Molecular mechanisms of macrolide and fluoroquinolone resistance among Korean isolates of over a period of five years 2014-2019.

Antimicrobial resistance in has become a global issue, and certain groups have a higher probability of acquiring resistant strains. Little is known about the genetic diversity and characteristics of the antimicrobial resistance-determining sites (ARDSs) of in the Korean population. Therefore, we examined the genetic diversity of the ARDSs of positive urogenital samples obtained from Korean females (G1) and males (G2) visiting primary care clinics and DNA samples from referred males (G3) with persistent urethritis. From 2014 to 2019, 54 patients from G1, 86 patients from G2, and 68 patients from G3 were included in the study. Sanger sequencing was performed on the 2058/2059 sites in the 23S rRNA gene and quinolone resistance-determining regions (QRDRs) of . The rates of mutation in G1, G2, and G3 were 1.85, 5.81, and 48.53 %, respectively, for A2059G in the 23S rRNA gene (<0.001); 1.85, 0, and 17.78 %, respectively, for M95R or I in (<0.001); 0, 0, and 31.11 %, respectively, for D99N or G in (<0.001); and 7.41, 16.28, and 30 %, respectively, for S83R or N or I in (=0.015). A2059G significantly increased the risk of mutations at the 95, 99, and 83 sites (all <0.01). In conclusion, although the genetic diversity of the ARDSs of was variable among the groups, it was generally lower in isolates with macrolide resistance and higher in isolates with quinolone resistance in Korea compared with the isolates in other countries. The G3 group demonstrated increased genetic diversity at the A2059G, 95, 99, and 83 sites.