The World Health Organization (WHO) estimates that 82.4 million people were newly infected with gonorrhoea in 2020, the second most common bacterial sexually transmitted infection (STI). While gonorrhoea is curable when treated with antibiotics, antimicrobial resistance (AMR) to gonorrhoea has increased over the past 50 years, rendering ineffective many classes of antibiotics, including quinolones and early-generation cephalosporins. Resistance to many older antibiotics has made gonorrhoea a multidrug-resistant pathogen.
In September 2021, The Lancet Microbe published the latest results from a retrospective observational study of the WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae isolates from 2017 to 2018. In total, 73 countries contributed data to the biennial report on the status of AMR in gonorrhoea, which confirmed that resistant gonococcal strains are globally widespread.
Key data from the report notes that the number of countries reporting gonococcal AMR have substantially increased compared with the previous global reports. Data on at least one or more drugs were provided by the 73 countries reporting. The WHO European Region had the highest number of reporting countries at 30, followed by the Western Pacific Region with 14 countries. Surveillance remains scarce in central America and the Caribbean and eastern Europe, and in the WHO African, Eastern Mediterranean, and South-East Asia Regions. The total number of gonorrhoea isolates examined for susceptibility to different antimicrobials varied from 12,895 for cefixime to 25,505 for ciprofloxacin in 2017, and from 15,876 for cefixime to 27,251 for ciprofloxacin in 2018.
Furthermore, the study reported decreased susceptibility or resistance to ceftriaxone in 21 out of 68 reporting countries, and to cefixime in 24 of 51 reporting countries. Resistance to azithromycin was reported by 51 of 61 reporting countries and to ciprofloxacin by all 70 reporting countries. In many countries, ciprofloxacin resistance is extremely high, azithromycin resistance is rapidly increasing, and resistance or decreased susceptibility to ceftriaxone and cefixime continue to emerge. Without new gonorrhoea treatments, it is believed there will be people with gonorrhoea infections that will be difficult to treat and cure.
Source: WHO, 22 November 2021