Dermatology Review
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eISSN: 2084-9893
ISSN: 0033-2526
Dermatology Review/Przegląd Dermatologiczny
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6/2025
vol. 112
 
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Review article

Gonorrhoea: New Threats from Multidrug-Resistant Strains of Neisseria Gonorrhoeae, and the Epidemiological Situation

Beata Młynarczyk-Bonikowska
1
,
Lidia Rudnicka
1

  1. Department of Dermatology and Venereology, Medical University of Warsaw, Poland
Dermatol Rev/Przegl Dermatol 2025, 112, 355-360
Online publish date: 2026/02/28
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1. Paris K.S., Font B., Mehta S.R., Huerta I., Bristow C.C.: 72-Hour transport recovery of antimicrobial resistant Neisseria gonorrhoeae isolates using the InTray® GC method. PLoS One 2022, 17, e0259668.
2. Cole M.J., Spiteri G., Jacobsson S., Woodford N., Tripodo F., Amato-Gauci A.J., et al.: Overall low extended-spectrum cephalosporin resistance but high azithromycin resistance in Neisseria gonorrhoeae in 24 European Countries, 2015. BMC Infect Dis 2017, 17, 617.
3. Day M.J., Spiteri G., Jacobsson S., Woodford N., Amato-Gauci A.J., Cole M.J., et al.: Stably high azithromycin resistance and decreasing ceftriaxone susceptibility in Neisseria gonorrhoeae in 25 European countries, 2016. BMC Infect Dis 2018, 18, 609.
4. Jacobsson S., Cole M.J., Spiteri G., Day M., Unemo M., Eder C., et al.: Associations between antimicrobial susceptibility/resistance of Neisseria gonorrhoeae isolates in European Union/European Economic Area and patients’ gender, sexual orientation and anatomical site of infection, 2009-2016. BMC Infect Dis 2021, 21, 273.
5. Day M.J., Jacobsson S., Spiteri G., Kulishev C., Sajedi N., Woodford N., et al.: Significant increase in azithromycin “resistance” and susceptibility to ceftriaxone and cefixime in Neisseria gonorrhoeae isolates in 26 European countries, 2019. BMC Infect Dis 2022, 22, 524.
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13. Lin X., Chen W., Xie Q., Yu Y., Liao Y., Feng Z., et al.: Dissemination and genome analysis of high-level ceftriaxone-resistant penA 60.001 Neisseria gonorrhoeae strains from the Guangdong Gonococcal Antibiotics Susceptibility Program (GD-GASP), 2016-2019. Emerg Microbes Infect 2022, 11, 344-350.
14. Sánchez-Busó L., Cole M.J., Spiteri G., Day M., Jacobsson S., Golparian D., et al.: Europe-wide expansion and eradication of multidrug-resistant Neisseria gonorrhoeae lineages: a genomic surveillance study. Lancet Microbe 2022, 3, e452-e463.
15. Palace S.G., Wang Y., Rubin D.H., Welsh M.A., Mortimer T.D., Cole K., et al.: RNA polymerase mutations cause cephalosporin resistance in clinical Neisseria gonorrhoeae isolates. Elife 2020, 9, e51407.
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17. Kandinov I., Gryadunov D., Vinokurova A., Antonova O., Kubanov A., Solomka V., et al.: In vitro susceptibility to β-lactam antibiotics and viability of Neisseria gonorrhoeae strains producing plasmid-mediated broad- and extended-spectrum β-lactamases. Front Microbiol 2022, 13, 896607.
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19. Qin X.L., Chen Y., Wu X.Z., Chen W.T., Xue Y.H., Huang J.M., et al.: Emerging epidemic of the Africa-type plasmid in penicillinase-producing Neisseria gonorrhoeae in Guangdong, China, 2013-2022. Emerg Microbes Infect 2025, 14, 2440489.
20. Młynarczyk-Bonikowska B., Majewska A., Malejczyk M., Młynarczyk G., Majewski S.: Multiresistant Neisseria gonorrhoeae: a new threat in second decade of the XXI century. Med Microbiol Immunol 2020, 209, 95-108.
21. Jacobsson S., Golparian D., Cole M., Spiteri G., Martin I., Bergheim T., et al.: Whole genome sequence analysis and molecular resistance mechanisms in azithromycin resistant Neisseria gonorrhoeae isolates in Europe from 2009 to 2014. J Antimicrob Chemother 2016, 71, 3109-3116.
22. Smolarczyk K., Mlynarczyk-Bonikowska B., Rudnicka E., Szukiewicz D., Meczekalski B., Smolarczyk R., et al.: The impact of selected bacterial sexually transmitted diseases on pregnancy and female fertility. Int J Mol Sci 2021, 22, 2170.
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24. Unemo M., Jacobsson S., Unemo M., Vodičar P.M., Zákoucká H.: High tetracycline resistance percentages in Neisseria gonorrhoeae in Europe: is doxycycline post-exposure prophylaxis unlikely to reduce the incident gonorrhoea cases? Lancet Regional Health Europe 2024, 38, 100871.
25. Unemo M., Golparian D., Skogen V., Olsen A.O., Moi H., Syversen G., et al.: Neisseria gonorrhoeae strain with high-level resistance to spectinomycin due to a novel resistance mechanism (mutated ribosomal protein S5) verified in Norway. Antimicrob Agents Chemother 2013, 57, 1057-1061.
26. Unemo M., Wi T.: Gepotidacin shows promise for the treatment of uncomplicated gonorrhoea. Lancet 2025, 405, 1560-1562.
27. Unemo M., Ringlander J., Wiggins C., Fredlund H., Jacobsson S., Cole M., et al.: High in vitro susceptibility to the novel spiropyrimidinetrione AZD0914 among contemporary clinical Neisseria gonorrhoeae isolates in 21 European countries. Antimicrob Agents Chemother 2015, 59, 5220-5225.
28. Unemo M., Ahlstrand J., Sánchez-Busó L., Day M., Aanensen D., Golparian D., et al.: High susceptibility to zoliflodacin and conserved target (GyrB) for zoliflodacin among 1209 consecutive clinical Neisseria gonorrhoeae isolates from 25 European countries, 2018. J Antimicrob Chemother 2021, 76, 1221-1228.
29. Młynarczyk-Bonikowska B., Serwin A.B., Golparian D., Walter de Walthoffen S., Majewski S., Koper M., et al.: Gonorrhoea epidemiology, antimicrobial susceptibility/resistance and genetic characteristics of Neisseria gonorrhoeae isolates from Poland, 2010-2012. BMC Inf Dis 2014, 14, 65-71.
30. https://pubmlst.org/bigsdb?db=pubmlst_neisseria_iso-lates&page=query&prov_field1=f_species& prov_value1=Neisseria%20gonorrhoeae&submit=1)
31. Kandinov I., Shaskolskiy B., Kravtsov D., Filippova M., Larkin A., Gryadunov D.: Mini-multilocus sequence typing scheme for the global population of Neisseria gonorrhoeae. Int J Mol Sci 2024, 25, 5781.
Copyright: © 2026 Polish Dermatological Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.



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