Interactions between Loci Contributing to Antimicrobial Resistance and Virulence in Neisseria gonorrhoeae.

In a recent mBio article, Ayala et al. (mBio 13:e00276-22, 2022, https://doi.org/10.1128/mbio.00276-22) identified a single nucleotide variant in the repressor in Neisseria gonorrhoeae that reduces binding to the promoter of the virulence factor and thereby increases its expression. The allele () frequently co-occurs with mutations in the operon promoter that reduce expression of another repressor, , resulting in overexpression of the efflux pump-encoding and increased antimicrobial resistance. Because also represses , a decline in would decrease expression of Hypothesizing that arose to circumvent the impact of promoter mutations on expression, the authors analyzed these loci in genomes of N. gonorrhoeae isolates from the preantibiotic era. Surprisingly, they found isolates with prior to selection for resistance-associated alleles. These results suggest that independent and perhaps interacting pressures have influenced the co-occurrence of these alleles.