Successful Treatment in UK Very Resistant Gonorrhea Case

Tim Locke

April 20, 2018

Antibiotic treatment with ertapenem (Invanz, Merck Sharp & Dohme) has been successful in the case of a man from the United Kingdom who acquired a strain of "very resistant gonorrhea" while on vacation in Southeast Asia.

Public Health England (PHE) has been investigating the infection, which was believed to be the first to display such high-level resistance to first-line treatments.

Officials say two similar cases have now been reported in Australia.

The British male patient is believed to have acquired the Neisseria gonorrheae infection from a woman he met while traveling in Southeast Asia.

The man sought treatment from sexual health services after returning to the United Kingdom earlier this year.

The infection demonstrated high-level resistance to the dual first-line antibiotics azithromycin (multiple brands) and ceftriaxone (Rocephin, F. Hoffman–La Roche). The patient has now been successfully treated with another antibiotic, ertapenem, given intravenously over 3 days.

No Further Spread in UK

In a news release, Gwenda Hughes, MD, consultant scientist and head of the sexually transmitted infection (STI) section at PHE, said: "We are pleased to report that the case of multidrug-resistant gonorrhea has been successfully treated. Investigations have also revealed there has been no further spread of this infection within the UK. PHE continues to actively monitor and tackle the spread of antibiotic resistance in gonorrhea and potential treatment failures.

"Two similar cases have just been reported in Australia and serve as a timely reminder that we expect to see further cases of multidrug-resistant gonorrhea in the future. These cases will be challenging for healthcare professionals to manage."

PHE is reminding general practitioners to refer suspected cases of gonorrhea to genitourinary medicine services for treatment.

Hughes also stressed PHE's safer sex message: "We urge the public to avoid getting or passing on gonorrhea by using condoms consistently and correctly with all new and casual partners. If you think you have been at risk, you should seek an STI screen at a sexual health clinic."

In the Australian cases, one patient was diagnosed in Western Australia, and the second in Queensland. One patient had had sex recently in Southeast Asia; the second had no history of recent travel overseas. In a statement issued by the Australian Government's Department of Health, Brendan Murphy, MBBS, PhD, the Commonwealth of Australia's chief medical officer, said: "The situation is being closely monitored by public health authorities."

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