<i>Neisseria gonorrhoeae</i>—Susceptibility Trends and Basic Molecular Mapping of the Isolates Collected in Israel During 2016–2022

Neisseria gonorrhoeae (NG) is the second most prevalent bacterial sexually transmitted infection worldwide with antimicrobial resistance for expanded-spectrum drugs. NG antimicrobial resistance (AMR) patterns and sequence types (ST) were analyzed in Israel for the first time between 2016 and 2022. The study examined 1,205 NG isolates collected by the Israeli National NG Reference Center from various healthcare organizations. Antimicrobial susceptibility testing (AST) was performed for seven antibiotics, and molecular characterization was conducted using NG Multi-Antigen Sequence Typing (NG-MAST) on selected isolates. Key findings include: High resistance rates were observed for ciprofloxacin (54.4%), azithromycin, tetracycline, and benzylpenicillin. All isolates remained susceptible to ceftriaxone and spectinomycin. 8.6% of isolates were classified as multi-drug resistant (MDR) and 3% as extensively drug resistant (XDR). 72 different NG-MAST sequence types were identified, with ST292, ST4269, and ST5441 being the most common. Some sequence types showed associations with MDR and XDR phenotypes. This study provides valuable insights into NG AMR trends and genetic diversity in Israel, highlighting the importance of ongoing surveillance for guiding treatment strategies and public health interventions