Growing threat of gonorrhoea becoming untreatable
The rising prevalence of antibiotic-resistant gonorrhoea is a “major public health threat”, sexual health experts have warned.
New data from the UK Health Security Agency (UKHSA) reveals that, between June 2022 and May 2024, 15 ceftriaxone-resistant gonorrhoea cases were detected in England.
“Antibiotic resistance of STIs poses an increasingly major public health threat”
Matt Phillips
As ceftriaxone is the ‘first line’ antibiotic used to treat gonorrhoea in the NHS, resistance to the drug can make treatment difficult, according to the UKHSA.
Meanwhile, of those 15 cases, five were found to be “extensively drug-resistant”, meaning they were resistant to multiple antibiotics including both first- and second-line treatment options.
The 15 ceftriaxone-resistant gonorrhoea cases between 2022 and 2024 account for almost half of the total number ever recorded.
Since the first case was detected in England in 2015, there have now been a total of 31 ceftriaxone-resistant gonorrhoea cases, seven of which were extensively drug-resistant.
The UKHSA has now sent a clinical alert to sexual health services over the rise and to highlight the steps clinicians need to take to manage the situation.
These include reporting all ceftriaxone-resistant strains to UKHSA.
Patients should also be checked after treatment to make sure the infection is gone, referred to as ‘test-of-cure’, with any “potential treatment failures” reported to UKHSA.
The drug-resistant cases come amid an overall increase in gonorrhoea infections, which continue to be at the highest level since records began in 1918.
In 2023, 85,223 gonorrhoea diagnoses were made in England, up 7.5% from 79,268 in 2022.
Dr Helen Fifer, consultant microbiologist at UKHSA, said the rise in antibiotic resistance meant there was a risk of gonorrhoea becoming untreatable in the future.
She warned that untreatable gonorrhoea could lead to “serious health issues”, including pelvic inflammatory disease and infertility, and said condoms were the best line of defence.
The issue of drug-resistant gonorrhoea has been a mounting concern for a while.
Speaking to Nursing Times last year, Jodie Crossman, national nurse representative for the British Association for Sexual Health and HIV (BASHH), said the risk of gonorrhoea becoming untreatable was an issue that everyone should be concerned about.
She said nurses and other health professionals needed to be “really careful with our stewardship of antibiotics” in order to help avoid this “disastrous” threat becoming a reality.
Today, Professor Matt Phillips, president of BASHH, reiterated the critical importance of tackling this issue.
He said: “The rise of antibiotic-resistant gonorrhoea infections in England is a worrying trend that must be addressed with immediate action.
“Antibiotic resistance of [sexually transmitted infections] poses an increasingly major public health threat, which can create physical and psychological harms and place additional demands on other parts of the NHS.”
He said a sexual health strategy was urgently needed from the government “if our expert sexual health workforce are to effectively meet these growing and changing needs in sexual health”.
The UKHSA said, to date, all detected cases of ceftriaxone-resistant gonorrhoea had been among heterosexual individuals, mostly in their 20s, and most acquired the infection abroad in the Asia-Pacific region.
While there has been “limited” transmission within England, the UKHSA said this was a risk as cases rise.
