Response plan to control and manage the threat of multi-and extensively drug-resistant gonorrhoea in Europe - Indicator monitoring 2023

Progress towards implementation of the 2019 Response Plan to control and manage the threat of multidrug-resistant gonorrhoea in Europe was mixed. While improvements were observed in training activities and alignment with European treatment guidelines (100% of countries reported guidelines aligned with the 2020 European recommendations in 2023, compared with 73.1% in 2019), there were decreases in several critical indicators. In particular, capacity for antimicrobial surveillance weakened, with participation in Euro-GASP decreasing slightly from 26/31 countries (83.9%) in 2019 to 24/30 (80%) in 2023. Similarly, the number of laboratories participating in external quality assessment (EQA) fell from 28 to 24. At national level, access to culture and antimicrobial susceptibility testing (AST) declined substantially, with the estimated proportion of sexually transmitted infection (STI) clinics with access to culture and AST decreasing from an average of 97.3% in 2019 to 82.6% in 2023, and the proportion of reported cases tested with culture falling from 38.5% to 29.5%.

Reporting completeness improved slightly, with overall epidemiological data completeness increasing from 83.2% in 2019 to 86.1% in 2023. However, key variables, such as mode of transmission, remained incomplete at approximately 50% completeness.

Overall, these findings indicate a reduced capacity in the European Union/European Economic Area (EU/EEA) to detect, monitor, and respond to antimicrobial-resistant Neisseria gonorrhoeae since the last reporting period.