Genomic analysis and antimicrobial resistance determinants in Neisseria gonorrhoeae isolates with decreased susceptibility and resistance to extended-spectrum cephalosporins in Argentina, 2011 to 2016

Objectives: To describe the genome-based epidemiology and molecular antimicrobial resistance determinants in N. gonorrhoeae isolates with decreased susceptibility and resistance to ESCs in Argentina from 2011 to 2016. Methods: A total of 158 N. gonorrhoeae isolates with decreased susceptibility and resistance to ESCs collected in 2011 – 2016 in Argentina were subjected to whole genome sequencing (WGS) and antimicrobial susceptibility testing.Results: One hundred and forty-three isolates (90.5%) showed a multi-drug resistant phenotype. Decreased susceptibility to ESCs was mainly associated with isolates possessing the mosaic penicillin-binding protein 2 (PBP2) XXXIV, together with an mtrR promoter A deletion and porB1b alterations G120K/A121N. Phylogenetic analysis revealed two cluster circulating, which were associated with N. gonorrhoeae multiantigen sequence typing (NG-MAST) ST1407 and closely related STs and characterized by a high prevalence rate and geographical persistence.Conclusions: Genomic profile of N. gonorrhoeae strains isolated in Argentina between 2011 and 2016 were associated with a global multi-drug resistant clone (ST1407). The identification of the geographic dissemination and characteristics of these predominant strains may help to focus action plans and public health politics to control the spread of these isolates.