TABLE 3.

Summary of genetic alterations identified in United States N. meningitidis urethritis clade (US_NmUC) with resulting phenotypic effects and presumed mechanisms for increased urethrotropic fitness

Genetic alteration	Phenotype	Result	Presumed mechanism of increased fitness
Insertion (IS1301) in cps locus	Prevents functional production of serogroup C capsule polymerase	US_NmUC is unencapsulated	Facilitates mucosal adherence
fHbp	Elevated protein expression of factor H binding protein	US_NmUC can hinder segments of complement activation	Evasion of host immune response
Acquired norB-aniA cassette	Enables denitrification	US_NmUC can thrive in anaerobic conditions	Enhanced ability to grow in the urethra