Genomic Characterization of Neisseria gonorrhoeae Strains from 2016 U.S. Sentinel Surveillance Displaying Reduced Susceptibility to Azithromycin

Abstract

In 2016, the proportion of <i>Neisseria gonorrhoeae</i> isolates with reduced susceptibility to azithromycin rose to 3.6%. A phylogenetic analysis of 334 <i>N. gonorrhoeae</i> isolates collected in 2016 revealed a single, geographically diverse lineage of isolates with MICs of 2 to 16 μg/ml that carried a mosaic-like <i>mtr</i> locus, whereas the majority of isolates with MICs of ≥16 μg/ml appeared sporadically and carried 23S rRNA mutations. Continued molecular surveillance of <i>N. gonorrhoeae</i> isolates will identify new resistance mechanisms.