Prevalence of Cefixime-Resistant Neisseria gonorrhoeae in Melbourne, Australia, 2021-2022.

Chow, Eric P F; Stevens, Kerrie; De Petra, Vesna; Chen, Marcus Y; Bradshaw, Catriona S; Sherry, Norelle L; Barbee, Lindley A; Vodstrcil, Lenka A et al. · J Infect Dis · 2024

cross_sectional · Level IV

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Abstract

While ceftriaxone remains the first-line treatment for gonorrhea, the US Centers for Disease Control and Prevention recommended cefixime as a second-line treatment in 2021. We tested 1176 Neisseria gonorrhoeae isolates among clients attending the Melbourne Sexual Health Centre in 2021 and 2022. The prevalence of cefixime resistance was 6.3% (74/1176), azithromycin resistance was 4.9% (58/1176), and ceftriaxone resistance was 0% (0/1176). Cefixime resistance was highest among women (16.4%, 10/61), followed by men who have sex with women (6.4%, 7/109) and men who have sex with men (5.8%, 57/982). The prevalence of cefixime-resistant N gonorrhoeae exceeds the threshold of the 5% resistance level recommended by the World Health Organization; thus, cefixime treatment would have limited benefits in Australia.

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