Common Patterns and Unique Threats in Antimicrobial Resistance as Demonstrated by Global Gonococcal Surveillance
Adriana Le Van
, Nazia Rahman, Reuel Sandy, Nelson Dozier, Hunter J. Smith, Melissa J. Martin, Katelyn V. Bartlett, Krit Harncharoenkul, Anna Nanava, Tamar Akhvlediani, Paul Rios, Supriya D. Mehta, Walter Agingu, Denis K. Byarugaba, Fred Wabwire-Mangen, Hannah Kibuuka, Bernard Erima, Hope O. Kabatasi, Naiki Attram, Dutsadee Peerapongpaisarn, Wilawan Oransathit, Wirote Oransathit, Umaporn Suksawad, Woradee Lurchachaiwong, Somchai Sriplienchan, Nonlawat Boonyalai, Maneerat Somsri, Nithinart Chaitaveep, Ann Jerse, and Eric Garges
Author affiliation: Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA (A. Le Van, R. Sandy); Uniformed Services University, Bethesda (A. Le Van, R. Sandy, N. Dozier, A. Jerse, E. Garges); Cherokee Nation Strategic Programs, Tulsa, Oklahoma, USA (N. Rahman); Global Emerging Infections Surveillance Branch, Armed Forces Health Surveillance Division, Silver Spring, Maryland, USA (N. Rahman, H.J. Smith); Multidrug Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring (M.J. Martin, K.V. Bartlett); Walter Reed Army Institute of Research, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand (K. Harncharoenkul, D. Peerapongpaisarn, Wilawan Oransathit, Wirote Oransathit, U. Suksawad, W. Lurchachaiwong, S. Sriplienchan, N. Boonyalai, M. Somsri, N. Chaitaveep); Walter Reed Army Institute of Research Europe-Middle East, Tbilisi, Georgia (A. Nanava, T. Akhvlediani); US Naval Medical Research Unit SOUTH, Lima, Peru (P. Rios); Rush University College of Medicine, Chicago, Illinois, USA (S.D. Mehta); Walter Reed Army Institute of Research-Africa, Kisumu, Kenya (W. Agingu); Makerere University Walter Reed Project, Kampala, Uganda (D.K. Byarugaba); Makerere University College of Veterinary Medicine, Kampala (D.K. Byarugaba, F. Wabwire-Mangen, H. Kibuuka, B. Erima, H.O. Kabatasi); US Naval Medical Research Unit EURAFCENT, Accra, Ghana (N. Attram); Walter Reed Army Institute of Research-Africa, Nairobi, Kenya (E. Garges)
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Figure 2
Figure 2. Minimum-spanning tree showing genome-based genetic relatedness of all N. gonorrhoeae isolates received at Uniformed Services University (n = 1,044), Bethesda, Maryland, USA, in study of common patterns and unique threats in antimicrobial resistance as demonstrated by global gonococcal surveillance. Tree was generated using core genome multilocus sequence typing. Each circle represents >1 isolates; isolates with 1–10 allelic differences are emphasized by gray shading around the lines and are considered highly genetically related with suspicion of nosocomial origin. Isolates are colored corresponding to their country of origin. Possible clonal isolates are shown with black arrows.
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