First Neisseria gonorrhoeae Genotyping Analysis in France: Identification of a Strain Cluster with Reduced Susceptibility to Ceftriaxone

DOI: 10.1128/JCM.01236-09

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FIG. 1.
Distribution of NG-MAST STs of the French N. gonorrhoeae isolates obtained in 2006 (n = 93) and the antibiotic (ATB) phenotypes of the isolates. Others STs were represented only by one isolate. STs indicated by black stars are newly described STs in the NG-MAST database.

TABLE 1.

Characteristics of antibiotic susceptibility phenotypes of the French N. gonorrhoeae isolates studied

Phenotype (no. of strains)	Antibiotic susceptibility (MIC [mg/liter]) to^a:
Phenotype (no. of strains)	Penicillin	β-Lactamase	Tetracycline	Ciprofloxacin	Ceftriaxone	Spectinomycin	Erythromycin^b
1 (10)	R (1-4)	Positive	hR (16-32)	I or R (0.5-4)	S (≤0.004)	S (4-8)	S
2 (6)	I (0.064-0.19)	Negative	hR (16-32)	I or R (0.5-2)	S (≤0.004)	S (4-6)	S
3 (39)	S or I (≤1)	Negative	S or I (0.125-1)	S (<0.002-0.012)	S (≤0.004)	S (4-12)	S
4 (31)	I (1-1.5)	Negative	I or R (1.5-3)	hR (≥32)	rS (0.016-0.032)	S (4-8)	S
5 (2)	I (0.5-0.75)	Negative	R (2)	S (0.008-0.012)	rS (0.012-0.016)	S (6-8)	S
6 (5)	I (0.125-0.75)	Negative	I or R (1-2)	R or hR (4-32)	S (0.003-0.016)	S (4-8)	S

↵ a The antimicrobial MIC interpretative standards and breakpoints for susceptibility and resistance (CLSI) for the antibiotics shown are as follows: penicillin MIC, ≥0.06 and ≥2; tetracycline MIC, ≥0.25 and ≥2; ciprofloxacin MIC, ≥0.06 and ≥1; ceftriaxone MIC, ≥0.5 and ≥1; and spectinomycin MIC, ≥32 and ≥64. S, susceptible; I, intermediate; R, resistant; rS, reduced susceptibility (ceftriaxone MIC, ≥0.012 and ≤0.032 mg/liter); hR, high level of resistance (tetracycline MIC, ≥16 mg/liter; ciprofloxacin MIC, ≥32 mg/liter).
↵ b Only the disk diffusion method was used for erythromycin.

TABLE 2.

Characteristics of French N. gonorrhoeae isolates associated with main NG-MAST sequence types

ST	Total no. of isolates	Isolate group^a	No. of isolates	Serotype	Geographic origin^b	Antibiotic susceptibility phenotype^c	Antibiotic susceptibility to^d:
ST	Total no. of isolates	Isolate group^a	No. of isolates	Serotype	Geographic origin^b	Antibiotic susceptibility phenotype^c	Penicillin	β-Lactamase	Tetracycline	Ciprofloxacin	Ceftriaxone	Spectinomycin	Erythromycin
225	16	I	12	B	Paris + OR	4	I	Negative	I or R	hR	rS	S	S
		I	2	B	Paris + OR	3	S or I	Negative	I	S	S	S	S
		II	2	B	Paris	4	I	Negative	R	hR	rS	S	S
1479	9	I	4	A	Paris + OR	1	R	Positive	hR	I or R	S	S	S
		I	2	A	Paris + OR	2	I	Negative	hR	I	S	S	S
		I	2	B	Paris + OR	2	I	Negative	hR	R	S	S	S
		II	1	A	Paris	1	R	Positive	hR	I	S	S	S
880	4	I	2	B	Paris + OR	4	I or R	Negative	R	hR	rS	S	S
		II	2	B	Paris + OR	4	I	Negative	R	hR	rS	S	S
26	3	I	2	B	Paris	3	I or S	Negative	I	S	S	S	S
		II	1	B	Paris	3	I	Negative	I	S	S	S	S
437	3	I	3	B	Paris + OR	4	I or R	Negative	R	R	rS	S	S
975	3	I	3	A	Paris + OR	3	S or I	Negative	S	S	S	S	S
1986	3	I	2	B	Paris + OR	3	S	Negative	S	S	S	S	S
		I	1	B		4	I	Negative	R	hR	rS	S	S
2	2	I	1	A	Paris	3	S	Negative	S	S	S	S	S
		I	1	B	OR	3	I	Negative	S	S	S	S	S
211	2	I	2	A	Paris + OR	1	R	Positive	hR	R	S	S	S
292	2	II	1	B	Paris	6	I	Negative	I	R	S	S	S
		II	1	B	Paris	4	I	Negative	R	hR	rS	S	S
359	2	II	2	B	Paris	3	S	Negative	I	S	S	S	S
1813	2	II	2	B	Paris	3	I	Negative	I	S	S	S	S
1987	2	I	1	A	Paris	3	S	Negative	S	S	S	S	S
		I	1	B	Paris	3	I	Negative	I	S	S	S	S

↵ a As defined in Materials and Methods.
↵ b Paris, Paris and its surroundings; OR, other regions outside Paris and its surroundings.
↵ c As described in Table 1.
↵ d S, susceptible; I, intermediate; R, resistant; hR, high level of resistance (tetracycline MIC, ≥16 mg/liter; ciprofloxacin MIC, ≥32 mg/liter); rS, reduced susceptibility (ceftriaxone MIC, ≥0.012 and ≤0.032 mg/liter.