Multidrug-resistant Neisseria gonorrhoeae isolate SE690: mosaic penA-60.001 gene causing ceftriaxone resistance internationally has spread to the more antimicrobial-susceptible genomic lineage, Sweden, September 2022

The emerging resistance in Neisseria gonorrhoeae (NG) to the last remaning option for empiric monotherapy of gonorrhoea, ceftriaxone, is a global public health concern. We report a ceftriaxone-resistant, multidrug-resistant NG strain in a female sex worker (FSW) in Sweden, September 2022.

It is imperative to increase the awareness of sporadic ceftriaxone-resistant cases, especially imported from Asia, and to enhance the AMR surveillance in Europe and globally, ideally including NGS, particularly in many Asian countries. Most importantly, improved prevention (including condom use), early diagnosis and treatment (including test-of-cure, sexual contact tracing and treatment of index case and contact) and increased focus on and testing of groups at higher risk for STIs, including sex workers and their clients, are imperative. Ultimately, novel, effective and affordable antimicrobials for the treatment of gonorrhoea are essential.