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Emergence of multi-drug resistant gonorrhoea highlights urgent need for reversal of sexual health cuts

The British Association for Sexual Health and HIV (BASHH) has reacted with deep concern following the first globally reported case of gonorrhoea with high-level resistance to azithromycin and resistance to ceftriaxone, the two antibiotics most commonly used to treat the infection.

The report from Public Health England (PHE) shows that the multi-drug-resistant (MDR) strain of gonorrhoea was identified from a heterosexual man who attended sexual health services in England in early 2018. The case reported one regular female partner in the UK, and a female sexual contact in south-east Asia a month prior to symptom onset.

To help contain the spread of MDR gonorrhoea, PHE has formed an incident management team (IMT) to coordinate the ongoing investigation and is also supporting clinical and microbiology teams in the management of the case.

The emergence of MDR-gonorrhoea follows an initial outbreak of high level azithromycin resistant gonorrhoea in England in 2015, and subsequent outbreaks across the country in 2016 and 2017.

Commenting on the emergence of MDR gonorrhoea, Dr Olwen Williams, President of the British Association for Sexual Health and HIV, said:

The emergence of this new strain of highly resistant gonorrhoea is of huge concern and is a significant development.

Clinicians are working closely with Public Health England and key partners to help contain its spread, the success of which is dependent on judicious use of antimicrobials, effective partner notification and robust laboratory testing services, all of which are in line with BASHH guidance.

We are however deeply concerned that the problem will worsen due to the dramatic cuts that have been delivered to the public health budget in recent years.

Worryingly this has left sexual health services at 'tipping point', with clinic closures coming at the worst possible time.

Emergence of multi-drug resistant gonorrhoea highlights urgent need for reversal of sexual health cuts