TABLE 2.
Molecular profiles associated with resistance to cefixime, ceftriaxone, and azithromycin in N. gonorrhoeae.
| All isolates | Non-mosaic penA isolates | All isolates | |||||||||||||
| Molecular markers | CFMS n (%) | CFMR n (%) | p | CROS n (%) | CROR n (%) | p | CFMS n (%) | CFMR n (%) | p | CROS n (%) | CROR n (%) | p | <AZM ECOFF n (%) | >AZM ECOFF n (%) | p |
| NG-STAR genotypea (penA type) | |||||||||||||||
| ST-202 (penA 2) | 4 (3.9) | 0 (0) | 1 | 4 (3.4) | 0 (0) | 1 | 0 (0) | 4 (50.0) | <0.0001 | ||||||
| ST-233 (penA 60) | 0 (0) | 3 (14.3) | 0.004 | 0 (0) | 3 (37.5) | <0.001 | 3 (2.6) | 0 (0) | 1 | ||||||
| ST-348 (penA 10) | 1 (1.0) | 4 (19.0) | 0.003 | 5 (4.3) | 0 (0) | 1 | 5 (4.3) | 0 (0) | 1 | ||||||
| ST-428 (penA 18) | 3 (2.9) | 2 (9.5) | 0.199 | 3 (2.6) | 2 (25.0) | 0.033 | 3 (3.0) | 2 (40.0) | 0.017 | 3 (3.0) | 2 (40.0) | 0.017 | 5 (4.3) | 0 (0) | 1 |
| penA type | |||||||||||||||
| Mosaic | 3 (2.9) | 16 (76.2) | <0.0001 | 16 (13.8) | 3 (37.5) | 0.196 | |||||||||
| penA 10 | 1 (1.0) | 10 (47.6) | <0.0001 | 11 (9.5) | 0 (0) | 1 | |||||||||
| penA 34 | 2 (1.9) | 1 (4.8) | 0.430 | 3 (2.6) | 0 (0) | 1 | |||||||||
| penA 60 | 0 (0) | 4 (19.0) | <0.001 | 1 (0.9) | 3 (37.5) | <0.001 | |||||||||
| penA 71 | 0 (0) | 1 (4.8) | 0.169 | 1 (0.9) | 0 (0) | 1 | |||||||||
| Non-mosaic | 100 (97.1) | 5 (23.8) | <0.0001 | 100 (86.2) | 5 (62.5) | 0.196 | |||||||||
| penA 18 | 15 (14.6) | 3 (14.3) | 0.759 | 14 (12.1) | 4 (50.0) | 0.015 | 15 (15.0) | 3 (60.0) | 0.034 | 14 (14.0) | 4 (80.0) | 0.003 | |||
| Substitutions in mosaic penA | |||||||||||||||
| D101E plusb | 3 (2.9) | 11 (52.4) | <0.0001 | 14 (12.1) | 0 (0) | 0.599 | |||||||||
| YGED201HAGE, Q214E | 4 (3.9) | 12 (57.1) | <0.0001 | 16 (13.8) | 0 (0) | 0.562 | |||||||||
| A311V, T483S, T485I | 0 (0) | 4 (19.0) | <0.001 | 1 (0.9) | 3 (37.5) | <0.001 | |||||||||
| I312M, V316T, N512Y plusc | 3 (2.9) | 16 (76.2) | <0.0001 | 16 (13.8) | 3 (37.5) | 0.196 | |||||||||
| P341S | 3 (2.9) | 12 (57.1) | <0.0001 | 15 (12.9) | 0 (0) | 0.594 | |||||||||
| GA375TP | 3 (2.9) | 13 (61.9) | <0.0001 | 16 (13.8) | 0 (0) | 0.562 | |||||||||
| A549T | 1 (1.0) | 15 (71.4) | <0.0001 | 13 (11.2) | 3 (37.5) | 0.061 | |||||||||
| PenA Substitutions | |||||||||||||||
| F374V | 0 (0) | 4 (19.0) | <0.001 | 1 (0.9) | 3 (37.5) | <0.001 | |||||||||
| A501Td | 15 (14.6) | 3 (14.3) | 0.759 | 14 (12.1) | 4 (50.0) | 0.015 | 15 (15.0) | 3 (60.0) | 0.034 | 14 (14.0) | 4 (80.0) | 0.003 | |||
| A501V | 58 (56.3) | 1 (4.8) | <0.0001 | 58 (50.0) | 1 (12.5) | 0.091 | |||||||||
| A516G | 100 (97.1) | 5 (23.8) | <0.0001 | 100 (86.2) | 5 (62.5) | 0.119 | |||||||||
| H541N | 23 (22.3) | 16 (76.2) | <0.0001 | 36 (31.0) | 3 (37.5) | 0.990 | |||||||||
