Abstract
Between November 2014 and May 2018, 118 laboratory-confirmed cases of high-level azithromycin resistant Neisseria gonorrhoeae were identified in England. Cases emerged among heterosexuals in Leeds but spread across England and into sexual networks of men who have sex with men as the outbreak progressed. The few epidemiological links identified indicate substantial under-diagnosis of cases and this, along with the upturn in cases in 2017, highlights the difficulties in controlling the outbreak.
Keywords:
England; MSM: men who have sex with men; Neisseria gonorrhoeae; STI; antimicrobial resistance; azithromycin; gonorrhoea.
MeSH terms
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Adolescent
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Adult
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Anti-Bacterial Agents / administration & dosage
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Anti-Bacterial Agents / pharmacology*
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Azithromycin / administration & dosage
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Azithromycin / pharmacology*
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Ceftriaxone / administration & dosage
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Contact Tracing
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Disease Outbreaks / prevention & control
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Disease Outbreaks / statistics & numerical data*
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Drug Resistance, Bacterial / drug effects*
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England / epidemiology
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Female
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Gonorrhea / diagnosis
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Gonorrhea / drug therapy*
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Gonorrhea / epidemiology
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Gonorrhea / microbiology
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Heterosexuality*
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Homosexuality, Male*
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Humans
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Male
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Microbial Sensitivity Tests
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Neisseria gonorrhoeae / drug effects*
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Neisseria gonorrhoeae / isolation & purification
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Population Surveillance
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Treatment Outcome
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Young Adult
Substances
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Anti-Bacterial Agents
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Ceftriaxone
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Azithromycin