Public Health England (PHE) is advising clinicians to be alert to possible cases of multi-drug resistant gonorrhoeae after 2 cases have been reported in Australia, less than a month after the first global case was reported by PHE.
On March 29, the United Kingdom was the first country in the world to report a case of Neisseria gonorrhoeae that was found to be resistant to currently recommended dual first-line therapy with ceftriaxone and azithromycin. On wider antimicrobial susceptibility testing, the strain was susceptible only to spectinomycin.
Two cases of gonorrhoea with resistance to ceftriaxone, azithromycin, ciprofloxacin, penicillin and tetracycline have subsequently been reported in Australia.
In the latest Health Protection Report, PHE advises clinicians that they may encounter multi-drug resistant gonorrhoeae isolates more frequently in the future and that these isolates will be challenging to manage.
It reminds GPs that all suspected cases of gonorrhoea should be referred to genitourinary medicine services for appropriate management. Clinical laboratories advise to continue referring N gonorrhoeae isolates with resistance to ceftriaxone or azithromycin to the PHE Reference Bacteriology at PHE Colindale for confirmation. Commissioners are being told to ensure that sexual health care pathways facilitate prompt diagnosis, culture for susceptibility testing, effective treatment, test of cure, partner notification and a full sexually-transmitted infection screen.