR/penA mutation patterns      
  WT/A-;H105Y/XVIII 2 (6.1) 0 (0.0) 4 (9.1) 3 (6.8) a, b > 0.05
  WT/A-;H105Y/V 6 (18.2) 1 (3.0) 6 (13.6) 3 (6.8)  
  WT/A-;H105Y/XXI 2 (6.1) 0 (0.0) 6 (13.6) 2 (4.5)  
  WT/A-;G45D/XXI 4 (12.1) 3 (9.1) 0 (0.0) 0 (0.0)  
  WT/A-;A39T/XVIII 3 (9.1) 3 (9.1) 5 (11.4) 3 (6.8)  
  C2611TAll/A-;H105Y/XVIII 0 (0.0) 0 (0.0) 2 (4.5) 2 (4.5)  
  C2611TAll/A-;G45D/XXI 0 (0.0) 0 (0.0) 2 (4.5) 2 (4.5)  
  Other patterns 16 (48.5) 2 (6.1) 17 (38.6) 2 (4.5)  
  1. AZM azithromycin, CRO D decreased susceptibility to ceftriaxone, CRO S susceptible to ceftriaxone, C2611T S mutation C2611T in a single allele, C2611T All C2611T mutations in all four alleles, aAdenine (A) deletion in the 13-bp inverted repeat (5’-AAAAAGACTTTTT-3’) within the -35 to -10 positions of the mtrR promoter. bUsing mtrR from N. gonorrhoeae FA1090 as a template. cIncluding CROS and CROD; dNew polymorphism patterns of PBP2: New 1 (A501V, F504L, A510V, A516G, H541N, P552V, I556V, I566V), New 2 (F504L, A510V, A516G, Y554H), New 3 (A501V, F504L, A510V, A516G, H541N, I566V). a: the AZM-LLR isolates were compared to the AZM-MLR isolates; b: the combined AZM-LLR/CROD isolates were compared to the combined AZM-MLR/CROD isolates; ND not determined (because of a small number of isolates)