ruleID	organism	gene	nodeID	refseq accession	GenBank accession	HMM accession	ARO accession	mutation	variation type	context	drug	drug class	phenotype	clinical category	breakpoint	breakpoint standard	PMID	evidence code	evidence grade	evidence limitations	rule curation note
NGO0001	s__Neisseria gonorrhoeae	16S	-	NZ_AP019853.2:1155759-1157299	-	-	ARO:3003495	c.1191C>T	Nucleotide variant detected	acquired	spectinomycin	-	nonwildtype	R	MIC >64 mg/L	EUCAST v14.0 (2024)	"2138078,  10770780"	"ECO:0001103 natural variation mutant evidence, ECO:0001113 point mutation phenotypic evidence"	moderate	statistical geno/pheno evidence but no experimental evidence	"Core ribosomal RNA gene, mutation confers spectinomycin resistance. Is C1191T in NCBI ReferenceGeneCatalog, C1189T in CARD. Not enough data to evaluate phenotype codification from geno-pheno data. NWT R assigned according to experimental evidence."
NGO0002	s__Neisseria gonorrhoeae	23S	-	NC_002946.2:1119158-1116249	-	-	ARO:3004836	c.[2059A>G][4]	Nucleotide variant detected in multi-copy gene	acquired	azithromycin	-	nonwildtype	R	MIC >1 mg/L	ECOFF (January 2024)	20585125	ECO:0001103 natural variation mutant evidence	strong		"Wildtype core gene in four copies. Not expected to confer drug resistance unless some of the copies are mutated. 23S rDNA 2045A>G substitution (2059A>G in E. coli; 2062 in AMRfinderplus). Experimental evidence from growth under antibiotic pressure, but not from transformation experiments (PMID 20585125)."
NGO0003	s__Neisseria gonorrhoeae	23S	-	NC_002946.2:1119158-1116249	-	-	ARO:3004836	c.[2059A>G][3]	Nucleotide variant detected in multi-copy gene	acquired	azithromycin	-	nonwildtype	R	MIC >1 mg/L	ECOFF (January 2024)	20585125	ECO:0001103 natural variation mutant evidence	strong		"Wildtype core gene in four copies. Not expected to confer drug resistance unless some of the copies are mutated. 23S rDNA 2045A>G substitution (2059A>G in E. coli; 2062 in AMRfinderplus). Experimental evidence from growth under antibiotic pressure, but not from transformation experiments (PMID 20585125)."
NGO0004	s__Neisseria gonorrhoeae	23S	-	NC_002946.2:1119158-1116249	-	-	ARO:3004836	c.[2059A>G][2]	Nucleotide variant detected in multi-copy gene	acquired	azithromycin	-	nonwildtype	R	MIC >1 mg/L	ECOFF (January 2024)	20585125	ECO:0001103 natural variation mutant evidence	moderate	statistical geno/pheno evidence but no experimental evidence	Wildtype core gene in four copies. Not expected to confer drug resistance unless some of the copies are mutated. 23S rDNA 2045A>G substitution (2059A>G in E. coli; 2062 in AMRfinderplus).
NGO0005	s__Neisseria gonorrhoeae	23S	-	NC_002946.2:1119158-1116249	-	-	ARO:3004836	c.[2059A>G][1]	Nucleotide variant detected in multi-copy gene	acquired	azithromycin	-	nonwildtype	S	MIC <=1 mg/L	ECOFF (January 2024)	20585125	ECO:0001103 natural variation mutant evidence	moderate	statistical geno/pheno evidence but no experimental evidence	Wildtype core gene in four copies. Not expected to confer drug resistance unless some of the copies are mutated. 23S rDNA 2045A>G substitution (2059A>G in E. coli; 2062 in AMRfinderplus). No clear evidence on whether 1 mutated copy exceeds the ECOFF.
NGO0006	s__Neisseria gonorrhoeae	23S	-	NC_002946.2:1119158-1116249	-	-	ARO:3004836	c.[2058A>G][4]	Nucleotide variant detected in multi-copy gene	acquired	azithromycin	-	nonwildtype	R	MIC >1 mg/L	ECOFF (January 2024)	33139288	ECO:0001103 natural variation mutant evidence	strong		"Wildtype core gene in four copies. Not expected to confer drug resistance unless some of the copies are mutated. 23S rDNA 2044A>G substitution (2058A>G in E. coli). Found in 3 and 4 mutated copies in PMID 33139288. Loss-of function of mtrC increases susceptibility to azithromycin, beta-lactams, tetracyclines and ciprofloxacin. PMID 32807804 reports particularly strong effects for azithromycin. Mutation not in the AMRfinderplus database."
NGO0007	s__Neisseria gonorrhoeae	23S	-	NC_002946.2:1119158-1116249	-	-	ARO:3004836	c.[2058A>G][3]	Nucleotide variant detected in multi-copy gene	acquired	azithromycin	-	nonwildtype	R	MIC >1 mg/L	ECOFF (January 2024)	33139288	ECO:0001103 natural variation mutant evidence	strong		"Wildtype core gene in four copies. Not expected to confer drug resistance unless some of the copies are mutated. 23S rDNA 2044A>G substitution (2058A>G in E. coli). Found in 3 and 4 mutated copies in PMID 33139288. Loss-of function of mtrC increases susceptibility to azithromycin, beta-lactams, tetracyclines and ciprofloxacin. PMID 32807804 reports particularly strong effects for azithromycin. Mutation not in the AMRfinderplus database."
NGO0008	s__Neisseria gonorrhoeae	23S	-	NC_002946.2:1119158-1116249	-	-	ARO:3004836	c.[2611C>T][4]	Nucleotide variant detected in multi-copy gene	acquired	azithromycin	-	nonwildtype	R	MIC >1 mg/L	ECOFF (January 2024)	12183262	ECO:0001103 natural variation mutant evidence	strong		Wildtype core gene in four copies. Not expected to confer drug resistance unless some of the copies are mutated. 23S rDNA 2597C>T substitution (2611C>T in E. coli; 2617 in AMRfinderplus). Found in different copy numbers in clinical and spontaneous mutants in PMID 12183262.
NGO0009	s__Neisseria gonorrhoeae	23S	-	NC_002946.2:1119158-1116249	-	-	ARO:3004836	c.[2611C>T][3]	Nucleotide variant detected in multi-copy gene	acquired	azithromycin	-	nonwildtype	R	MIC >1 mg/L	ECOFF (January 2024)	12183262	ECO:0001103 natural variation mutant evidence	strong		Wildtype core gene in four copies. Not expected to confer drug resistance unless some of the copies are mutated. 23S rDNA 2597C>T substitution (2611C>T in E. coli; 2617 in AMRfinderplus). Found in different copy numbers in clinical and spontaneous mutants in PMID 12183262.
NGO0010	s__Neisseria gonorrhoeae	23S	-	NC_002946.2:1119158-1116249	-	-	ARO:3004836	c.[2611C>T][2]	Nucleotide variant detected in multi-copy gene	acquired	azithromycin	-	nonwildtype	R	MIC >1 mg/L	ECOFF (January 2024)	12183262	ECO:0001103 natural variation mutant evidence	moderate	lacks evidence of the degree to which MIC is affected	"Wildtype core gene in four copies. Not expected to confer drug resistance unless some of the copies are mutated. 23S rDNA 2597C>T substitution (2611C>T in E. coli; 2617 in AMRfinderplus). Found in different copy numbers in clinical and spontaneous mutants in PMID 12183262  (1 strain with 2 mutated copies with MIC = 1 mg/L, just on the ECOFF)."
NGO0011	s__Neisseria gonorrhoeae	23S	-	NC_002946.2:1119158-1116249	-	-	ARO:3004836	c.[2611C>T][1]	Nucleotide variant detected in multi-copy gene	acquired	azithromycin	-	nonwildtype	S	MIC <=1 mg/L	ECOFF (January 2024)	12183262	ECO:0001103 natural variation mutant evidence	moderate	lacks evidence of the degree to which MIC is affected	"Wildtype core gene in four copies. Not expected to confer drug resistance unless some of the copies are mutated. 23S rDNA 2597C>T substitution (2611C>T in E. coli; 2617 in AMRfinderplus). Found in different copy numbers in clinical and spontaneous mutants in PMID 12183262 (1 strain with 1 mutated copy with MIC = 0.5 mg/L, below the ECOFF). No clear evidence on whether 1 mutated copy exceeds the ECOFF."
