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

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 ceftr...

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Published inEuro surveillance : bulletin européen sur les maladies transmissibles Vol. 23; no. 27; p. 1
Main Authors Eyre, David W, Sanderson, Nicholas D, Lord, Emily, Regisford-Reimmer, Natasha, Chau, Kevin, Barker, Leanne, Morgan, Markus, Newnham, Robert, Golparian, Daniel, Unemo, Magnus, Crook, Derrick W, Peto, Tim Ea, Hughes, Gwenda, Cole, Michelle J, Fifer, Helen, Edwards, Anne, Andersson, Monique I
Format Journal Article
LanguageEnglish
Published Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 05.07.2018
European Centre for Disease Prevention and Control (ECDC)
Subjects
Adult
Anti-Bacterial Agents - therapeutic use
Antibiotics
Azithromycin - pharmacology
Bacteria
Ceftriaxone - pharmacology
Doxycycline - pharmacology
Drug resistance
Drug Resistance, Bacterial - drug effects
England
Gonorrhea
Gonorrhea - diagnosis
Gonorrhea - drug therapy
Humans
Male
Medical treatment
Microbial Sensitivity Tests
Neisseria gonorrhoeae - drug effects
Neisseria gonorrhoeae - genetics
Neisseria gonorrhoeae - isolation & purification
Rapid Communication
Sequence Analysis
Spectinomycin - therapeutic use
Thailand
Travel
Treatment Failure
England
Thailand
United Kingdom > UK
gonorrhoea
antimicrobial resistance
treatment failure
antimicrobial treatment, whole-genome sequencing
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Summary: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.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
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Correspondence: David Eyre (david.eyre@bdi.ox.ac.uk)
ISSN:1560-7917
1025-496X
1560-7917
DOI:10.2807/1560-7917.ES.2018.23.27.1800323