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    Wednesday, 25 July 2018 14:07
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PublicHealthEnglandApril 18 2016

An outbreak of high level azithromycin-resistant (HL-AziR) gonorrhoea which originated in Leeds and the north of England has spread. While Leeds was the main area of HL-AziR cases in early 2015, cases started to occur in the south of England including London from September 2015, Public Health England has warned.

Although only a total of 34 cases of highly azithromycin-resistant Neisseria gonorrhoeae were recorded between November 2014 and April 2016, PHE is concerned due to the fact that few antimicrobials remain effective in treating gonorrhoea.

“Initial cases were among heterosexuals but more recent evidence suggests HL-AziR is now spreading among men who have sex with men. Partner notification has been of limited success: of 50 partners thus far reported, only 22 (44%) were successfully contacted, 18 (82%) of which were tested; 17 (94%) tested positive for gonorrhoea,” said PHE.

“A National Resistance Alert was issued to all microbiologists in October 2015 to ensure all gonococcal samples are tested for azithromycin resistance and resistant isolates referred to PHE’s Sexually Transmitted Bacteria Reference Unit (STBRU). As the outbreak has spread, further reminders to raise awareness among clinicians and microbiologists are being issued.”

PHE has advised that the current recommended therapy is for intramuscular ceftriaxone 500mg in combination with azithromycin 1g given orally to help reduce the chances of development of resistance to both drugs simultaneously.

Links:

PHE announcement

PHE Health Protection Report

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