FIG 2.

Tiered laboratory responsibilities for Neisseria gonorrhoeae testing in the AR Lab Network. Specimens enter the tiered system at the local clinical laboratory as soon as possible after being collected from the patient. Recovered isolates are then sent to the appropriate regional laboratory (West, Mountain, Southeast, or Mid-Atlantic) where AST and genome sequencing are conducted. Confirmatory AST testing and genomic sequence analysis are performed at the CDC. Arrows indicate the flow of isolates within the laboratory network. SOP, standard operating protocol; SURRG, Strengthening the U.S. Response to Resistant Gonorrhea project; AST, antimicrobial susceptibility testing; WGS, whole-genome sequencing; ID, identification; EQA, external quality assurance; PT, proficiency testing; NCBI, National Center for Biotechnology Information. BaseSpace is a cloud-based genomics sequence hub built by Illumina (San Diego, CA), sFTP, secure file transfer protocol site.