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Case Reports
. 2018 Jul;23(27):1800323.
doi: 10.2807/1560-7917.ES.2018.23.27.1800323.

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

David W Eyre  1   2 , Nicholas D Sanderson  2 , Emily Lord  3 , Natasha Regisford-Reimmer  3 , Kevin Chau  2 , Leanne Barker  2 , Markus Morgan  3 , Robert Newnham  3 , Daniel Golparian  4 , Magnus Unemo  4 , Derrick W Crook  2   5   6 , Tim Ea Peto  2   6 , Gwenda Hughes  5 , Michelle J Cole  5 , Helen Fifer  5 , Anne Edwards  3   7 , Monique I Andersson  3   7
Affiliations
Case Reports

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

David W Eyre et al. Euro Surveill. 2018 Jul.

Abstract

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.

Keywords: antimicrobial resistance; antimicrobial treatment, whole-genome sequencing; gonorrhoea; treatment failure.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Genetic relatedness with previous ceftriaxone resistant isolates of Neisseria gonorrhoeae case imported from Thailand to England, February 2018
Figure 2
Figure 2
Phylogeny of the most closely related existing Neisseria gonorrhoeae genome sequences to the imported Neisseria gonorrhoeae case from Thailand to England, February 2018
See this image and copyright information in PMC

References

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