Multidrug-resistant Neisseria gonorrhoeae infection with ceftriaxone resistance and intermediate resistance to azithromycin, Denmark, 2017

Euro Surveill. 2017 Oct;22(42):17-00659. doi: 10.2807/1560-7917.ES.2017.22.42.17-00659.

Abstract

We describe a multidrug-resistant Neisseria gonorrhoeae infection with ceftriaxone resistance and azithromycin intermediate resistance in a heterosexual man in Denmark, 2017. Whole genome sequencing of the strain GK124 identified MSLT ST1903, NG-MAST ST1614 and all relevant resistance determinants including similar penA resistance mutations previously described in ceftriaxone-resistant gonococcal strains. Although treatment with ceftriaxone 0.5 g plus azithromycin 2 g was successful, increased awareness of spread of gonococcal strains threatening the recommended dual therapy is crucial.

Keywords: Neisseria gonorrhoeae; Resfinder; STD; antibiotic; multidrug-resistant; treatment.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Azithromycin / administration & dosage
  • Azithromycin / therapeutic use*
  • Ceftriaxone / administration & dosage
  • Ceftriaxone / therapeutic use*
  • Denmark
  • Gonorrhea / drug therapy*
  • Gonorrhea / microbiology
  • Humans
  • Injections, Intramuscular
  • Male
  • Microbial Sensitivity Tests
  • Neisseria gonorrhoeae / drug effects*
  • Neisseria gonorrhoeae / genetics
  • Neisseria gonorrhoeae / isolation & purification
  • Nucleic Acid Amplification Techniques
  • Treatment Outcome
  • Urethritis / drug therapy
  • Urethritis / microbiology
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Ceftriaxone
  • Azithromycin