New reports of extremely-drug-resistant gonorrhoea pose significant risks for sexual health

9th January 2019

The British Association for Sexual Health and HIV (BASHH) has reacted with deep concern following reports showing that new cases of extensively-drug-resistant (XDR) gonorrhoea have been identified in England.

An incident alert published today by Public Health England (PHE) has confirmed that in the last three months, two new cases of XDR gonorrhoea have been identified in heterosexual females in different locations in England, with possible links to a party destination in continental Europe.

The cases have presented with resistance patterns to ceftriaxone and azithromycin, the two antibiotics routinely used as the first line treatment for gonorrhoea. Both cases were eventually successfully cleared, although the second case required three days of intravenous treatment to do so. As a next step, PHE are prioritising identifying the origins of these isolates, the potential for further transmission and are working to help contain their spread.

Today’s announcement follows the first globally reported case of gonorrhoea with high-level resistance to azithromycin and resistance to ceftriaxone in England in 2018. The first outbreak of gonorrhoea with high level azithromycin resistance occurred in England in 2015, with subsequent outbreaks across the country reported in 2016 and 2017. Rates of gonorrhoea in England are at their highest level in decades, with a total of 44,676 new diagnoses made in 2017, representing a 22% increase compared to the previous year.

Worryingly, these developments come against the backdrop of significant and persistent funding cuts for public health, from which sexual health services are funded. A latest £85m cut was delivered by the Government to the public health budget just before Christmas, bringing total real-terms public health cuts to £700m between 2014 and 2020.    

Practising safer sex through use of condoms with all new and casual sexual partners continues to be of vital importance, as does promoting and ensuring high quality and rapid access to HIV, syphilis, gonorrhoea and chlamydia testing. Anyone who has symptoms of a sexually transmitted infection or is worried about their sexual health should visit their local sexual health clinic.

Commenting on Public Health England’s announcement, Dr Olwen Williams, President of BASHH said:

We are deeply concerned by these new developments and BASHH are working closely with national and local partners to help prevent further spread of multi-drug resistant gonorrhoea.

To mitigate this risk, it is essential that all parts of the system work collaboratively and help to ensure that culture tests, partner notification measures and tests of cure are in place. We would also like to remind all healthcare providers about the crucial importance of adhering to BASHH guidelines for the management and treatment of gonorrhoea.

Notes to editors

  • The British Association for Sexual Health and HIV is the lead professional representative body for those managing STIs and HIV in the UK. It seeks to innovate and deliver excellent tailored education and training to healthcare professionals, trainers and trainees in the UK, and to determine, monitor and maintain standards of governance in the provision of sexual health and HIV care.
  • The Public Health England statement can be accessed here.
  • Interviews can be coordinated with representatives from BASHH by contacting / 0207 492 1783, / 0207 492 1780

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