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. 2024 Mar 28;73(12):255-259.
doi: 10.15585/mmwr.mm7312a2.

Ceftriaxone-Resistant Gonorrhea - China, 2022

Xiaoyu Zhu, Yue Xi, Xiangdong Gong, Shaochun Chen

Ceftriaxone-Resistant Gonorrhea - China, 2022

Xiaoyu Zhu et al. MMWR Morb Mortal Wkly Rep. .

Abstract

Gonorrhea is a widespread sexually transmitted infection; in 2022, China reported 96,313 cases of gonorrhea, making it the fourth most common notifiable infectious disease in the country after viral hepatitis, pulmonary tuberculosis, and syphilis. The rise in prevalence in antimicrobial-resistant strains, particularly the international spread of ceftriaxone-resistant clones, poses a formidable challenge to gonorrhea control. The China Gonococcal Resistance Surveillance Program (China-GRSP), established in 1987 and covering 19 of 34 provincial-level administrative units, continuously monitors gonococcal antimicrobial resistance. In 2022, 13 China-GRSP sentinel sites collected 2,804 gonococcal isolates, representing 2.9% of all cases reported in China, and 4.1% of cases reported in the 13 participating provinces. The prevalence of Neisseria gonorrhoeae resistance to ceftriaxone was 8.1%, approximately three times the 2017 rate of 2.9%; five provinces reported >10% ceftriaxone resistance. Resistance prevalences to cefixime, azithromycin, tetracycline, penicillin, and ciprofloxacin were 16.0%, 16.9%, 77.1%, 77.8%, and 97.6%, respectively. Only one case of spectinomycin resistance was reported. These data highlight a substantial increase in ceftriaxone resistance from 2017 to 2022. Effective diagnosis and treatment and appropriate management of sex partners are essential to protect the health of infected persons and prevent ongoing transmission of gonorrhea, including transmission of resistant strains. Identifying reasons for the spread of ceftriaxone-resistant N. gonorrhoeae in China could guide strategies, such as antibiotic stewardship, to mitigate the rising resistance rate and curb the spread of resistant strains.

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Conflict of interest statement

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. All authors report support from the Chinese Academy of Medical Sciences for Fundamental Research Operations of the Central-Level Public Welfare Research, and from the Jiangsu Provincial Medical Key Laboratory for Jiangsu Province Capability Improvement Project through Science, Technology, and Education. No other potential conflicts of interest were disclosed.

Figures

FIGURE
FIGURE
Reported rates of ceftriaxone resistance — 13 Gonococcal Resistance Surveillance Program sentinel sites, China, 2022 Abbreviation: GRSP = Gonococcal Resistance Surveillance Program. * Data from 13 of 19 provincial sentinel surveillance sites were included in the analysis.
See this image and copyright information in PMC

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