NGO0012	s__Neisseria gonorrhoeae	blaTEM-1	blaTEM-1	WP_000027057.1	-	-	ARO:3000873	-	Gene presence detected	acquired	benzylpenicillin	-	nonwildtype	R	MIC >1 mg/L	EUCAST v14.0 (2024)	"11585791, 25149062"	ECO:0000005 enzymatic activity assay evidence	strong		The presence of a TEM beta-lactamase in a plasmid in N. gonorrhoeae causes high-level resistance to benzylpenicillin
NGO0013	s__Neisseria gonorrhoeae	blaTEM-135	blaTEM-135	WP_015058868.1	-	-	ARO:3000999	-	Gene presence detected	acquired	benzylpenicillin	-	nonwildtype	R	MIC >1 mg/L	EUCAST v14.0 (2024)	"11585791, 25149062"	ECO:0000005 enzymatic activity assay evidence	strong		The presence of a TEM beta-lactamase in a plasmid in N. gonorrhoeae causes high-level resistance to benzylpenicillin
NGO0014	s__Neisseria gonorrhoeae	folP	-	WP_003702942.1	-	-	ARO:3004873	p.Arg228Ser	Protein variant detected	acquired	-	sulfonamide antibiotic	nonwildtype	R	not applicable	EUCAST v14.0 (2024)	"27432602, 15673729"	"ECO:0001113 point mutation phenotypic evidence, ECO:0001103 natural variation mutant evidence"	moderate	"statistical geno/pheno evidence but no experimental evidence, low clinical relevance"	"Wild type gene encoding dihydropteroate synthase, mutation confers resistance to sulfonamides. Originally described in N. meningitidis and can be tracked in N. gonorrhoeae for surveillance purposes. No MIC data available for geno-pheno comparisons, NWT R assigned as phenotype according to experimental evidence. "
NGO0015	s__Neisseria gonorrhoeae	folP	-	WP_003702942.1	-	-	ARO:3004873	p.Phe31Leu	Protein variant detected	acquired	-	sulfonamide antibiotic	nonwildtype	R	not applicable	EUCAST v14.0 (2024)	7642493	"ECO:0001113 point mutation phenotypic evidence, ECO:0001091 knockout phenotypic evidence, ECO:0000012 functional complementation evidence"	weak	"lacks evidence for this species, low clinical relevance"	"Wild type gene encoding dihydropteroate synthase, mutation confers resistance to sulfonamides. Originally described in N. meningitidis and can be tracked in N. gonorrhoeae for surveillance purposes. No MIC data available for geno-pheno comparisons, NWT R assigned as phenotype according to experimental evidence."
NGO0016	s__Neisseria gonorrhoeae	folP	-	WP_003702942.1	-	-	ARO:3004873	p.Gly194Cys	Protein variant detected	acquired	-	sulfonamide antibiotic	nonwildtype	R	not applicable	EUCAST v14.0 (2024)	7642493	"ECO:0001113 point mutation phenotypic evidence, ECO:0001091 knockout phenotypic evidence, ECO:0000012 functional complementation evidence"	weak	"lacks evidence for this species, low clinical relevance"	"Wild type gene encoding dihydropteroate synthase, mutation confers resistance to sulfonamides. Originally described in N. meningitidis and can be tracked in N. gonorrhoeae for surveillance purposes. No MIC data available for geno-pheno comparisons, NWT R assigned as phenotype according to experimental evidence. "
NGO0017	s__Neisseria gonorrhoeae	folP	-	WP_003702942.1	-	-	ARO:3004873	p.194_195insSerGly	Protein variant detected	acquired	-	sulfonamide antibiotic	nonwildtype	R	not applicable	EUCAST v14.0 (2024)	7642493	"ECO:0001113 point mutation phenotypic evidence, ECO:0001091 knockout phenotypic evidence, ECO:0000012 functional complementation evidence"	weak	"lacks evidence for this species, low clinical relevance"	"Wild type gene encoding dihydropteroate synthase, mutation confers resistance to sulfonamides. Originally described in N. meningitidis and can be tracked in N. gonorrhoeae for surveillance purposes. No MIC data available for geno-pheno comparisons, NWT R assigned as phenotype according to experimental evidence. "
NGO0018	s__Neisseria gonorrhoeae	gyrA	-	WP_033785346.1	-	-	ARO:3003292	p.Ser91Phe	Protein variant detected	acquired	ciprofloxacin	-	nonwildtype	R	MIC >0.06 mg/L	EUCAST v14.0 (2024)	"7830580, 11181352"	"ECO:0005027 genetic transformation evidence, ECO:0001103 natural variation mutant evidence"	strong		"Wildtype core gene, not expected to confer drug resistance unless a S91F mutation is present."
NGO0019	s__Neisseria gonorrhoeae	gyrA	-	WP_033785346.1	-	-	ARO:3003292	p.Ser91Tyr	Protein variant detected	acquired	ciprofloxacin	-	nonwildtype	R	MIC >0.06 mg/L	EUCAST v14.0 (2024)	"35453249, 33432328, 11181352"	ECO:0001103 natural variation mutant evidence	strong		Mutation found when exposing WHO_F to increasing concentrations of ciprofloxacin. Found in natural populations in low proportions compared with S91F.
NGO0020	s__Neisseria gonorrhoeae	gyrA	-	WP_033785346.1	-	-	ARO:3003292	p.Asp95Ala	Protein variant detected	acquired	ciprofloxacin	-	wildtype	S	MIC <=0.03 mg/L	EUCAST v14.0 (2024)	"30961546, 30961546"	ECO:0001103 natural variation mutant evidence	moderate	lacks evidence of the degree to which MIC is affected	"This mutation tends to appear together with S91 mutations, so its individual effect on MIC is difficult to assess. In isolates with only this mutation, according to ECOFF and clinical breakpoints, the most frequent phenotype is WT S."
NGO0021	s__Neisseria gonorrhoeae	gyrA	-	WP_033785346.1	-	-	ARO:3003292	p.Asp95Asn	Protein variant detected	acquired	ciprofloxacin	-	nonwildtype	R	MIC >0.06 mg/L	EUCAST v14.0 (2024)	"7830580, 11181352"	"ECO:0005027 genetic transformation evidence, ECO:0001103 natural variation mutant evidence"	moderate	lacks evidence of the degree to which MIC is affected	"This mutation tends to appear together with S91 mutations, so its individual effect on MIC is difficult to assess."
NGO0022	s__Neisseria gonorrhoeae	gyrA	-	WP_033785346.1	-	-	ARO:3003292	p.Asp95Gly	Protein variant detected	acquired	ciprofloxacin	-	nonwildtype	S	MIC <=0.03 mg/L	EUCAST v14.0 (2024)	"7830580, 11181352"	"ECO:0005027 genetic transformation evidence, ECO:0001103 natural variation mutant evidence"	moderate	lacks evidence of the degree to which MIC is affected	"This mutation tends to appear together with S91 mutations, so its individual effect on MIC is difficult to assess. In isolates with only this mutation, nearly the same number of isolates had a S/I vs R phenotype. With this information and also with the experimental evidence, a NWT S phenotype is indicated."
NGO0023	s__Neisseria gonorrhoeae	gyrB	-	WP_050171206.1	-	-	ARO:3004859	p.Asp429Asn	Protein variant detected	acquired	Zoliflodacin	-	nonwildtype	R	not applicable	not applicable	"31730160, 38216602, 36868257"	"ECO:0001113 point mutation phenotypic evidence, ECO:0005027 genetic transformation evidence"	moderate	unknown clinical relevance	"This mutation was found in low frequency when exposing N. gonorrhoeae to zoliflodacin in vitro in PMID 31730160. It was also induced in commensal Neisseria spp and transfered via transformation to N. gonorrhoeae in 38216602. Can also arise through selection on ciprofloxacin in vitro (PMID 36868257), increasing ciprofloxacin MICs."
