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A Case of Decreased Susceptibility to Ceftriaxone in Neisseria gonorrhoeae in the Absence of a Mosaic Penicillin-Binding Protein 2 (penA) Allele

Abrams, A. Jeanine PhD*; Kirkcaldy, Robert D. MD, MPH*; Pettus, Kevin BS*; Fox, Jan L. MPH, RN; Kubin, Grace PhD; Trees, David L. PhD*

doi: 10.1097/OLQ.0000000000000645
Case Reports

Abstract: We report a case of Neisseria gonorrhoeae with a non-mosaic penA allele that exhibited decreased susceptibility to extended-spectrum cephalosporins, including a ceftriaxone minimum inhibitory concentration of 0.5 μg/mL. An analysis of resistance determinants suggested that the observed phenotype might have resulted from the combined effects of mutations in multiple genes.

Case report examines a Neisseria gonorrhoeae isolate with a nonmosaic penA allele that exhibited decreased susceptibility to ceftriaxone and other extended-spectrum cephalosporins.

From the *CDC Division of STD Prevention, Atlanta, GA; †Oklahoma State Department of Health, HIV/STD Service, Oklahoma City, OK; and ‡Texas Department of State Health Services, Laboratory Services Section, Austin, TX

Conflict of Interest and Sources of Funding: None declared.

Disclaimer: The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Correspondence: A. Jeanine Abrams, PhD, Centers for Disease Control and Prevention, Division of STD Prevention, Laboratory Reference and Research Branch 1600 Clifton Rd. NE MS A12 Atlanta, GA 30333. E-mail:

Received for publication February 21, 2017, and accepted April 4, 2017.

© Copyright 2017 American Sexually Transmitted Diseases Association