Rising gonorrhoea antimicrobial resistance in Europe

A recent report by the European Centre for Disease Prevention and Control has highlighted the danger that rising antibiotic resistance may mean that soon gonorrhoea may become an untreatable disease in some parts of Europe.

According to the report the most worrying result is the increase in the percentage of isolates with decreased susceptibility to cefixime and the increase in the number of countries where this phenotype was identified between 2009 and 2010. [Fig 1]

 

Fig 1. European Centre for Disease Prevention and Control

Patient characteristics of isolates with decreased susceptibility did not differ greatly when compared to the overall population, except for age: patients with decreased susceptibility to cefixime were more likely to be older.

There is some evidence that the rates of ciprofloxacin and azithromycin resistance have both decreased since 2009. However they remain worringly high across Europe (53% and 7%, respectively).

Similar results for cefixime – which is the first line drug therapy in many centres – have been reported by the European gonococcal antimicrobial surveillance programme (Euro-GASP) – Fig 2

 

Cephalosporine resistance in gonococcal isolates 2009 – Euro-GASP

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