Genetic characteristics of azithromycin-resistant Neisseria gonorrhoeae collected in Hyogo, Japan during 2015-2019

Azithromycin (AZM) is the therapeutic for sexually transmitted infections and is used for N. gonorrhoeae when its first-line and second-line drugs are not available. Recently, the susceptibility of N. gonorrhoeae against AZM is decreasing worldwide. Azithromycin-resistant (AZM-R) rates among N. gonorrhoeae in Japan are increasing, and the gene mutations and epidemiological characteristics of AZM-R in N. gonorrhoeae have not been fully investigated. We determined the susceptibility to azithromycin and its correlation with genetic characteristics of N. gonorrhoeae. In order to perform molecular epidemiological analysis with higher resolution, we sequenced the genomes of a total of 24 strains of N. gonorrhoeae and obtained read data.