NGO0024	s__Neisseria gonorrhoeae	gyrB	-	WP_050171206.1	-	-	ARO:3004859	p.Lys450Asn	Protein variant detected	acquired	Zoliflodacin	-	nonwildtype	R	not applicable	not applicable	"31730160, 38216602"	"ECO:0001113 point mutation phenotypic evidence, ECO:0005027 genetic transformation evidence"	moderate	unknown clinical relevance	This mutation was found in low frequency when exposing N. gonorrhoeae to zoliflodacin in vitro in PMID 31730160. It was also induced in commensal Neisseria spp and transfered via transformation to N. gonorrhoeae in 38216602.
NGO0025	s__Neisseria gonorrhoeae	gyrB	-	WP_050171206.1	-	-	ARO:3004859	p.Lys450Thr	Protein variant detected	acquired	Zoliflodacin	-	nonwildtype	R	not applicable	not applicable	"31730160, 38216602"	"ECO:0001113 point mutation phenotypic evidence, ECO:0005027 genetic transformation evidence"	moderate	unknown clinical relevance	This mutation was found in low frequency when exposing N. gonorrhoeae to zoliflodacin in vitro in PMID 31730160. It was also induced in commensal Neisseria spp and transfered via transformation to N. gonorrhoeae in 38216602.
NGO0026	s__Neisseria gonorrhoeae	macAB	-	NZ_AP023073.1:147313-147537	-	-	ARO:3000533	c.[-48G>T]	Promoter variant detected	acquired	azithromycin	-	nonwildtype	S	MIC <=1 mg/L	ECOFF (January 2024)	16162665	ECO:0005027 genetic transformation evidence	strong	"lacks evidence of the degree to which MIC is affected, low clinical relevance"	"In vitro evidence from PMID 16162665, very rare in clinical isolates."
NGO0027	s__Neisseria gonorrhoeae	mtrC	-	NZ_CP012026.1:1110850-1110550	-	-	ARO:3005004	c.[-120C>T]	Promoter variant detected	acquired	azithromycin	-	nonwildtype	S	MIC <=1 mg/L	ECOFF (January 2024)	18761689	ECO:0005027 genetic transformation evidence	moderate	low clinical relevance	"Promoter of mtrR. Decreases susceptibility to azithromycin, beta-lactams and tetracycline when mutated. mtrC_C-120T. Same as mtrR_G-131A."
NGO0028	s__Neisseria gonorrhoeae	mtrC	-	NZ_CP012026.1:1110850-1110550	-	-	ARO:3005004	-	Inactivating mutation detected	acquired	azithromycin	-	wildtype	S	MIC <=1 mg/L	ECOFF (January 2024)	"32807804, 9534233"	"ECO:0000012 functional complementation evidence, ECO:0005027 genetic transformation evidence"	strong		"Loss-of function of mtrC increases susceptibility to azithromycin, beta-lactams, tetracyclines and ciprofloxacin. PMID 32807804 reports particularly strong effects for azithromycin. "
NGO0029	s__Neisseria gonorrhoeae	mtrC	-	NZ_CP012026.1:1110850-1110550	-	-	ARO:3005004	c.[-120C>T]	Promoter variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	ECOFF (January 2024)	18761689	ECO:0005027 genetic transformation evidence	moderate	low clinical relevance	"Promoter of mtrR. Decreases susceptibility to azithromycin, beta-lactams and tetracycline when mutated. mtrC_C-120T. Same as mtrR_G-131A."
NGO0030	s__Neisseria gonorrhoeae	mtrC	-	NZ_CP012026.1:1110850-1110550	-	-	ARO:3005004	c.[-120C>T]	Promoter variant detected	acquired	tetracycline	-	nonwildtype	S	MIC <=0.5 mg/L	ECOFF (January 2024)	18761689	ECO:0005027 genetic transformation evidence	moderate	low clinical relevance	"Promoter of mtrR. Decreases susceptibility to azithromycin, beta-lactams and tetracycline when mutated. mtrC_C-120T. Same as mtrR_G-131A."
NGO0031	s__Neisseria gonorrhoeae	mtrD	-	WP_003695678.1	-	-	ARO:3000811	-	Inactivating mutation detected	acquired	azithromycin	-	wildtype	S	MIC <=1 mg/L	ECOFF (January 2024)	9534233	ECO:0005027 genetic transformation evidence	moderate	lacks evidence of the degree to which MIC is affected	Small deletions in mtrD were linked to antimicrobial hypersusceptibility in PMID 9534233. Mutation not in the AMRfinderplus database.
NGO0032	s__Neisseria gonorrhoeae	mtrD	-	WP_003695678.1	-	-	ARO:3000811	p.Arg714Gly	Protein variant detected	acquired	azithromycin	-	nonwildtype	R	MIC >1 mg/L	ECOFF (January 2024)	"32457251, 32843551"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence, ECO:0001103 natural variation mutant evidence, ECO:0001034 crystallography evidence"	strong		"This mutation decreases susceptibility to azithromycin, often found in mosaic mtrD. Mutation not in the AMRfinderplus database. NWT R phenotype assigned according to experimental evidence."
NGO0033	s__Neisseria gonorrhoeae	mtrD	-	WP_003695678.1	-	-	ARO:3000811	p.Lys823Glu	Protein variant detected	acquired	azithromycin	-	nonwildtype	R	MIC >1 mg/L	ECOFF (January 2024)	"32457251, 32843551"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence, ECO:0001103 natural variation mutant evidence, ECO:0001034 crystallography evidence"	strong		"This mutation decreases susceptibility to azithromycin, often found in mosaic mtrD. Mutation not in the AMRfinderplus database. NWT R phenotype assigned according to experimental evidence."
NGO0034	s__Neisseria gonorrhoeae	mtrR	mtrR	WP_047924300.1	-	-	ARO:3004851	p.Ala39Thr	Protein variant detected	acquired	azithromycin	-	nonwildtype	S	MIC <=1 mg/L	ECOFF (January 2024)	18761689	ECO:0005027 genetic transformation evidence	moderate	low clinical relevance	"Repressor of the MtrCDE efflux pump. Decreases susceptibility to azithromycin, beta-lactams and tetracycline when mutated. mtrR_A39T. In PMID 33875000, isolates with only this mutation have a wide ranges of MICs~0.015-16 mg/L, most of them below the ECOFF. Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0035	s__Neisseria gonorrhoeae	mtrR	mtrR	WP_047924300.1	-	-	ARO:3004851	p.Gly45Asp	Protein variant detected	acquired	azithromycin	-	nonwildtype	S	MIC <=1 mg/L	ECOFF (January 2024)	"7773394, 18761689"	ECO:0005027 genetic transformation evidence	moderate	low clinical relevance	"Repressor of the MtrCDE efflux pump. Decreases susceptibility to azithromycin, cephalosporins and tetracycline when mutated. mtrR_G45D. In PMID 33875000, isolates with only this mutation had MIC ranges from ~0.03-4 mg/L, most of them below the ECOFF. Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0036	s__Neisseria gonorrhoeae	mtrR	mtrR	NZ_CP043871.1:1392766-1393015	-	-	ARO:3004851	c.[-53Adel]	Promoter variant detected	acquired	azithromycin	-	nonwildtype	S	MIC <=1 mg/L	ECOFF (January 2024)	"12270819, 12493797"	ECO:0005027 genetic transformation evidence	moderate	lacks evidence of the degree to which MIC is affected	"Promoter of mtrR. Decreases susceptibility to azithromycin, beta-lactams and tetracycline when mutated. MICs indistinguishable from strains without this deletion in PMID 12493797. PMID 12270819 shows an effect in decreasing susceptibility to penicillin by transformation experiments. In geno-pheno comparisons, most isolates with only this deletion were WT S (n=6442/6655). Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0037	s__Neisseria gonorrhoeae	mtrR	mtrR	NZ_CP043871.1:1392766-1393015	-	-	ARO:3004851	c.[-56A>C]	Promoter variant detected	acquired	azithromycin	-	nonwildtype	S	MIC <=1 mg/L	ECOFF (January 2024)	39012901	ECO:0001103 natural variation mutant evidence	weak	"statistical geno/pheno evidence but no experimental evidence, unknown clinical relevance"	"This mutation showed increased MICs of azithromycin in PMID 39012901, although other works only associate it with reduced susceptibility to penicillin and tetracycline. In PMID 33875000, isolates with only this mutation showed MIC values just below the ECOFF for azithromycin. Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0038	s__Neisseria gonorrhoeae	mtrR	mtrR	NZ_CP043871.1:1392766-1393015	-	-	ARO:3004851	c.[-131G>A]	Promoter variant detected	acquired	azithromycin	-	nonwildtype	S	MIC <=1 mg/L	ECOFF (January 2024)	18761689	ECO:0005027 genetic transformation evidence	moderate	low clinical relevance	"Promoter of mtrR. Decreases susceptibility to azithromycin, beta-lactams and tetracycline when mutated. mtrR_G-131A. Same as mtrC_C-120T. Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0039	s__Neisseria gonorrhoeae	mtrR	mtrR	WP_047924300.1	-	-	ARO:3004851	p.Ala39Thr	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	ECOFF (January 2024)	18761689	ECO:0005027 genetic transformation evidence	moderate	low clinical relevance	"Repressor of the MtrCDE efflux pump. Decreases susceptibility to azithromycin, beta-lactams and tetracycline when mutated. mtrR_A39T. In PMID 33875000, isolates with only this mutation have a wide ranges of MICs~0.015-16 mg/L, most of them below the ECOFF. Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0040	s__Neisseria gonorrhoeae	mtrR	mtrR	WP_047924300.1	-	-	ARO:3004851	p.Gly45Asp	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	ECOFF (January 2024)	"7773394, 18761689"	ECO:0005027 genetic transformation evidence	moderate	low clinical relevance	"Repressor of the MtrCDE efflux pump. Decreases susceptibility to azithromycin, cephalosporins and tetracycline when mutated. mtrR_G45D. In PMID 33875000, isolates with only this mutation had MIC ranges from ~0.03-4 mg/L, most of them below the ECOFF. Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0041	s__Neisseria gonorrhoeae	mtrR	mtrR	WP_047924300.1	-	-	ARO:3005004	-	Inactivating mutation detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	ECOFF (January 2024)	"32807804, 9534233"	"ECO:0000012 functional complementation evidence, ECO:0005027 genetic transformation evidence"	strong		"Loss-of function of mtrC increases susceptibility to azithromycin, beta-lactams, tetracyclines and ciprofloxacin. PMID 32807804 reports particularly strong effects for azithromycin.  Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0042	s__Neisseria gonorrhoeae	mtrR	mtrR	NZ_CP043871.1:1392766-1393015	-	-	ARO:3004851	c.[-53Adel]	Promoter variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	ECOFF (January 2024)	"12270819, 12493797"	ECO:0005027 genetic transformation evidence	moderate	lacks evidence of the degree to which MIC is affected	"Promoter of mtrR. Decreases susceptibility to azithromycin, beta-lactams and tetracycline when mutated. MICs indistinguishable from strains without this deletion in PMID 12493797. PMID 12270819 shows an effect in decreasing susceptibility to penicillin by transformation experiments. In geno-pheno comparisons, most isolates with only this deletion were WT S (n=6442/6655). Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0043	s__Neisseria gonorrhoeae	mtrR	mtrR	NZ_CP043871.1:1392766-1393015	-	-	ARO:3004851	c.[-56A>C]	Promoter variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	ECOFF (January 2024)	39012901	ECO:0001103 natural variation mutant evidence	weak	"statistical geno/pheno evidence but no experimental evidence, unknown clinical relevance"	"This mutation showed increased MICs of azithromycin in PMID 39012901, although other works only associate it with reduced susceptibility to penicillin and tetracycline. In PMID 33875000, isolates with only this mutation showed MIC values just below the ECOFF for azithromycin. Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0044	s__Neisseria gonorrhoeae	mtrR	mtrR	NZ_CP043871.1:1392766-1393015	-	-	ARO:3004851	c.[-131G>A]	Promoter variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	ECOFF (January 2024)	18761689	ECO:0005027 genetic transformation evidence	moderate	low clinical relevance	"Promoter of mtrR. Decreases susceptibility to azithromycin, beta-lactams and tetracycline when mutated. mtrR_G-131A. Same as mtrC_C-120T. Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0045	s__Neisseria gonorrhoeae	mtrR	mtrR	WP_047924300.1	-	-	ARO:3004851	p.Ala39Thr	Protein variant detected	acquired	tetracycline	-	nonwildtype	S	MIC <=0.5 mg/L	ECOFF (January 2024)	18761689	ECO:0005027 genetic transformation evidence	moderate	low clinical relevance	"Repressor of the MtrCDE efflux pump. Decreases susceptibility to azithromycin, beta-lactams and tetracycline when mutated. mtrR_A39T. In PMID 33875000, isolates with only this mutation have a wide ranges of MICs~0.015-16 mg/L, most of them below the ECOFF. Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0046	s__Neisseria gonorrhoeae	mtrR	mtrR	WP_047924300.1	-	-	ARO:3004851	p.Gly45Asp	Protein variant detected	acquired	tetracycline	-	nonwildtype	S	MIC <=0.5 mg/L	ECOFF (January 2024)	"7773394, 18761689"	ECO:0005027 genetic transformation evidence	moderate	low clinical relevance	"Repressor of the MtrCDE efflux pump. Decreases susceptibility to azithromycin, cephalosporins and tetracycline when mutated. mtrR_G45D. In PMID 33875000, isolates with only this mutation had MIC ranges from ~0.03-4 mg/L, most of them below the ECOFF. Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0047	s__Neisseria gonorrhoeae	mtrR	mtrR	WP_047924300.1	-	-	ARO:3005004	-	Inactivating mutation detected	acquired	tetracycline	-	nonwildtype	S	MIC <=0.5 mg/L	ECOFF (January 2024)	"32807804, 9534233"	"ECO:0000012 functional complementation evidence, ECO:0005027 genetic transformation evidence"	strong		"Loss-of function of mtrC increases susceptibility to azithromycin, beta-lactams, tetracyclines and ciprofloxacin. PMID 32807804 reports particularly strong effects for azithromycin.  Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0048	s__Neisseria gonorrhoeae	mtrR	mtrR	NZ_CP043871.1:1392766-1393015	-	-	ARO:3004851	c.[-53Adel]	Promoter variant detected	acquired	tetracycline	-	nonwildtype	S	MIC <=0.5 mg/L	ECOFF (January 2024)	"12270819, 12493797"	ECO:0005027 genetic transformation evidence	moderate	lacks evidence of the degree to which MIC is affected	"Promoter of mtrR. Decreases susceptibility to azithromycin, beta-lactams and tetracycline when mutated. MICs indistinguishable from strains without this deletion in PMID 12493797. PMID 12270819 shows an effect in decreasing susceptibility to penicillin by transformation experiments. In geno-pheno comparisons, most isolates with only this deletion were WT S (n=6442/6655). Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0049	s__Neisseria gonorrhoeae	mtrR	mtrR	NZ_CP043871.1:1392766-1393015	-	-	ARO:3004851	c.[-56A>C]	Promoter variant detected	acquired	tetracycline	-	nonwildtype	S	MIC <=0.5 mg/L	ECOFF (January 2024)	39012901	ECO:0001103 natural variation mutant evidence	weak	"statistical geno/pheno evidence but no experimental evidence, unknown clinical relevance"	"This mutation showed increased MICs of azithromycin in PMID 39012901, although other works only associate it with reduced susceptibility to penicillin and tetracycline. In PMID 33875000, isolates with only this mutation showed MIC values just below the ECOFF for azithromycin. Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0050	s__Neisseria gonorrhoeae	mtrR	mtrR	NZ_CP043871.1:1392766-1393015	-	-	ARO:3004851	c.[-131G>A]	Promoter variant detected	acquired	tetracycline	-	nonwildtype	S	MIC <=0.5 mg/L	ECOFF (January 2024)	18761689	ECO:0005027 genetic transformation evidence	moderate	low clinical relevance	"Promoter of mtrR. Decreases susceptibility to azithromycin, beta-lactams and tetracycline when mutated. mtrR_G-131A. Same as mtrC_C-120T. Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0051	s__Neisseria gonorrhoeae	norM	-	NZ_AP023073.1:1198657-1198990	-	-	ARO:3001327	c.[-104C>T]	Promoter variant detected	acquired	ciprofloxacin	-	nonwildtype	S	MIC <=0.03 mg/L	EUCAST v14.0 (2024)	12533487	ECO:0005027 genetic transformation evidence	moderate	"lacks evidence of the degree to which MIC is affected, low clinical relevance"	"In vitro evidence from PMID 12533487, very rare in clinical isolates."
