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.
Ceftriaxone , Gonorrhea , Humans , Azithromycin/pharmacology , Ceftriaxone/pharmacology , France , Gonorrhea/diagnosis , Gonorrhea/drug therapy , Multilocus Sequence Typing , Neisseria gonorrhoeae/genetics
We report two cases of multidrug-resistant Neisseria gonorrhoeae urogenital infection with ceftriaxone resistance in a heterosexual couple in south-western France who were successfully treated with a single, high dose of intramuscular ceftriaxone (1 g). Whole genome sequencing of isolate F91 identified MLST13871, NG-MAST1086, NG-STAR233. Patient history revealed the isolate F91 was most likely acquired during a trip to Cambodia and belongs to the successful multidrug-resistant FC428 Asian clone.
Gonorrhea/diagnosis , Neisseria gonorrhoeae/genetics , Neisseria gonorrhoeae/isolation & purification , Anti-Bacterial Agents/therapeutic use , Azithromycin/therapeutic use , Back Pain/etiology , Cambodia , Ceftriaxone/therapeutic use , Drug Resistance, Multiple, Bacterial , Dysuria/etiology , France , Gonorrhea/drug therapy , Heterosexuality , Humans , Male , Microbial Sensitivity Tests , Multilocus Sequence Typing , Neisseria gonorrhoeae/drug effects , Nucleic Acid Amplification Techniques , Travel , Treatment Outcome , Urethritis/drug therapy , Urethritis/microbiology , Whole Genome Sequencing
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.
Anti-Bacterial Agents/therapeutic use , Ceftriaxone/therapeutic use , Doxycycline/therapeutic use , Gonorrhea/drug therapy , Neisseria gonorrhoeae/isolation & purification , Adult , Drug Resistance, Multiple, Bacterial/drug effects , Drug Resistance, Multiple, Bacterial/genetics , Female , Gonorrhea/microbiology , Humans , Microbial Sensitivity Tests , Multilocus Sequence Typing , Neisseria gonorrhoeae/drug effects , Neisseria gonorrhoeae/genetics , Nucleic Acid Amplification Techniques , Treatment Failure , Whole Genome Sequencing
