Within a matter of weeks, three cases of gonorrhoea that are resistant to the recommended first line antibiotic treatment have been detected in Europe and Australia. These are the first global reports of Neisseria gonorrhoeae with high-level resistance to azithromycin and ceftriaxone resistance that also show resistance to several other vital antibiotics. At a time with limited alternatives to the current dual therapy, lack of a vaccine and insufficient surveillance capacity in some regions, these cases highlight the growing threat of drug-resistance – which could lead to untreatable gonorrhoea.

Neisseria gonorrhoea continues to show high levels of resistance to azithromycin across the European Union and European Economic Area, according to the 2016 results of the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP).

Gonorrhoea is the second most commonly notified sexually transmitted infection across the EU/EEA countries with almost 500 000 reported cases between 2007 and 2016. The infection is treatable but Neisseria gonorrhoeae keep showing high levels of azithromycin resistance according to latest results of the European Gonococcal Antimicrobial Surveillance Programme.

ECDC comment on the study 'Detection in the United Kingdom of the Neisseria gonorrhoeae FC428 clone, with ceftriaxone resistance and intermediate resistance to azithromycin, October to December 2018' by Eyre et al. in the Eurosurveillance edition of 7 March 2019.

With more than 32 000 cases, gonorrhoea was the second most commonly reported sexually transmitted infection (STI) in Europe in 2010. As data from the ECDC report Gonococcal antimicrobial susceptibility surveillance in Europe 2010 illustrates, gonococci have become more resistant to common agents for treatment and show reduced susceptibility to newer antibiotics. “This indicates the risk that gonorrhoea may become an untreatable disease in the near future”, stresses ECDC Director Marc Sprenger.

ECDC is looking to establish a scientific collaboration with an organisation which can perform whole genome sequencing (WGS) of Neisseria gonorrhoeae, carry out related data analyses, share results of the analyses with ECDC and the participants of the European Gonococcal Antimicrobial Surveillance Programme as well as visualise the results.