NGO0052	s__Neisseria gonorrhoeae	norM	-	NZ_AP023073.1:1198657-1198990	-	-	ARO:3001327	c.[-7A>G]	Promoter variant detected	acquired	ciprofloxacin	-	nonwildtype	S	MIC <=0.03 mg/L	EUCAST v14.0 (2024)	12533487	ECO:0005027 genetic transformation evidence	moderate	"lacks evidence of the degree to which MIC is affected, low clinical relevance"	"In vitro evidence from PMID 12533487, very rare in clinical isolates."
NGO0053	s__Neisseria gonorrhoeae	parC	-	WP_010951227.1	-	-	ARO:3003929	p.Asp86Asn	Protein variant detected	acquired	ciprofloxacin	-	nonwildtype	S	MIC <=0.03 mg/L	EUCAST v14.0 (2024)	"11181352, 33875000"	ECO:0001103 natural variation mutant evidence	strong		"This mutation was found when exposing susceptible strains to increasing concentrations of ciprofloxacin in strains with gyrA mutations (PMID 11181352). Mutation also found in isolation (without other mutations in gyrA or parC) in a low proportion with MICs~0.25 mg/L (PMID 33875000). Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0054	s__Neisseria gonorrhoeae	parC	-	WP_010951227.1	-	-	ARO:3003929	p.Asp86Gly	Protein variant detected	acquired	ciprofloxacin	-	wildtype	S	MIC <=0.03 mg/L	EUCAST v14.0 (2024)	39004438	ECO:0001103 natural variation mutant evidence	weak	"lacks evidence of the degree to which MIC is affected, unknown clinical relevance"	Found in only one isolate in a global screening of ~33k N. gonorrhoeae isolates (PMID 39004438). Not found alone in geno-pheno comparisons nor clear experimental evidence of this mutation increasing MIC. No experimental evidence to call this mutation NWT.
NGO0055	s__Neisseria gonorrhoeae	parC	-	WP_010951227.1	-	-	ARO:3003929	p.Ser87Ile	Protein variant detected	acquired	ciprofloxacin	-	wildtype	S	MIC <=0.03 mg/L	EUCAST v14.0 (2024)	"35369513, 33875000"	ECO:0001103 natural variation mutant evidence	weak	"lacks evidence of the degree to which MIC is affected, unknown clinical relevance"	"This mutation tends to appear together with gyrA mutations, so its individual effect on MIC is difficult to assess. Likely acquired through recombination (PMID 35369513), found in Neisseria meningitidis (PMID 29233459). No experimental evidence to call this mutation NWT."
NGO0056	s__Neisseria gonorrhoeae	parC	-	WP_010951227.1	-	-	ARO:3003929	p.Ser87Asn	Protein variant detected	acquired	ciprofloxacin	-	nonwildtype	S	MIC <=0.03 mg/L	EUCAST v14.0 (2024)	11181352	ECO:0001103 natural variation mutant evidence	moderate	lacks evidence of the degree to which MIC is affected	"This mutation was found when exposing susceptible strains to increasing concentrations of ciprofloxacin in strains with gyrA mutations (PMID 11181352). Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0057	s__Neisseria gonorrhoeae	parC	-	WP_010951227.1	-	-	ARO:3003929	p.Ser87Arg	Protein variant detected	acquired	ciprofloxacin	-	nonwildtype	S	MIC <=0.03 mg/L	EUCAST v14.0 (2024)	11181352	ECO:0001103 natural variation mutant evidence	moderate	lacks evidence of the degree to which MIC is affected	"This mutation was found when exposing susceptible strains to increasing concentrations of ciprofloxacin in strains with gyrA mutations (PMID 11181352). Mutation also found in isolation (without other mutations in gyrA or parC) in isolates showing a wide range of MICs~0.003->32 mg/L (PMID 33875000).  Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0058	s__Neisseria gonorrhoeae	parC	-	WP_010951227.1	-	-	ARO:3003929	p.Ser87Cys	Protein variant detected	acquired	ciprofloxacin	-	nonwildtype	S	MIC <=0.03 mg/L	EUCAST v14.0 (2024)	36735316	ECO:0001103 natural variation mutant evidence	weak	unknown clinical relevance	NWT phenotype assigned due to experimental evidence even though MIC values do not reach the ECOFF.
NGO0059	s__Neisseria gonorrhoeae	parC	-	WP_010951227.1	-	-	ARO:3003929	p.Ser88Pro	Protein variant detected	acquired	ciprofloxacin	-	nonwildtype	S	MIC <=0.03 mg/L	EUCAST v14.0 (2024)	"7830580, 11181352"	"ECO:0005027 genetic transformation evidence, ECO:0001103 natural variation mutant evidence"	moderate	lacks evidence of the degree to which MIC is affected	"This mutation tends to appear together with gyrA mutations, so its individual effect on MIC is difficult to assess, but there is evidence from PMID 7830580 that it appears when increasing the concentration of ciprofloxacin.  Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0060	s__Neisseria gonorrhoeae	parC	-	WP_010951227.1	-	-	ARO:3003929	p.Glu91Lys	Protein variant detected	acquired	ciprofloxacin	-	nonwildtype	S	MIC <=0.03 mg/L	EUCAST v14.0 (2024)	"7830580, 11181352"	ECO:0001103 natural variation mutant evidence	moderate	lacks evidence of the degree to which MIC is affected	"This mutation tends to appear together with gyrA mutations, so its individual effect on MIC is difficult to assess.  Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0061	s__Neisseria gonorrhoeae	parC	-	WP_010951227.1	-	-	ARO:3003929	p.Glu91Gly	Protein variant detected	acquired	ciprofloxacin	-	nonwildtype	S	MIC <=0.03 mg/L	EUCAST v14.0 (2024)	12529019	ECO:0001103 natural variation mutant evidence	moderate	lacks evidence of the degree to which MIC is affected	"This mutation tends to appear together with gyrA mutations, so its individual effect on MIC is difficult to assess. Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0062	s__Neisseria gonorrhoeae	parC	-	WP_010951227.1	-	-	ARO:3003929	p.Glu91Gln	Protein variant detected	acquired	ciprofloxacin	-	nonwildtype	S	MIC <=0.03 mg/L	EUCAST v14.0 (2024)	"12529019, 11181352"	ECO:0001103 natural variation mutant evidence	moderate	lacks evidence of the degree to which MIC is affected	"This mutation tends to appear together with gyrA mutations, so its individual effect on MIC is difficult to assess. Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0063	s__Neisseria gonorrhoeae	parC	-	WP_010951227.1	-	-	ARO:3003929	p.Glu91Ala	Protein variant detected	acquired	ciprofloxacin	-	nonwildtype	S	MIC <=0.03 mg/L	EUCAST v14.0 (2024)	35369513	ECO:0001103 natural variation mutant evidence	moderate	lacks evidence of the degree to which MIC is affected	"This mutation tends to appear together with gyrA mutations, so its individual effect on MIC is difficult to assess. Likely acquired through recombination (PMID 35369513).  Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0064	s__Neisseria gonorrhoeae	parE	-	WP_003691666.1	-	-	ARO:3003313	p.Gly410Val	Protein variant detected	acquired	ciprofloxacin	-	nonwildtype	S	MIC <=0.03 mg/L	EUCAST v14.0 (2024)	12529019	ECO:0001103 natural variation mutant evidence	weak	"lacks evidence of the degree to which MIC is affected, unknown clinical relevance"	"This mutation tends to appear together with gyrA mutations, so its individual effect on MIC is difficult to assess. Although in pheno-geno comparisons most of the isolates with only this mutation are WT, an NWT phenotype assigned due to experimental evidence."
