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Euro Surveill. 2018 May;23(21). doi: 10.2807/1560-7917.ES.2018.23.21.1800264.

Multidrug-resistant Neisseria gonorrhoeae failing treatment with ceftriaxone and doxycycline in France, November 2017.

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French National Reference Center for bacterial STI, Associated laboratory for gonococci, APHP, Paris, France.
Infectious Agents Department, Saint Louis Hospital, APHP, Paris, France.
Dermatology Department, CeGGID (Free Information Screening and Diagnostics Centers), Saint Louis Hospital, APHP, Paris, France.
Paris Diderot University, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France.
University of Bordeaux, USC EA 3671 Mycoplasmal and chlamydial infections in humans; Centre Hospitalier Universitaire de Bordeaux, French National Reference Center for bacterial STIs, Bordeaux, France.
Santé Publique France, French National Public Health Agency, Saint-Maurice, France.
WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Ӧrebro University, Ӧrebro, Sweden.


We report a multidrug-resistant Neisseria gonorrhoeae urogenital and pharyngeal infection with ceftriaxone resistance and intermediate resistance to azithromycin in a heterosexual woman in her 20s in France. Treatment with ceftriaxone plus doxycycline failed for the pharyngeal localisation. Whole-genome sequencing of isolate F90 identified MLST1903, NG-MAST ST3435, NG-STAR233, and relevant resistance determinants. F90 showed phenotypic and genotypic similarities to an internationally spreading multidrug-resistant and ceftriaxone-resistant clone detected in Japan and subsequently in Australia, Canada and Denmark.


antimicrobial resistance; antimicrobial treatment; diagnosis; gonorrhoea; treatment failure

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