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

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

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Department of Clinical Microbiology, Hvidovre Hospital, Copenhagen, Denmark.
These authors contributed equally to the work.
Department of Dermatovenerology, Bispebjerg Hospital, Copenhagen, Denmark.
Department of Bio and Health Informatics, Technical University of Denmark, Lyngby, Denmark.
WHO Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
These authors share last authorship.
Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.


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.


Neisseria gonorrhoeae; Resfinder; STD; antibiotic; multidrug-resistant; treatment

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