Observational studyThe Lancet. Microbe2025
WHO global gonococcal antimicrobial surveillance programmes, 2019-22: a retrospective observational study.
Observational study in The Lancet. Microbe, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Fatty acids-based compounds as novel prophylaxis or treatment for oropharyngealEmerging microbes & infections · 2026Article
- Abolishing PorB-induced mitophagy enhances gonococcal outer membrane vesicle vaccine efficacy.Emerging microbes & infections · 2026Article
- Heterogeneity of azithromycin resistance markers inNew microbes and new infections · 2026Review
- Preclinical Evaluation of Novel ConservedVaccines · 2026Article
- Rise ofAntimicrobial agents and chemotherapy · 2026Article
- Antimicrobial resistance in Neisseria gonorrhoeae isolates at the Bangrak STIs Center, Bangkok, Thailand and WGS of antimicrobial-resistant isolates, 2018-23.The Journal of antimicrobial chemotherapy · 2026Article
- Antimicrobial Resistance in Extragenital Neisseria gonorrhoeae Infections, US Military Centers, 2022-2024.Emerging infectious diseases · 2026Article
- Phenotypic and genotypic characterization ofJAC-antimicrobial resistance · 2026Article
- Preclinical characterization of immune responses induced by a candidate gonococcal native outer membrane vesicle vaccine.mSphere · 2026Article
- Advancements in Technologies Targeting Horizontal Gene TransferRoutes to Control Drug Resistance Evolution.ACS bio & med chem Au · 2026Review
- Pre-clinical efficacy of a candidate outer membrane vesicle gonococcal vaccine in comparison with 4CMenB.NPJ vaccines · 2026Article
- Emergence of Ceftriaxone-Resistant Neisseria gonorrhoeae penA-60-Carrying Strains, Thailand, 2025.Emerging infectious diseases · 2026Article
- Limitations of Global Surveillance for Neisseria gonorrhoeae Antimicrobial Resistance.Emerging infectious diseases · 2026Review
- Inferring Sexual Network Bridging Using Genomics: A Simulation Study.medRxiv : the preprint server for health sciences · 2026Article
- Bacteriophage-Based Therapeutics for Bacterial Sexually Transmitted Infections: From Biological Barriers to Translational Strategies.Pathogens (Basel, Switzerland) · 2026Review
- A penicillin-binding protein inhibitor series to target drug-resistant Neisseria gonorrhoeae.Nature microbiology · 2026Article
- Assessing N. gonorrhoeae prevalence and testing capacity for new treatment rollout: a scoping review for Cambodia, Thailand, Vietnam and South Africa.BMC infectious diseases · 2026Article
- Trends in population structure, antimicrobial susceptibility and resistance determinants ofJAC-antimicrobial resistance · 2026Article
- High in vitro activity of the novel antimicrobial gepotidacin against Neisseria gonorrhoeae isolates in eight WHO Enhanced Gonococcal Antimicrobial Surveillance Programme countries in three WHO regions, 2021-24.The Journal of antimicrobial chemotherapy · 2026Article
- In Vitro Activity of Zoliflodacin AgainstAntibiotics (Basel, Switzerland) · 2026Article
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Authors and funding
13 authors.
Funding
Abstract
backgroundGonorrhoea and gonococcal antimicrobial resistance (AMR) remain global public health concerns, and enhanced quality-assured global surveillance of gonococcal AMR is imperative to inform management guidelines and public health policies. We aimed to describe the results of surveillance of gonococcal AMR conducted globally by WHO and discuss the actions needed to retain our ability to treat gonorrhoea.
methodsIn this retrospective observational study, we present gonococcal AMR data reported to WHO by 77 countries between Jan 1, 2019, and Dec 31, 2022. Gonococcal isolates were tested for minimum inhibitory concentrations of one to four key antimicrobials (ceftriaxone, cefixime, azithromycin, and ciprofloxacin) in each country. We used breakpoints for resistance and decreased susceptibility to antimicrobials from the European Committee on Antimicrobial Susceptibility Testing or Clinical Laboratory and Standards Institute.
findings29 (39%) of 75 participating countries reported at least one isolate with resistance or decreased susceptibility to ceftriaxone, 28 (50%) of 56 reported resistance or decreased susceptibility to cefixime, 58 (88%) of 66 reported resistance to azithromycin, and 74 (99%) of 75 reported resistance to ciprofloxacin. Globally, azithromycin resistance is increasing, as is resistance or decreased susceptibility to ceftriaxone and cefixime, especially in the WHO Western Pacific region. Resistance to ciprofloxacin remained very high globally. Since 2017-18, the numbers of reporting countries, examined isolates, and resistant isolates have increased. However, surveillance levels remain inadequate in central America and the Caribbean, eastern Europe, and the WHO African, Eastern Mediterranean, and South-East Asia regions.
interpretationGlobal AMR surveillance conducted by WHO is expanding and, in selected countries, improving through standardisation and quality assurance, as well as implementation of extragenital sampling, test of cure, and whole-genome sequencing. This approach provides evidence-based data for management guidelines and public health policies. Improvements in prevention, early diagnosis, treatment of patients and their contacts, surveillance (of infection rates, AMR, treatment failures, and antimicrobial use), and antimicrobial stewardship are essential. WHO supports this work through several global action plans on AMR, new global gonorrhoea treatment recommendations, surveillance, and research.
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