New data from the UK Health
Security Agency (UKHSA) highlights a concerning rise in
antibiotic-resistant gonorrhoea infections in England.
In 2023, over 85,000 gonorrhoea diagnoses were reported in
England, the highest number since records began in 1918. This
highlights the importance of regular STI testing, especially if
you have condomless sex with new or casual partners. While the
infection can usually be easily treated, some strains are
resistant to commonly used antibiotics and are harder to treat. A
type that poses a particular threat is ceftriaxone-resistant
gonorrhoea. Ceftriaxone is the ‘first line' antibiotic used to
treat gonorrhoea in this country and so resistance to the drug
can make treatment difficult, especially for gonorrhoea
infections in the throat.
Between June 2022 and May 2024, 15 ceftriaxone-resistant
gonorrhoea cases were detected in England, including 5 that were
found to be extensively drug-resistant (resistant to both first-
and second-line treatment options and to other antibiotics).
Since the first case detected in England in 2015, there
have now been a total of 31 ceftriaxone-resistant gonorrhoea
cases, 7 of which were extensively drug-resistant.
To date, all detected cases have been among heterosexual
individuals, mostly in their 20s, and most acquired the infection
abroad. There has been limited transmission within England, but
the increasing number of cases in recent years is concerning as
it increases the chance of wider spread and treatment challenges.
Dr Helen Fifer, Consultant Microbiologist at UKHSA, said:
Gonorrhoea is becoming increasingly resistant to antibiotics,
risking the possibility of it becoming untreatable in the future.
Untreated gonorrhoea can lead to serious health issues, including
pelvic inflammatory disease and infertility. Condoms are the best
defence, but if you didn't use one with a recent new or casual
partner, get tested to detect the infection and prevent onwards
transmission.
Professor Matt Phillips, President of the British Association for
Sexual Health and HIV, said:
The rise of antibiotic-resistant gonorrhoea infections in England
is a worrying trend that must be addressed with immediate action.
Antibiotic resistance of STIs poses an increasingly major public
health threat, which can create physical and psychological harms
and place additional demands on other parts of the NHS. BASHH,
alongside sector partners, has repeatedly called for a sexual
health strategy for England; this must be a priority if our
expert sexual health workforce are to effectively meet these
growing and changing needs in sexual health.
Meanwhile, the latest data from
UKHSA show that syphilis rates are still rising.
Syphilis can cause severe, irreversible, and potentially
life-threatening damage to the brain, heart, or nerves if not
treated. In 2023, diagnoses of infectious syphilis rose to 9,513,
a 9.4% increase from 2022 (8,693). The highest rates were among
gay, bisexual and other men who have sex with men, however, the
largest proportional rise between 2022 and 2023 was in
heterosexual individuals. UKHSA is also reminding healthcare
professionals to be alert to the signs of syphilis, because it
can cause a range of symptoms affecting multiple organ systems
and, without treatment, can lead to serious and permanent harm.
While the increase in gonorrhoea and syphilis diagnoses will in
part be due to increases in testing, it may also be due to more
transmission of these STIs within the population.
Both of these STIs are easy to catch and are on the rise. If you
are having condomless sex with new or casual partners, regular
testing for STIs and HIV is essential to maintain good sexual
health. Testing is free and can be accessed through local
sexual health clinics, university and college medical centres
or through self-sampling kits sent discreetly through the post.
