The European Centre for Disease Prevention and Control (ECDC) is reporting the first global cases of an extensively drug-resistant (XDR) gonorrhoea.
The first three cases of infection with XDR Neisseria gonorrhoeae resistant to ceftriaxone and with high-level resistance to azithromycin on a global scale were reported in the United Kingdom (n=1) and Australia (n=2) in February and March respectively. The case from the UK and one case from Australia were travel-associated and both acquired gonorrhoea in South-East Asia.
In a rapid risk assessment, the ECDC said considering that two of the three XDR gonorrhoea cases reported were travel-related, provision of information on safer sex practices should be considered as routine advice for travellers.
It said clinicians need to be aware of the possibility of further cases which are resistant to ceftriaxone and azithromycin, ensure that tests of cure are performed for all diagnosed cases, and submit samples for culture and antimicrobial susceptibility testing from all suspected or proven positive sites of infection. Particular attention should be paid to effective detection and treatment of pharyngeal gonorrhoea, which is frequently more difficult to eradicate compared to urogenital infection.
The ECDC said the cases highlight the need for novel antimicrobials for the disease to be developed.