Genomic and Phenotypic Variability in Neisseria gonorrhoeae Antimicrobial Susceptibility England

摘要

Antimicrobial resistance (AMR) in is a global concern. Phylogenetic analyses resolve uncertainties regarding genetic relatedness of isolates with identical phenotypes and inform whether AMR is due to new mutations and clonal expansion or separate introductions by importation. We sequenced 1,277 isolates with associated epidemiologic and antimicrobial susceptibility data collected during 2013–2016 to investigate genomic variability in England. Comparing genetic markers and phenotypes for AMR, we identified 2 lineages with different antimicrobial susceptibility profiles and 3 clusters with elevated MICs for ceftriaxone, varying mutations in the allele, and different epidemiologic characteristics. Our results indicate with reduced antimicrobial susceptibility emerged independently and multiple times in different sexual networks in England, through new mutation or recombination events and by importation. Monitoring and control for AMR in should cover the entire population affected, rather than focusing on specific risk groups or locations.