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Related Experiment Video

Updated: Jul 5, 2026

Quantitative Examination of Antibiotic Susceptibility of Neisseria gonorrhoeae Aggregates Using ATP-utilization Commercial Assays and Live/Dead Staining
08:04

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Published on: February 8, 2019

WHO global gonococcal antimicrobial surveillance programmes, 2019-22: a retrospective observational study.

Magnus Unemo1, Monica M Lahra2, Michelle J Cole3

  • 1WHO Collaborating Centre for Gonorrhoea and other STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Institute for Global Health, University College London, London, UK.

The Lancet. Microbe
|September 27, 2025
PubMed
Summary

Gonococcal antimicrobial resistance (AMR) is a growing global threat. WHO surveillance shows increasing resistance to key antibiotics like ceftriaxone and azithromycin, necessitating urgent public health action to preserve treatment options.

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Area of Science:

  • Public Health
  • Microbiology
  • Infectious Diseases

Background:

  • Gonorrhoea and its antimicrobial resistance (AMR) are significant global health challenges.
  • Enhanced, quality-assured global surveillance of gonococcal AMR is critical for informing treatment guidelines and public health strategies.

Purpose of the Study:

  • To report on global gonococcal AMR surveillance data collected by the World Health Organization (WHO).
  • To discuss necessary actions to maintain effective gonorrhoea treatment capabilities.

Main Methods:

  • Retrospective observational study analyzing gonococcal AMR data from 77 countries (Jan 2019–Dec 2022).
  • Minimum inhibitory concentrations of key antimicrobials (ceftriaxone, cefixime, azithromycin, ciprofloxacin) were tested.
  • Resistance breakpoints followed European Committee on Antimicrobial Susceptibility Testing or Clinical Laboratory and Standards Institute guidelines.

Main Results:

  • High rates of resistance were reported globally: 99% for ciprofloxacin, 88% for azithromycin, 50% for cefixime, and 39% for ceftriaxone.
  • Increasing resistance to azithromycin, ceftriaxone, and cefixime was observed, particularly in the WHO Western Pacific region.
  • Surveillance remains inadequate in several regions, including Central America, the Caribbean, Eastern Europe, and parts of Africa, the Eastern Mediterranean, and South-East Asia.

Conclusions:

  • WHO's global AMR surveillance is expanding and improving with standardization and quality assurance.
  • Evidence-based data from surveillance inform management guidelines and public health policies.
  • Improvements in prevention, diagnosis, treatment, surveillance, and antimicrobial stewardship are essential to combat gonococcal AMR.