*Antimicrobial MIC tested by using Etest (bioMérieux, https://www.biomerieux.com). Interpretation according to Clinical and Laboratory Standards Institute (CLSI) standards (4). CLSI cutoff for susceptible is MIC <0.06 μg/mL, for intermediate is MIC 0.12–1 μg/mL, for resistant is MIC >2 μg/mL. A MIC of 1 was described as reduced susceptibility. †Missense mutation. ‡Promoter deletion. §The penA gene that encodes the PBP2 shared 99.77% identity with the penA encoded by the World Health Organization Alfa strain. However, it could not be classified by using the NG-STAR platform (https://ngstar.canada.ca) because of 2 gaps in the sequence, and the closest NG STAR type was the nonmosaic allele 18.001. ¶MIC 0.75 μg/mL was within susceptible range, although elevated compared with local reference strains. CLSI MIC cutoff for N. gonorrhoeae azithromycin susceptibility is MIC <1 μg/mL. However, CLSI has set a susceptible only interpretive breakpoint at this value, with the recommendation that this applies when azithromycin (1 g single dose) is used in combination with another antimicrobial, such as ceftriaxone. #Efflux pumps encoded in this strain include mtrA, macA, macB, and farA.