There are two strains resistant to ceftriaxone, the antibiotic recommended for the treatment of gonorrhea.
He European Center for Disease Prevention and Control (ECDC) has published a report highlighting the threat which represents the increase in antimicrobial resistance (AMR) in Neisseria gonorrhoeae bacteriacommonly known as gonococcus, the cause of gonorrhea.
For the ECDC, this “worrying trend”, indicated by surveillance data, underlines the “critical need” for continuous monitoring to inform safety guidelines. treatment and control measures, and to ensure the “prudent use” of antimicrobialsin a context of increasing cases of gonorrhea in Europe.
Data from Gonococcal Antimicrobial Susceptibility Surveillance in the European Union/European Economic Area for 2022 show two strains resistant to ceftriaxone, the antibiotic recommended for the treatment of gonorrhea. These strains also showed extensive drug resistance (XDR) and multiple drug resistance (MDR), further limiting treatment options.
In 2022, 23 European countries submitted 4,396 isolates from patients diagnosed with gonorrhea to the European Gonococcal Antimicrobial Surveillance Program (Euro-GASP). The proportion of azithromycin-resistant isolates increased significantly to 25.6 percent, compared to 14.2 percent in 2021.
Azithromycin is often used with ceftriaxone to treat gonorrhea, so this finding is especially worrying, the ECDC points out. Resistance to ciprofloxacin also increased, with 65.9 percent of isolates showing resistance in 2022, up from 62.8 percent in 2021.
“While resistance to cefixime remains low (0.3%), it is crucial to maintain vigilance, especially as gonococcal strains resistant to cefixime and ceftriaxone are spreading internationally», highlights the ECDC.
48% more gonorrhea cases
In addition, In 2022, a total of 70,881 confirmed cases of gonorrhea were reported in 28 EU/EEA countries.which represents a 48 percent increase compared to 2021. The notification rate for the EU/EEA in 2022 is the highest recorded since European surveillance of sexually transmitted infections began in 2009.
The ECDC will ensure that, although most gonorrhea infections in the EU/EEA remain treatable with recommended antibiotics Currently, the trends of increasing resistance “are worrying and require greater vigilance.”
The increase in resistant strains may compromise the effectiveness of existing therapeutic options, which represents a significant challenge for public health until new therapeutic options are available. To address these concerns, ECDC recommends enhanced surveillance, continued and expanded susceptibility surveillance to quality-assured antimicrobials to rapidly detect and monitor resistance patterns, and periodically review and update treatment guidelines based on evidence. latest surveillance data on antimicrobial resistance to ensure that the most effective therapeutic options are available.
Development of new treatments
Invest in the development of new antimicrobial treatments and alternative regimens is vital to anticipate the evolution of resistance, the organization highlights.
The ECDC also recommends Strengthen public health initiatives aimed at preventing the spread of gonorrheaincluding increased access to diagnostic services, as well as fostering international cooperation to help monitor and control the spread of resistant strains across borders.
The European Center for Disease Prevention and Control has also stressed the importance of prevention to slow the spread of gonorrhea and mitigate the risk of AMR.
In this sense, it recommends the promotion of safer sexual practicesincluding the correct and systematic use of condoms during vaginal, anal and oral sexual relations, something “crucial to reduce transmission.”
«Sexually transmitted infection screening and early treatment are also essential», according to the agency, which also ensures that “the prudent use of antimicrobials is essential to stop the development and spread of resistant strains.” This includes following recommended treatment guidelines, avoiding unnecessary use of antibiotics, completing the full course of prescribed antibiotics, and advising patients to be retested to ensure they have been cured, the ECDC concludes.
