CIENCIASMEDICASNEWS: Ahead of Print - Identification of Internationally Disseminated Ceftriaxone-Resistant Neisseria gonorrhoeae Strain FC428, China - Volume 25, Number 7—July 2019 - Emerging Infectious Diseases journal

Author affiliations: Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China (S.-C. Chen, Y. Han, X.-Y. Zhu, Y.-P. Yin); Chinese Center for Disease Control and Prevention, Nanjing (S.-C. Chen, Y. Han, X-.Y. Zhu, Y.-P. Yin); Beijing Ditan Hospital Capital Medical University, Beijing, China (L.-F. Yuan)

Abstract

In 2016, we identified a ceftriaxone-resistant Neisseria gonorrhoeae isolate in China. The strain genotype was identical to the resistant clone FC428 that originated in Japan. Enhanced international collaborative surveillance programs are crucial to track the transmission of the ceftriaxone-resistant clones.

Ceftriaxone has been used to treat gonorrhea in China and most other countries for >1 decade, but the level of decreased susceptibility or clinical resistance to ceftriaxone has increased (1). Moreover, the international spread of ceftriaxone-resistant clones has been recognized as a threat to effective control of gonorrhea (2). We describe an imported ceftriaxone-resistant N. gonorrhoeae strain isolated in China in 2016.

The patient was a heterosexual man in his late twenties. He reported unprotected 1-night heterosexual sex in Beijing in July 2016. Urethral discharge with dysuria occurred 3 days after the sexual activity. He was prescribed oral cephalosporin when he visited a private clinic in July. Because the urethral discharge did not resolve, he visited the sexually transmitted diseases clinic in Beijing Ditan Hospital (Beijing, China) in August.

Laboratory analysis of a urethral swab sample found gram-negative diplococci within leukocytes. Culture and nucleic acid amplification test were positive for N. gonorrhoeae. Screening for other sexually transmitted infections by nucleic acid amplification test was negative for Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis.