Gonorrhoea treatment failure caused by a Neisseria gonorrhoeae strain with combined ceftriaxone and high-level azithromycin resistance, England, February 2018.

Eyre, DW; Sanderson, ND; Lord, E; Regisford-Reimmer, N; Chau, K; Barker, L; Morgan, M; Newnham, R; Golparian, D; Unemo, M; +7 more...Crook, DW; Peto, TE; Hughes, G

; Cole, MJ; Fifer, H; Edwards, A; Andersson, MI and (2018) Gonorrhoea treatment failure caused by a Neisseria gonorrhoeae strain with combined ceftriaxone and high-level azithromycin resistance, England, February 2018. Eurosurveillance, 23 (27). pp. 2-7. ISSN 1560-7917 DOI: 10.2807/1560-7917.ES.2018.23.27.1800323

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We describe a gonorrhoea case with combined high-level azithromycin resistance and ceftriaxone resistance. In February 2018, a heterosexual male was diagnosed with gonorrhoea in the United Kingdom following sexual intercourse with a locally resident female in Thailand and failed treatment with ceftriaxone plus doxycycline and subsequently spectinomycin. Resistance arose from two mechanisms combining for the first time in a genetic background similar to a commonly circulating strain. Urgent action is essential to prevent further spread.