Extensively drug-resistant (XDR) Neisseria gonorrhoeae causing possible gonorrhoea treatment failure with ceftriaxone plus azithromycin in Austria, April 2022

Author:

Pleininger Sonja1,Indra Alexander1,Golparian Daniel2,Heger Florian1,Schindler Stefanie1,Jacobsson Susanne2,Heidler Stefan3,Unemo Magnus42

Affiliation:

1. Austrian Agency for Health and Food Safety, Vienna, Austria

2. WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for STIs, Faculty of Medicine and Health, Örebro University, Örebro, Sweden

3. Urology Department, LKH Hochsteiermark, Leoben, Austria

4. Institute for Global Health, University College London, London, United Kingdom

Abstract

We describe a gonorrhoea case with ceftriaxone plus high-level azithromycin resistance. In April 2022, an Austrian heterosexual male was diagnosed with gonorrhoea after sexual intercourse with a female sex worker in Cambodia. Recommended treatment with ceftriaxone (1 g) plus azithromycin (1.5 g) possibly failed. Worryingly, this is the second strain in an Asian Neisseria gonorrhoeae genomic sublineage including high-level azithromycin-resistant strains that developed ceftriaxone resistance by acquisition of mosaic penA-60.001. Enhanced resistance surveillance and actions are imperative to prevent spread.

Publisher

European Centre for Disease Control and Prevention (ECDC)

Subject

Virology,Public Health, Environmental and Occupational Health,Epidemiology

Reference23 articles.

1. 2020 European guideline for the diagnosis and treatment of gonorrhoea in adults.;Unemo;Int J STD AIDS,2020

2. Update to CDC’s Treatment Guidelines for Gonococcal Infection, 2020.;St Cyr;MMWR Morb Mortal Wkly Rep,2020

3. World Health Organization (WHO). WHO guidelines for the treatment of Neisseria gonorrhoeae. Geneva: WHO; 2016. Available from: https://www.who.int/publications/i/item/9789241549691

4. Meeting the public health challenge of multidrug- and extensively drug-resistant Neisseria gonorrhoeae.;Tapsall;Expert Rev Anti Infect Ther,2009

5. The European response to control and manage multi- and extensively drug-resistant Neisseria gonorrhoeae.;Cole;Euro Surveill,2022

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