FIG 7 .

Alignment of wild-type and mosaic Neisseria gonorrhoeae mtr promoters with N. lactamica and N. meningitidis references. Nucleotide alignment of the mtr promoter region from N. gonorrhoeae FA1090 (AE004969.1), N. lactamica 020-06 (FN995097.1), and N. meningitidis NZ-05/33 (CP002424.1) with the gonococcal isolates used in this study. The minor allele variants for each position are shown in red on a pink background. Sequence features include the interleaved mtrCDE and mtrR promoters (yellow background), MtrR binding site (maroon bars), inverted repeat in the mtrR promoter (black bar), 153-bp Correia element insertion (red arrows), and integration host factor (IHF) binding site (blue bar) (21, 29, 30, 33). The C-to-T transition 120 bp upstream of the mtrC start codon (mtr₁₂₀ [purple background]) has been demonstrated to increase expression of the efflux pump components and enhance resistance to various substrates of the pump (29); however, no T variants were detected at this site. Deletion of a single A (A deletion) in the mtrR promoter inverted repeated (blue background) has also been shown to increase expression of the efflux pump and enhance mtr-mediated resistance (30); no A-deletion variants were present. Interestingly, the N. lactamica reference, N. meningitidis reference, and all 29 isolates with mosaic mtr promoter regions had a C transversion in the second position within this repeat (blue background).