Figure 4.

Gonococcal infections in patients with multiple episodes of gonorrhea occurring <100 days apart. Closely related isolates were obtained predominantly from human immunodeficiency virus (HIV)–positive individuals <100 days apart. In other infections, which occurred within a similar time frame, unrelated strains were recovered. Strains are marked with colored boxes, which refer to a cluster, as indicated in the legend. The distance between 2 strains is depicted in number of days between the 2 episodes of gonococcal disease in the same individual. The numbers in brackets refer to number of locus differences by cgMLST between the two strains. +, HIV positive at the time of strain isolation.