Multidrug-resistant Neisseria gonorrhoeae failing treatment with ceftriaxone and doxycycline in France, November 2017

doi:10.2807/1560-7917.ES.2018.23.21.1800264

Case Reports

. 2018 May;23(21):1800264.

doi: 10.2807/1560-7917.ES.2018.23.21.1800264.

Multidrug-resistant Neisseria gonorrhoeae failing treatment with ceftriaxone and doxycycline in France, November 2017

Thibault Poncin^{1

2}, Sebastien Fouere³, Aymeric Braille^{1

2}, Francois Camelena^{1

2

4}, Myriem Agsous^{1

2}, Cecile Bebear⁵, Sylvain Kumanski², Florence Lot⁶, Severine Mercier-Delarue¹, Ndeindo Ndeikoundam Ngangro⁶, Maud Salmona¹, Nathalie Schnepf^{1

2}, Julie Timsit³, Magnus Unemo⁷, Beatrice Bercot^{1

2

4}

Affiliations

¹ Infectious Agents Department, Saint Louis Hospital, APHP, Paris, France.
² French National Reference Center for bacterial STI, Associated laboratory for gonococci, APHP, Paris, France.
³ Dermatology Department, CeGGID (Free Information Screening and Diagnostics Centers), Saint Louis Hospital, APHP, Paris, France.
⁴ Paris Diderot University, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France.
⁵ University of Bordeaux, USC EA 3671 Mycoplasmal and chlamydial infections in humans; Centre Hospitalier Universitaire de Bordeaux, French National Reference Center for bacterial STIs, Bordeaux, France.
⁶ Santé Publique France, French National Public Health Agency, Saint-Maurice, France.
⁷ WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Ӧrebro University, Ӧrebro, Sweden.

PMID: 29845928
PMCID: PMC6152217
DOI: 10.2807/1560-7917.ES.2018.23.21.1800264

Case Reports

Multidrug-resistant Neisseria gonorrhoeae failing treatment with ceftriaxone and doxycycline in France, November 2017

Thibault Poncin et al. Euro Surveill. 2018 May.

. 2018 May;23(21):1800264.

doi: 10.2807/1560-7917.ES.2018.23.21.1800264.

Authors

Affiliations

¹ Infectious Agents Department, Saint Louis Hospital, APHP, Paris, France.
² French National Reference Center for bacterial STI, Associated laboratory for gonococci, APHP, Paris, France.
³ Dermatology Department, CeGGID (Free Information Screening and Diagnostics Centers), Saint Louis Hospital, APHP, Paris, France.
⁴ Paris Diderot University, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France.
⁵ University of Bordeaux, USC EA 3671 Mycoplasmal and chlamydial infections in humans; Centre Hospitalier Universitaire de Bordeaux, French National Reference Center for bacterial STIs, Bordeaux, France.
⁶ Santé Publique France, French National Public Health Agency, Saint-Maurice, France.
⁷ WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Ӧrebro University, Ӧrebro, Sweden.

PMID: 29845928
PMCID: PMC6152217
DOI: 10.2807/1560-7917.ES.2018.23.21.1800264

Abstract

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.

Keywords: antimicrobial resistance; antimicrobial treatment; diagnosis; gonorrhoea; treatment failure.

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Conflict of interest statement

Conflict of interest: None declared

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References

1. Wi T, Lahra MM, Ndowa F, Bala M, Dillon JR, Ramon-Pardo P, et al. Antimicrobial resistance in Neisseria gonorrhoeae: Global surveillance and a call for international collaborative action. PLoS Med. 2017;14(7):e1002344. 10.1371/journal.pmed.1002344 - DOI - PMC - PubMed
1. World Health Organization (WHO). Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae. Geneva: WHO; 2012. Available from: http://www.who.int/reproductivehealth/publications/rtis/9789241503501/en/
1. European Centre for Disease Prevention and Control (ECDC). Response plan to control and manage the threat of multidrugresistant gonorrhoea in Europe. Stockholm: ECDC; 2012. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publicat....
1. Fifer H, Natarajan U, Jones L, Alexander S, Hughes G, Golparian D, et al. Failure of dual antimicrobial therapy in treatment of gonorrhea. N Engl J Med. 2016;374(25):2504-6. 10.1056/NEJMc1512757 - DOI - PubMed
1. Geisler WM, Uniyal A, Lee JY, Lensing SY, Johnson S, Perry RC, et al. Azithromycin versus Doxycycline for Urogenital Chlamydia trachomatis Infection. N Engl J Med. 2015;373(26):2512-21. 10.1056/NEJMoa1502599 - DOI - PMC - PubMed

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[1] Wi T, Lahra MM, Ndowa F, Bala M, Dillon JR, Ramon-Pardo P, et al. Antimicrobial resistance in Neisseria gonorrhoeae: Global surveillance and a call for international collaborative action. PLoS Med. 2017;14(7):e1002344. 10.1371/journal.pmed.1002344 - DOI - PMC - PubMed

[2] Wi T, Lahra MM, Ndowa F, Bala M, Dillon JR, Ramon-Pardo P, et al. Antimicrobial resistance in Neisseria gonorrhoeae: Global surveillance and a call for international collaborative action. PLoS Med. 2017;14(7):e1002344. 10.1371/journal.pmed.1002344 - DOI - PMC - PubMed

[3] World Health Organization (WHO). Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae. Geneva: WHO; 2012. Available from: http://www.who.int/reproductivehealth/publications/rtis/9789241503501/en/

[4] World Health Organization (WHO). Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae. Geneva: WHO; 2012. Available from: http://www.who.int/reproductivehealth/publications/rtis/9789241503501/en/

[5] European Centre for Disease Prevention and Control (ECDC). Response plan to control and manage the threat of multidrugresistant gonorrhoea in Europe. Stockholm: ECDC; 2012. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publicat....

[6] European Centre for Disease Prevention and Control (ECDC). Response plan to control and manage the threat of multidrugresistant gonorrhoea in Europe. Stockholm: ECDC; 2012. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publicat....

[7] Fifer H, Natarajan U, Jones L, Alexander S, Hughes G, Golparian D, et al. Failure of dual antimicrobial therapy in treatment of gonorrhea. N Engl J Med. 2016;374(25):2504-6. 10.1056/NEJMc1512757 - DOI - PubMed

[8] Fifer H, Natarajan U, Jones L, Alexander S, Hughes G, Golparian D, et al. Failure of dual antimicrobial therapy in treatment of gonorrhea. N Engl J Med. 2016;374(25):2504-6. 10.1056/NEJMc1512757 - DOI - PubMed

[9] Geisler WM, Uniyal A, Lee JY, Lensing SY, Johnson S, Perry RC, et al. Azithromycin versus Doxycycline for Urogenital Chlamydia trachomatis Infection. N Engl J Med. 2015;373(26):2512-21. 10.1056/NEJMoa1502599 - DOI - PMC - PubMed

[10] Geisler WM, Uniyal A, Lee JY, Lensing SY, Johnson S, Perry RC, et al. Azithromycin versus Doxycycline for Urogenital Chlamydia trachomatis Infection. N Engl J Med. 2015;373(26):2512-21. 10.1056/NEJMoa1502599 - DOI - PMC - PubMed

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Multidrug-resistant Neisseria gonorrhoeae failing treatment with ceftriaxone and doxycycline in France, November 2017

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Multidrug-resistant Neisseria gonorrhoeae failing treatment with ceftriaxone and doxycycline in France, November 2017

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