First Description of a Cefixime and Ciprofloxacin-Resistant Neisseria gonorrhoeae Isolate with Mutations in Key Antimicrobial Susceptibility-Determining Genes from the Country of Georgia

Abstract Antimicrobial resistance in Neisseria gonorrhoeae ( N. gonorrhoeae ) is a global health problem. Enhanced international collaborative surveillance and disease control is needed to reduce the global burden of this important pathogen. Currently, the antimicrobial resistance properties and molecular mechanisms of multidrug resistant N. gonorrhoeae in the country of Georgia represent a significant knowledge gap. Here we report the isolation of a strain of N. gonorrhoeae exhibiting resistance to cefixime and ciprofloxacin with reduced susceptibility to penicillin and tetracycline from a patient being treated at a Georgian medical center. Notably, this isolate was found to contain a mosaic penA allele; and to harbor mutations in genes conferring susceptibility to the beta-lactam, cephalosporin, fluoroquinolone, macrolide and penicillin classes of antibiotic. To our knowledge, this is the first report to describe the key mutations conferring the antimicrobial resistance properties of an isolate of N. gonorrhoeae from the country of Georgia.