Gonococcal antimicrobial susceptibilities:

During 2019–2022, 77 countries and territories in six WHO regions reported data on antimicrobial resistance (AMR) results for gonococcal isolates to the WHO global Gonococcal Antimicrobial Surveillance Programme (WHO-GASP), the Enhanced GASP (EGASP), and/or the Global AMR Surveillance System (GLASS).  AMR results were reported for ceftriaxone from 75 countries and territories, cefixime from 56, azithromycin from 66, and ciprofloxacin from 75. Of these:

• 38.7% reported at least one isolate with resistance or decreased susceptibility (R/DS) to ceftriaxone;
• 50.0% reported at least one isolate with R/DS to cefixime;
• 87.9% reported at least one azithromycin-resistant isolate; and,
• 98.7% reported at least one ciprofloxacin-resistant isolate.

The annual percentage of R/DS to ceftriaxone and cefixime, and resistance to azithromycin and ciprofloxacin in countries ranged from 0–46.7%, 0–63.6%, 0–59.1%, and 0–100%, respectively.  The number of countries reporting data on AMR in gonorrhoea has increased from 66 in 2018 to 77 in 2019–2022. The proportions of countries reporting ceftriaxone R/DS, cefixime R/DS and azithromycin-resistant isolates has increased since 2017–2018 (30.8%, 47.1% and 83.6%, respectively).

Resistant strains in N. gonorrhoeae continue to be a critical challenge to STI prevention and control efforts.

Since 1992 AMR in N. gonorrhoeae has been monitored through the WHO-GASP and since 2016, N. gonorrhoeae is a priority pathogen monitored through GLASS. WHO-GASP, EGASP and GLASS methodology for surveillance of AMR in N. gonorrhoeae are being aligned and data collection is being synergized. Data on AMR in N. gonorrhoeae received through WHO-GASP, EGASP and GLASS have been integrated.