NGO0065	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Ala311Val	Protein variant detected	acquired	-	cephalosporin	nonwildtype	R	MIC >0.125 mg/L	EUCAST v14.0 (2024)	23587946	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		"This mutation significantly increases MIC to ceftriaxone, cefixime and penicillin when introduced in a strain with a susceptible penA allele and shows an additive effect when introduced together with T316P and T483S (PMID 23587946)."
NGO0066	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Ile312Met	Protein variant detected	acquired	-	cephalosporin	nonwildtype	R	MIC >0.125 mg/L	EUCAST v14.0 (2024)	"16940068, 20704258"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		"This mutation significantly increases MIC to ceftriaxone, cefixime and penicillin, especially in combination with V316T and G545S (PMID 16940068)."
NGO0067	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Val316Thr	Protein variant detected	acquired	-	cephalosporin	nonwildtype	R	MIC >0.125 mg/L	EUCAST v14.0 (2024)	"16940068, 20704258"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		"This mutation significantly increases MIC to ceftriaxone, cefixime and penicillin, especially in combination with I312M and G545S (PMID 16940068)."
NGO0068	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Val316Pro	Protein variant detected	acquired	-	cephalosporin	nonwildtype	R	MIC >0.125 mg/L	EUCAST v14.0 (2024)	23587946	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		"This mutation significantly increases MIC to ceftriaxone, cefixime and penicillin when introduced in a strain with a susceptible penA allele and shows an additive effect when introduced together with A311V and T316P (PMID 23587946)."
NGO0069	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.345_346insAsp	Protein variant detected	acquired	-	cephalosporin	nonwildtype	S	MIC <=0.125 mg/L	EUCAST v14.0 (2024)	"2120542, 33875000, 35544098"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	moderate	low clinical relevance	The insertion of an aspartate in this position (not any other amino acid) decreases susceptibility to penicillin (PMID 2120542). The presence of strains with only this mutation in penA has shown MIC levels ~0.02-8 mg/L of benzylpenicillin and mostly <=0.125 mg/L of ceftriaxone and cefixime in PMID 33875000. This mutation has the greatest impact on penicillin MICs after controlling for bla presence/absence and has high specificity for predicting penicillin susceptibility in PMID 35544098.
NGO0070	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Thr483Ser	Protein variant detected	acquired	-	cephalosporin	nonwildtype	R	MIC >0.125 mg/L	EUCAST v14.0 (2024)	23587946	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		"This mutation significantly increases MIC to ceftriaxone, cefixime and penicillin when introduced in a strain with a susceptible penA allele and shows an additive effect when introduced together with A311V and T483S (PMID 23587946)."
NGO0071	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Ala501Pro	Protein variant detected	acquired	-	cephalosporin	nonwildtype	S	MIC <=0.125 mg/L	EUCAST v14.0 (2024)	"22155830, 17591846"	ECO:0005027 genetic transformation evidence	moderate	unknown clinical relevance	There are reports of susceptible gonococcal isolates with penA A501 mutations (e.g. PMID 17591846).
NGO0072	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Ala501Thr	Protein variant detected	acquired	-	cephalosporin	nonwildtype	S	MIC <=0.125 mg/L	EUCAST v14.0 (2024)	17591846	ECO:0001113 point mutation phenotypic evidence	weak	"lacks evidence of the degree to which MIC is affected, unknown clinical relevance"	There are reports of susceptible gonococcal isolates with penA A501 mutations (e.g. PMID 17591846).
NGO0073	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Ala501Val	Protein variant detected	acquired	-	cephalosporin	nonwildtype	S	MIC <=0.125 mg/L	EUCAST v14.0 (2024)	"20704258, 17591846"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	moderate	unknown clinical relevance	There are reports of susceptible gonococcal isolates with penA A501 mutations (e.g. PMID 17591846).
NGO0074	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Ile312Met	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	I	MIC >0.06 mg/L	EUCAST v14.0 (2024)	"16940068, 20704258"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		"This mutation significantly increases MIC to ceftriaxone, cefixime and penicillin, especially in combination with V316T and G545S (PMID 16940068)."
NGO0075	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Val316Thr	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	I	MIC >0.06 mg/L	EUCAST v14.0 (2024)	"16940068, 20704258"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		"This mutation significantly increases MIC to ceftriaxone, cefixime and penicillin, especially in combination with I312M and G545S (PMID 16940068)."
NGO0076	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Val316Pro	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	I	MIC >0.06 mg/L	EUCAST v14.0 (2024)	23587946	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		"This mutation significantly increases MIC to ceftriaxone, cefixime and penicillin when introduced in a strain with a susceptible penA allele and shows an additive effect when introduced together with A311V and T316P (PMID 23587946)."
NGO0077	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.345_346insAsp	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	EUCAST v14.0 (2024)	"2120542, 33875000, 35544098"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	moderate	low clinical relevance	The insertion of an aspartate in this position (not any other amino acid) decreases susceptibility to penicillin (PMID 2120542). The presence of strains with only this mutation in penA has shown MIC levels ~0.02-8 mg/L of benzylpenicillin and mostly <=0.125 mg/L of ceftriaxone and cefixime in PMID 33875000. The absence of this insertion has the greatest impact on penicillin MICs after controlling for bla presence/absence and has high specificity for predicting penicillin susceptibility in PMID 35544098.
NGO0078	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Thr483Ser	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	I	MIC >0.06 mg/L	EUCAST v14.0 (2024)	23587946	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		"This mutation significantly increases MIC to ceftriaxone, cefixime and penicillin when introduced in a strain with a susceptible penA allele and shows an additive effect when introduced together with A311V and T483S (PMID 23587946)."
NGO0079	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Ala501Pro	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	EUCAST v14.0 (2024)	"22155830, 17591846"	ECO:0005027 genetic transformation evidence	moderate	unknown clinical relevance	There are reports of susceptible gonococcal isolates with penA A501 mutations (e.g. PMID 17591846).
NGO0080	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Ala501Thr	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	EUCAST v14.0 (2024)	17591846	ECO:0001113 point mutation phenotypic evidence	weak	"lacks evidence of the degree to which MIC is affected, unknown clinical relevance"	There are reports of susceptible gonococcal isolates with penA A501 mutations (e.g. PMID 17591846).
NGO0081	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Ala501Val	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	EUCAST v14.0 (2024)	"20704258, 17591846"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	moderate	unknown clinical relevance	There are reports of susceptible gonococcal isolates with penA A501 mutations (e.g. PMID 17591846).
NGO0082	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Phe504Leu	Protein variant detected	acquired	-	cephalosporin	nonwildtype	S	MIC <=0.125 mg/L	EUCAST v14.0 (2024)	"20704258, 18986991"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence, ECO:0001034 crystallography evidence"	strong		"Reverting this mutation substantially reduced MIC of penicillin and had a minimal effect on cephalosporin MICs in PMID 20704258. This mutation has an effect on the structure of PBP2, specially in combination with P551L (PMID 18986991)."
NGO0083	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Ala510Val	Protein variant detected	acquired	-	cephalosporin	nonwildtype	S	MIC <=0.125 mg/L	EUCAST v14.0 (2024)	"20704258, 18986991"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence, ECO:0001034 crystallography evidence"	strong		Reverting this mutation substantially reduced MIC of penicillin but not of cephalosporins in PMID 20704258.
NGO0084	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Asn512Tyr	Protein variant detected	acquired	-	cephalosporin	nonwildtype	S	MIC <=0.125 mg/L	EUCAST v14.0 (2024)	20704258	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		"Reverting this mutation reduced MIC of ceftriaxone, cefixime and penicillin in PMID 20704258."
NGO0085	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Ala516Gly	Protein variant detected	acquired	-	cephalosporin	nonwildtype	S	MIC <=0.125 mg/L	EUCAST v14.0 (2024)	18986991	ECO:0001034 crystallography evidence	strong		This mutation has a minor effect in the structure of PBP2 (PMID 18986991).
NGO0086	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Gly542Ser	Protein variant detected	acquired	-	cephalosporin	nonwildtype	S	MIC <=0.125 mg/L	EUCAST v14.0 (2024)	"32779717, 20511367"	ECO:0001103 natural variation mutant evidence	weak	statistical geno/pheno evidence but no experimental evidence	This mutation has been statistically associated with increased MICs of ceftriaxone and penicillin (e.g. PMID 20511367) but experimental evidence is not available.
