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

Author:

Chow Eric P F123ORCID,Stevens Kerrie4,De Petra Vesna14,Chen Marcus Y12ORCID,Bradshaw Catriona S123ORCID,Sherry Norelle L45ORCID,Barbee Lindley A67,Vodstrcil Lenka A123ORCID,Aguirre Ivette1,Seib Kate L8ORCID,Maddaford Kate12ORCID,Williamson Deborah A91011ORCID,Howden Benjamin P4512ORCID,Fairley Christopher K12ORCID

Affiliation:

1. Melbourne Sexual Health Centre, Alfred Health , Melbourne, Victoria , Australia

2. School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University , Melbourne, Victoria , Australia

3. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne , Melbourne, Victoria , Australia

4. Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity , Melbourne, Victoria , Australia

5. Department of Infectious Diseases and Immunology, Austin Health , Heidelberg, Victoria , Australia

6. Department of Medicine, University of Washington , Seattle, Washington , USA

7. Public Health–Seattle and King County HIV/STD Program , Seattle, Washington , USA

8. Institute for Glycomics, Griffith University , Southport, Queensland , Australia

9. Victorian Infectious Disease Reference Laboratory, The Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity , Melbourne, Victoria , Australia

10. Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity , Melbourne, Victoria , Australia

11. Department of Infectious Diseases and Immune Defence, Walter and Eliza Hall Institute of Medical Research , Melbourne, Victoria , Australia

12. Centre for Pathogen Genomics, The University of Melbourne , Melbourne, Victoria , Australia

Abstract

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.

Funder

Australian National Health and Medical Research Council

Emerging Leadership Investigator Grant

Australian National Health and Medical Research Council Leadership Investigator Grant

Publisher

Oxford University Press (OUP)

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