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

Thibault Poncin; Sebastien Fouere; Aymeric Braille; Francois Camelena; Myriem Agsous; Cecile Bebear; Sylvain Kumanski; Florence Lot; Severine Mercier-Delarue; Ndeindo Ndeikoundam Ngangro; Maud Salmona; Nathalie Schnepf; Julie Timsit; Magnus Unemo; Beatrice Bercot

doi:10.2807/1560-7917.ES.2018.23.21.1800264

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

Euro Surveill. 2018 May;23(21):1800264. doi: 10.2807/1560-7917.ES.2018.23.21.1800264.

Authors

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

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.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anti-Bacterial Agents / therapeutic use*
Ceftriaxone / therapeutic use*
Doxycycline / therapeutic use*
Drug Resistance, Multiple, Bacterial / drug effects
Drug Resistance, Multiple, Bacterial / genetics
Female
Gonorrhea / drug therapy*
Gonorrhea / microbiology
Humans
Microbial Sensitivity Tests
Multilocus Sequence Typing
Neisseria gonorrhoeae / drug effects
Neisseria gonorrhoeae / genetics
Neisseria gonorrhoeae / isolation & purification*
Nucleic Acid Amplification Techniques
Treatment Failure
Whole Genome Sequencing

Substances

Anti-Bacterial Agents
Ceftriaxone
Doxycycline