NGO0087	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Gly545Ser	Protein variant detected	acquired	-	cephalosporin	nonwildtype	R	MIC >0.125 mg/L	EUCAST v14.0 (2024)	"16940068, 20704258"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		"This mutation significantly increases MIC to ceftriaxone, cefixime and penicillin, especially in combination with I312M and V316T (PMID 16940068)."
NGO0088	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Gly542Ser	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	EUCAST v14.0 (2024)	"32779717, 20511367"	ECO:0001103 natural variation mutant evidence	weak	statistical geno/pheno evidence but no experimental evidence	This mutation has been statistically associated with increased MICs of ceftriaxone and penicillin (e.g. PMID 20511367) but experimental evidence is not available.
NGO0089	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Gly545Ser	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	I	MIC >0.06 mg/L	EUCAST v14.0 (2024)	"16940068, 20704258"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		"This mutation significantly increases MIC to ceftriaxone, cefixime and penicillin, especially in combination with I312M and V316T (PMID 16940068)."
NGO0090	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Pro551Leu	Protein variant detected	acquired	-	cephalosporin	nonwildtype	S	MIC <=0.125 mg/L	EUCAST v14.0 (2024)	"32779717, 20511367"	ECO:0001103 natural variation mutant evidence	weak	statistical geno/pheno evidence but no experimental evidence	This mutation has been statistically associated with increased MICs of ceftriaxone and penicillin (e.g. PMID 20511367) but experimental evidence is not available.
NGO0091	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Pro551Ser	Protein variant detected	acquired	-	cephalosporin	nonwildtype	S	MIC <=0.125 mg/L	EUCAST v14.0 (2024)	"18986991, 20511367"	ECO:0001034 crystallography evidence	strong		"This mutation causes the largest effect in the structure of the C-terminal end of PBP2, specially in combination with F504L (PMID 18986991)."
NGO0092	s__Neisseria gonorrhoeae	penA	-	WP_003693546.1	-	-	ARO:3004832	p.Pro551Ser	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	EUCAST v14.0 (2024)	"18986991, 20511367"	ECO:0001034 crystallography evidence	strong		"This mutation causes the largest effect in the structure of the C-terminal end of PBP2, specially in combination with F504L (PMID 18986991)."
NGO0093	s__Neisseria gonorrhoeae	ponA	-	WP_003687357.1	-	-	ARO:3004833	p.Leu421Pro	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	I	MIC >0.06 mg/L	EUCAST v14.0 (2024)	11850260	ECO:0005027 genetic transformation evidence	strong		Reverting this mutation via transformation decreased MIC of penicillin in PMID 11850260.
NGO0094	s__Neisseria gonorrhoeae	porB1b	-	WP_106333382.1	-	-	ARO:3000464	p.Gly120Lys	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	I	MIC >0.06 mg/L	EUCAST v14.0 (2024)	12183233	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		This mutation increases MIC of penicillin and tetracycline (PMID 12183233).
NGO0095	s__Neisseria gonorrhoeae	porB1b	-	WP_106333382.1	-	-	ARO:3000464	p.Gly120Asp	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	EUCAST v14.0 (2024)	12183233	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		This mutation showed a small increase of penicillin MIC and not tetracycline (PMID 12183233).
NGO0096	s__Neisseria gonorrhoeae	porB1b	-	WP_106333382.1	-	-	ARO:3000464	p.Gly120Pro	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	EUCAST v14.0 (2024)	12183233	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	weak	"lacks evidence of the degree to which MIC is affected, unknown clinical relevance"	This mutation was validated in a double mutant with A121P in PMID 12183233. The individual effect of the mutation has not been assessed.
NGO0097	s__Neisseria gonorrhoeae	porB1b	-	WP_106333382.1	-	-	ARO:3000464	p.Gly120Arg	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	EUCAST v14.0 (2024)	12183233	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	weak	"lacks evidence of the degree to which MIC is affected, unknown clinical relevance"	This mutation was validated in a double mutant with A121H in PMID 12183233. The individual effect of the mutation has not been assessed.
NGO0098	s__Neisseria gonorrhoeae	porB1b	-	WP_106333382.1	-	-	ARO:3000464	p.Ala121Asn	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	I	MIC >0.06 mg/L	EUCAST v14.0 (2024)	12183233	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	weak	"lacks evidence of the degree to which MIC is affected, unknown clinical relevance"	This mutation was validated in a double mutant with G120N in PMID 12183233. The individual effect of the mutation has not been assessed.
NGO0099	s__Neisseria gonorrhoeae	porB1b	-	WP_106333382.1	-	-	ARO:3000464	p.Ala121Asp	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	I	MIC >0.06 mg/L	EUCAST v14.0 (2024)	12183233	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		"Validated by transformation individually, although the increase in MIC is not that high as in the double mutant G120D+A12D."
NGO0100	s__Neisseria gonorrhoeae	porB1b	-	WP_106333382.1	-	-	ARO:3000464	p.Ala121Gly	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	EUCAST v14.0 (2024)	37294009	ECO:0001103 natural variation mutant evidence	weak	"lacks evidence of the degree to which MIC is affected, unknown clinical relevance, statistical geno/pheno evidence but no experimental evidence"	Mutation found in the gonococcal population (e.g. PMID 37294009).
NGO0101	s__Neisseria gonorrhoeae	porB1b	-	WP_106333382.1	-	-	ARO:3000464	p.Ala121Ser	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	EUCAST v14.0 (2024)	37294009	ECO:0001103 natural variation mutant evidence	weak	"lacks evidence of the degree to which MIC is affected, unknown clinical relevance, statistical geno/pheno evidence but no experimental evidence"	Mutation found in the gonococcal population (e.g. PMID 37294009).
NGO0102	s__Neisseria gonorrhoeae	porB1b	-	WP_106333382.1	-	-	ARO:3000464	p.Ala121His	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	EUCAST v14.0 (2024)	12183233	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	weak	"lacks evidence of the degree to which MIC is affected, unknown clinical relevance"	This mutation was validated in a double mutant with G120R in PMID 12183233. The individual effect of the mutation has not been assessed.
NGO0103	s__Neisseria gonorrhoeae	porB1b	-	WP_106333382.1	-	-	ARO:3000464	p.Ala121Pro	Protein variant detected	acquired	benzylpenicillin	-	nonwildtype	S	MIC <=0.06 mg/L	EUCAST v14.0 (2024)	12183233	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	weak	"lacks evidence of the degree to which MIC is affected, unknown clinical relevance"	This mutation was validated in a double mutant with G120P in PMID 12183233. The individual effect of the mutation has not been assessed.
NGO0104	s__Neisseria gonorrhoeae	rplD	-	WP_003690088.1	-	-	ARO:3004956	p.Gly70Asp	Protein variant detected	acquired	azithromycin	-	nonwildtype	S	MIC <=1 mg/L	ECOFF (January 2024)	33097713	ECO:0005027 genetic transformation evidence	strong		"Contributes to decreased susceptibility to azithromycin. In pheno-geno comparisons, most isolates with only this deletion were WT S (n=303/320), but a NWT phenotype is assigned because there is experimental evidence that this mutation increases MIC of azithromycin."
NGO0105	s__Neisseria gonorrhoeae	rplV	-	WP_002215424.1	-	-	-	p.Lys83_89insLysLysGlyProSerLeuLys	Protein variant detected	acquired	azithromycin	-	nonwildtype	R	MIC >1 mg/L	ECOFF (January 2024)	27638945	ECO:0001103 natural variation mutant evidence	moderate	"lacks evidence of the degree to which MIC is affected, unknown clinical relevance"	One isolate was found in PMID 27638945 with an MIC=16 mg/L.
NGO0106	s__Neisseria gonorrhoeae	rplV	-	WP_002215424.1	-	-	-	p.Lys90_94LysAlaArgAlaLys	Protein variant detected	acquired	azithromycin	-	nonwildtype	R	MIC >1 mg/L	ECOFF (January 2024)	27638945	ECO:0001103 natural variation mutant evidence	moderate	"lacks evidence of the degree to which MIC is affected, unknown clinical relevance"	One isolate was found in PMID 27638945 with an MIC=16 mg/L.
