Ceftriaxone-Resistant Gonorrhea - China, 2022

Area of Science:

• Public Health
• Infectious Diseases
• Microbiology

Background:

• Gonorrhea is a prevalent sexually transmitted infection globally and in China, where it was the fourth most common notifiable disease in 2022.
• The emergence and spread of antimicrobial-resistant Neisseria gonorrhoeae strains, especially ceftriaxone-resistant ones, present a significant public health threat.
• The China Gonococcal Resistance Surveillance Program (China-GRSP) has been monitoring antimicrobial resistance in gonorrhea since 1987.

Purpose of the Study:

• To assess the current antimicrobial resistance patterns of Neisseria gonorrhoeae isolates in China.
• To evaluate the trends in resistance, particularly to ceftriaxone, between 2017 and 2022.
• To inform strategies for gonorrhea control and the management of antimicrobial resistance.

Main Methods:

• The China-GRSP collected 2,804 gonococcal isolates from 13 sentinel sites in 2022.
• Antimicrobial susceptibility testing was performed on the collected isolates.
• Data from 2017 and 2022 were compared to identify resistance trends.

Main Results:

• In 2022, the prevalence of Neisseria gonorrhoeae resistance to ceftriaxone was 8.1%, a threefold increase from 2.9% in 2017.
• Five provinces reported ceftriaxone resistance rates exceeding 10%.
• High resistance rates were also observed for cefixime (16.0%), azithromycin (16.9%), tetracycline (77.1%), penicillin (77.8%), and ciprofloxacin (97.6%). Only one case of spectinomycin resistance was reported.

Conclusions:

• There has been a substantial increase in ceftriaxone resistance in Neisseria gonorrhoeae in China from 2017 to 2022.
• Effective diagnosis, treatment, and partner management are crucial to prevent transmission of gonorrhea and resistant strains.
• Further research into the drivers of ceftriaxone-resistant N. gonorrhoeae spread is needed to guide antibiotic stewardship and control strategies.