ECDC warns drug-resistant gonorrhoea spreading across Europe

The European Centre for Disease Prevention and Control (ECDC) warned on Thursday that gonococcal strains resistant to the antibiotic ceftriaxone, used to treat gonorrhoea, were on the rise across European countries.
The ECDC said its risk assessment showed growing evidence of the spread of the resistant strain across the continent over the past two years and warned that it could pose a challenge to the future treatment of the disease.
“Local transmission of ceftriaxone-resistant gonorrhoea in Europe is a warning sign we should not ignore,” says Csaba Ködmön, an ECDC microbiology expert.
“While the risk to the general population is currently low, growing resistance reduces the effectiveness of the therapies we rely on today. If highly drug-resistant strains become established and continue to spread, treatment options could become increasingly limited.”
Mr Ködmön stressed the need for stronger prevention and timely testing to improve early detection of resistant strains and limit their spread.
The ECDC said that, based on reports from 11 European countries, it reviewed the rise in ceftriaxone-resistant gonorrhoea infections since 2022 and the risks they pose to sexually active people.
It noted that the risk remains low for generally sexually active people, but it is higher among people who have intercourse without condoms, those with multiple sexual partners, sex workers, and those travelling to areas with high prevalence of drug-resistant gonorrhoea.
“Early detections of ceftriaxone-resistant cases in Europe have been associated with importation from areas with higher circulation of such resistant strains, particularly from South-East Asia. This remains the main route of introduction into Europe,” the centre said.
The ECDC added that gonorrhoea remains one of the most common sexually transmitted diseases globally, with 82 million cases reported yearly.
According to the centre, more than 106,000 gonorrhoea cases were reported in the European Union and European Economic Area in 2024, marking the highest number since EU surveillance began in 2019.
“If left untreated, gonorrhoea infection can lead to severe complications, including pelvic inflammatory disease, infertility, and ectopic pregnancy,” it warned.
The centre urged targeted prevention measures, increased awareness of safer sex practices, and continued surveillance of gonococcal antimicrobial resistance and of antimicrobial susceptibility testing.
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