High prevalence of ceftriaxone-resistant Neisseria gonorrhoeae in Hanoi, Vietnam, 2023-2024

Jolein Gyonne Elise Laumen, Vu N Hieu, Pham H Nhung, Koen Vandelannoote, Nguyen Thi Tam, Nguyen T Trang, Nguyen T N Diep, Thomas Kesteman, Rogier H van Doorn, Tran M Chau, Paul C Adamson
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Abstract

Ceftriaxone resistance in Neisseria gonorrhoeae is an escalating global health concern, threatening the efficacy of empiric treatment. In the Asia-Pacific region, a rapid surge in ceftriaxone resistance has been observed, primarily associated with the penA-60.001 allele. This study, conducted in Hanoi, Vietnam between 2023 and 2024, analyzed 352 N. gonorrhoeae isolates and found a 27% prevalence of ceftriaxone resistance. Whole-genome sequencing identified that resistance was predominantly driven by the mosaic penA-237.001 allele, with a smaller contribution from penA-60.001. The high prevalence of resistance and the emergence of new alleles underscore the urgent threat to ceftriaxone as an empiric treatment option.
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