NGO0107	s__Neisseria gonorrhoeae	rpoB	-	WP_003690105.1	-	-	ARO:3003288	p.Pro157Leu	Protein variant detected	acquired	-	cephalosporin	nonwildtype	S	MIC <=0.125 mg/L	EUCAST v14.0 (2024)	32011233	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		The introduction of this mutation into a ceftriaxone-susceptible strain recapitulated the reduced susceptibility of the donor strain in PMID 32011233. 
NGO0108	s__Neisseria gonorrhoeae	rpoB	-	WP_003690105.1	-	-	ARO:3003288	p.Gly158Val	Protein variant detected	acquired	-	cephalosporin	nonwildtype	S	MIC <=0.125 mg/L	EUCAST v14.0 (2024)	32011233	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		The introduction of this mutation into a ceftriaxone-susceptible strain recapitulated the reduced susceptibility of the donor strain in PMID 32011233. 
NGO0109	s__Neisseria gonorrhoeae	rpoB	-	WP_003690105.1	-	-	ARO:3003288	p.Arg201His	Protein variant detected	acquired	-	cephalosporin	nonwildtype	S	MIC <=0.125 mg/L	EUCAST v14.0 (2024)	32011233	ECO:0005027 genetic transformation evidence	strong		The introduction of this mutation into a ceftriaxone-susceptible strain recapitulated the reduced susceptibility of the donor strain in PMID 32011233. 
NGO0110	s__Neisseria gonorrhoeae	rpoB	-	WP_003690105.1	-	-	ARO:3003288	p.His552Asn	Protein variant detected	acquired	rifampin	-	nonwildtype	R	not applicable	not applicable	14614066	ECO:0005027 genetic transformation evidence	moderate	lacks evidence for this species	"The experimental evidence is in N. meningitidis, although increased MICs of rifampin have been found associated with this mutation in N. gonorrhoeae (e.g. three WHO reference strains, PMID 38889110). His553Asn in the AMRfinderplus database."
NGO0111	s__Neisseria gonorrhoeae	rpoD	-	WP_003688264.1	-	-	-	p.92_95delAsp	Protein variant detected	acquired	-	cephalosporin	nonwildtype	S	MIC <=0.125 mg/L	EUCAST v14.0 (2024)	32011233	ECO:0005027 genetic transformation evidence	strong		The introduction of this mutation into a ceftriaxone-susceptible strain recapitulated the reduced susceptibility of the donor strain in PMID 32011233. 
NGO0112	s__Neisseria gonorrhoeae	rpoD	-	WP_003688264.1	-	-	-	p.Glu98Lys	Protein variant detected	acquired	-	cephalosporin	nonwildtype	S	MIC <=0.125 mg/L	EUCAST v14.0 (2024)	32011233	ECO:0005027 genetic transformation evidence	strong		The introduction of this mutation into a ceftriaxone-susceptible strain recapitulated the reduced susceptibility of the donor strain in PMID 32011233. 
NGO0113	s__Neisseria gonorrhoeae	rpsE	-	WP_002215445.1	-	-	ARO:3007526	p.Thr24Pro	Protein variant detected	acquired	spectinomycin	-	nonwildtype	R	MIC >64 mg/L	EUCAST v14.0 (2024)	23183436	ECO:0005027 genetic transformation evidence	strong		Confers low level resistance to spectinomycin. Not enough data to evaluate phenotype codification from geno-pheno data. NWT R assigned according to experimental evidence.
NGO0114	s__Neisseria gonorrhoeae	rpsE	-	WP_002215445.1	-	-	ARO:3007526	p.27_28delVal	Protein variant detected	acquired	spectinomycin	-	nonwildtype	R	MIC >64 mg/L	EUCAST v14.0 (2024)	23183436	ECO:0005027 genetic transformation evidence	moderate	lacks evidence of the degree to which MIC is affected	rpsE mutations in codon 27 and 28 are very close to each other and the individual effects are difficult to assess. V27del+K28E conferred high-level spectinomycin resistance in an isolate from Norway (PMID 23183436). 
NGO0115	s__Neisseria gonorrhoeae	rpsE	-	WP_002215445.1	-	-	ARO:3007526	p.Lys28Glu	Protein variant detected	acquired	spectinomycin	-	nonwildtype	R	MIC >64 mg/L	EUCAST v14.0 (2024)	23183436	ECO:0005027 genetic transformation evidence	moderate	lacks evidence of the degree to which MIC is affected	rpsE mutations in codon 27 and 28 are very close to each other and the individual effects are difficult to assess. V27del+K28E conferred high-level spectinomycin resistance in an isolate from Norway (PMID 23183436). 
NGO0116	s__Neisseria gonorrhoeae	rpsJ	-	WP_002215394.1	-	-	ARO:3003930	p.Val57Met	Protein variant detected	acquired	tetracycline	-	nonwildtype	R	MIC >0.5 mg/L	EUCAST v14.0 (2024)	16189114	"ECO:0001113 point mutation phenotypic evidence, ECO:0005027 genetic transformation evidence"	strong		This mutation causes intermediate resistance to tetracycline in N. gonorrhoeae.
NGO0117	s__Neisseria gonorrhoeae	rpsJ	-	WP_002215394.1	-	-	ARO:3003930	p.Val57Leu	Protein variant detected	acquired	tetracycline	-	nonwildtype	R	MIC >0.5 mg/L	EUCAST v14.0 (2024)	16189114	"ECO:0001113 point mutation phenotypic evidence, ECO:0005027 genetic transformation evidence"	strong		This mutation causes the same level of resistance to tetracycline than V57M.
NGO0118	s__Neisseria gonorrhoeae	rpsJ	-	WP_002215394.1	-	-	ARO:3003930	p.Val57Gln	Protein variant detected	acquired	tetracycline	-	nonwildtype	R	MIC >0.5 mg/L	EUCAST v14.0 (2024)	16189114	"ECO:0001113 point mutation phenotypic evidence, ECO:0005027 genetic transformation evidence"	strong		This mutation causes the same level of resistance to tetracycline than V57M.
NGO0119	s__Neisseria gonorrhoeae	tet(M)	tet(M)	WP_063856403.1	-	-	ARO:3000186	-	Gene presence detected	acquired	tetracycline	-	nonwildtype	R	MIC >0.5 mg/L	EUCAST v14.0 (2024)	3099640	ECO:0005027 genetic transformation evidence	strong		The presence of this gene on the conjugative plasmid causes high-level tetracycline resistance.
NGO0120	s__Neisseria gonorrhoeae	NGO0065 & NGO0066 & (NGO0067 | NGO0068) & NGO0070 & NGO0087	-	-	-	-	-	-	Combination	-	-	cephalosporin	nonwildtype	R	MIC >0.125 mg/L	EUCAST v14.0 (2024)	"16940068, 20704258, 23587946"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		"penA mosaic (A311V, I312M, V316P/T, T483S and G545S)"
NGO0121	s__Neisseria gonorrhoeae	NGO0065 & NGO0066 & NGO0087	-	-	-	-	-	-	Combination	-	-	cephalosporin	nonwildtype	R	MIC >0.125 mg/L	EUCAST v14.0 (2024)	"16940068, 20704258"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		"penA mosaic (I312M, V316T, G545S)"
NGO0122	s__Neisseria gonorrhoeae	NGO0065 & NGO0066 & NGO0087	-	-	-	-	-	-	Combination	-	benzylpenicillin	-	nonwildtype	I	MIC >0.06 mg/L	EUCAST v14.0 (2024)	"16940068, 20704258"	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		"penA mosaic (I312M, V316T, G545S)"
NGO0123	s__Neisseria gonorrhoeae	NGO0094 & NGO0098	-	-	-	-	-	-	Combination	-	benzylpenicillin	-	nonwildtype	I	MIC >0.06 mg/L	EUCAST v14.0 (2024)	12183233	"ECO:0005027 genetic transformation evidence, ECO:0001113 point mutation phenotypic evidence"	strong		The effect in increasing MIC to penicillin and tetracycline is higher in the double mutant porB G120K A121N (PMID 12183233).