| G542S | 27 (26.2) | 3 (14.3) | 0.245 | 26 (22.4) | 4 (50.0) | 0.182 | 27e (27.0) | 3f (60.0) | 0.277 | 26g (26.0) | 4h (80.0) | 0.036 | |||
| P552V, KI555QV | 17 (16.5) | 15 (71.4) | <0.0001 | 29 (25.0) | 3 (37.5) | 0.716 | |||||||||
| I566V, A574NV | 47 (45.6) | 18 (85.7) | <0.001 | 58 (50) | 7 (87.5) | 0.091 | |||||||||
| porB genotype | |||||||||||||||
| porB1a | 7 (6.8) | 1 (4.8) | 1 | 8 (6.9) | 0 (0) | 1 | |||||||||
| porB1b | 96 (93.2) | 20 (95.2) | 1 | 108 (93.1) | 8 (100) | 1 | |||||||||
| PorB1b Substitutions | |||||||||||||||
| T87A | 8 (8.3) | 2 (10.0) | 0.844 | 7 (6.5) | 3 (37.5) | 0.021 | |||||||||
| T89S | 10 (10.4) | 3 (15.0) | 0.816 | 10 (9.3) | 3 (37.5) | 0.045 | |||||||||
| GA120KD | 52 (54.2) | 15 (75.0) | 0.086 | 60 (55.6) | 7 (87.5) | 0.163 | |||||||||
| G213S/Y | 11 (11.5) | 4 (20.0) | 0.503 | 10 (9.3) | 5 (62.5) | <0.001 | 11 (11.8) | 2 (40.0) | 0.1294 | 10 (10.8) | 3 (60.0) | 0.016 | |||
| Q214L | 7 (7.3) | 2 (10.0) | 0.962 | 6 (5.6) | 3 (37.5) | 0.015 | |||||||||
| G259A | 61 (63.5) | 17 (85.0) | 0.063 | 70 (64.8) | 8 (100) | 0.041 | |||||||||
| PonA Substitutions | |||||||||||||||
| T375A | 100 (97.1) | 21 (100) | 1 | 113 (97.4) | 8 (100) | 1 | |||||||||
| L421P | 99 (96.1) | 21 (100) | 1 | 112 (96.6) | 8 (100) | 1 | |||||||||
| MtrR Substitutions | |||||||||||||||
| A39T | 10 (9.7) | 3 (14.3) | 0.816 | 13 (11.2) | 0 (0) | 1 | 13 (11.20) | 0 (0) | 1 | ||||||
| A40D | 4 (3.9) | 8 (38.1) | <0.0001 | 12 (10.3) | 0 (0) | 1 | 12 (10.3) | 0 (0) | 1 | ||||||
| G45D | 33 (32) | 1 (4.8) | 0.011 | 32 (27.6) | 2 (25) | 1 | 28 (24.1) | 6 (75.0) | 0.007 | ||||||
| T86A | 10 (9.7) | 8 (38.1) | 0.002 | 18 (15.5) | 0 (0) | 0.493 | 18 (15.5) | 0 (0) | 0.493 | ||||||
| H105Y | 49 (47.6) | 8 (38.1) | 0.427 | 51 (44) | 6 (75) | 0.181 | 56 (48.3) | 1 (12.5) | 0.110 | ||||||
| promoter -35A | 88 (85.4) | 10 (47.6) | <0.001 | 91 (78.4) | 7 (87.5) | 0.873 | 90 (77.6) | 8 (100) | 0.290 | ||||||
| 23S rRNA Mutations | |||||||||||||||
| A2059G | 0 (0) | 7 (87.5) | <0.0001 | ||||||||||||
χ2 test was used to identify molecular profiles associated with resistance to cefixime (CFMR), ceftriaxone (CROR), and azithromycin (>AZM ECOFF). aNG-STAR genotypes were reported previously (Yang et al., 2020). bAlso including substitutions V160A, N173S, A280V, D285E, R288K, and R291Q. cAlso including substitutions A323S, T326V, L328A/P, NERL329TDTF, Q335L, SP342AT, RD345Q, S352T, R373M, E377K, E385D, I388V, N406S, RP411QK, A437V, V443E, L447V, IF461VI, E464A, Q457K, RE468KK, N472E, P480A, and G545S. d,f,hAll isolates were penA 18 allele. eIncluding 10 isolates with penA 5, 1 isolate with penA 17, 15 isolates with penA 18, and 1 isolate with penA 41. gIncluding 10 isolates with penA 5, 1 isolate with penA 17, 14 isolates with penA 18, and 1 isolate with penA 41. Bold values indicate p < 0.05.