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Two cases of extensively drug-resistant (XDR) Neisseria gonorrhoeae infection combining ceftriaxone-resistance and high-level azithromycin resistance, France, November 2022 and May 2023
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Clara Maubaret1,2,3,*
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François Caméléna1,2,3,*
, Manel Mrimèche1,2,3 , Aymeric Braille2,3 , Mathilde Liberge1,2,3 , Mary Mainardis2,3 , Clémence Guillaume4 , Franck Noel5 , Cécile Bébéar6,7
, Jean-Michel Molina8,9 , Florence Lot10 , Emilie Chazelle10 , Béatrice Berçot1,2,3
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View Affiliations Hide AffiliationsAffiliations: 1 Paris Cité University, INSERM1137, IAME, Paris, France 2 APHP, Infectious Agents Department, Saint Louis - Lariboisière University Hospitals, Paris, France 3 French National Reference Centre for bacterial STI, Associated Laboratory for Gonococci, Paris, France 4 Orléans Hospital, Microbiology Laboratory, Orléans, France 5 Bioxa Laboratoire, Microbiology Laboratory, Bezannes, France 6 University of Bordeaux, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France 7 University Hospital, Bacteriology Department, French National Reference Centre for Bacterial STIs, Bordeaux France 8 Paris Cité University, INSERM, UMR S976, Paris, France 9 AP-HP, Infectious Disease Department, Saint Louis – Lariboisière Hospitals, Paris, France 10 Santé publique France, the national public health agency, Saint-Maurice, France * These authors contributed equally to this work and share first authorship.Beatrice Berçotbeatrice.bercot aphp.fr
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Citation style for this article: Maubaret Clara, Caméléna François, Mrimèche Manel, Braille Aymeric, Liberge Mathilde, Mainardis Mary, Guillaume Clémence, Noel Franck, Bébéar Cécile, Molina Jean-Michel, Lot Florence, Chazelle Emilie, Berçot Béatrice. Two cases of extensively drug-resistant (XDR) Neisseria gonorrhoeae infection combining ceftriaxone-resistance and high-level azithromycin resistance, France, November 2022 and May 2023. Euro Surveill. 2023;28(37):pii=2300456. https://doi.org/10.2807/1560-7917.ES.2023.28.37.2300456 Received: 25 Aug 2023; Accepted: 14 Sept 2023
Abstract
We report two extensively drug-resistant (XDR) Neisseria gonorrhoeae (NG) isolates combining high-level resistance to azithromycin and resistance to ceftriaxone, obtained in France from two heterosexual patients, one of whom returned from Cambodia. Whole genome sequencing identified MLST ST16406, the mosaic penA-60.001 which caused ceftriaxone resistance in the internationally spreading FC428 clone, and the A2059G mutation in the 23S rRNA gene. The NG isolates F93 and F94 were related to XDR isolates detected in Austria and the United Kingdom in 2022.

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