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-60.001 allele had higher ceftriaxone MICs than isolates of the typical ST1903 FC428 clone. This may be attributed to a main clade of MLST ST7365 strains in China exhibiting elevated ceftriaxone MICs, and the temporal phylogeny showed this clade emerged around 1994. In summary, we reveal the unique genomic and evolutionary patterns of ceftriaxone-resistant gonococcal strains in China, and the 357 not previously reported isolates substantially increase the number of global ceftriaxone-resistant isolates. Our results suggest potential evolutionary pathways and directions of ceftriaxone-resistant strains, and provide valuable data for examining genomic epidemiology, antimicrobial resistance determinants and formulating strategies for surveillance and interventions.
Zhang et al. (Thu,) studied this question.