TY - JOUR AU - Lee, Hyukmin AU - Suh, Young Hee AU - Lee, Sunhwa AU - Kim, Yong-Kyun AU - Han, Mi-Soon AU - Bae, Hye Gyung AU - Unemo, Magnus AU - Lee, Kyungwon T1 - Emergence and Spread of Cephalosporin-Resistant Neisseria gonorrhoeae with Mosaic penA Alleles, South Korea, 2012–2017 T2 - Emerging Infectious Disease journal PY - 2019 VL - 25 IS - 3 SP - 416 SN - 1080-6059 AB - In South Korea, surveillance of antimicrobial drug resistance in Neisseria gonorrhoeae is extremely limited. We describe the emergence and subsequent national spread of N. gonorrhoeae strains with mosaic penA alleles associated with decreased susceptibility and resistance to extended-spectrum cephalosporins. From 2012 through 2017, the proportion of mosaic penA alleles in gonococcal-positive nucleic acid amplification test (NAAT) specimens across South Korea increased from 1.1% to 23.9%. Gonococcal strains with mosaic penA alleles emerged in the international hubs of Seoul in Gyeonggi Province and Busan in South Gyeongsang Province and subsequently spread across South Korea. Most common was mosaic penA-10.001 (n = 572 isolates; 94.7%), which is associated with cefixime resistance. We also identified mosaic penA-34.001 and penA-60.001, both of which are associated with multidrug-resistant gonococcal strains and spread of cefixime and ceftriaxone resistance. Implementation of molecular resistance prediction from N. gonorrhoeae–positive nucleic acid amplification test specimens is imperative in South Korea and internationally. KW - Neisseria gonorrhoeae KW - gonorrhea KW - antimicrobial treatment KW - antimicrobial resistance KW - ceftriaxone KW - cefixime KW - penA KW - NG-MAST KW - MLST KW - Korea KW - bacteria KW - South Korea KW - cephalosporin KW - sexually transmitted infections KW - AMR DO - 10.3201/eid2503.181503 UR - https://wwwnc.cdc.gov/eid/article/25/3/18-1503_article ER - End of Reference