Two cases of extensively drug-resistant (XDR) Neisseria gonorrhoeae infection combining ceftriaxone-resistance and high-level azithromycin resistance, France, November 2022 and May 2023

Euro Surveill. 2023 Sep;28(37):2300456. doi: 10.2807/1560-7917.ES.2023.28.37.2300456.

Abstract

We report two extensively drug-resistant (XDR) Neisseria gonorrhoeae (NG) isolates combining high-level resistance to azithromycin and resistance to ceftriaxone, obtained in France from two heterosexual patients, one of whom returned from Cambodia. Whole genome sequencing identified MLST ST16406, the mosaic penA-60.001 which caused ceftriaxone resistance in the internationally spreading FC428 clone, and the A2059G mutation in the 23S rRNA gene. The NG isolates F93 and F94 were related to XDR isolates detected in Austria and the United Kingdom in 2022.

Keywords: XDR, gonorrhea, penA-60.001, A2059G mutation, France; bacterial infections; gonorrhoea; laboratory; laboratory surveillance; molecular methods; multidrug resistance; sexually transmitted infections; typing.

Publication types

  • Case Reports

MeSH terms

  • Azithromycin / pharmacology
  • Ceftriaxone* / pharmacology
  • France
  • Gonorrhea* / diagnosis
  • Gonorrhea* / drug therapy
  • Humans
  • Multilocus Sequence Typing
  • Neisseria gonorrhoeae / genetics

Substances

  • Azithromycin
  • Ceftriaxone