Gonorrhoea is becoming increasingly resistant to antibiotics, and could be untreatable in the future, health officials have warned as a report reveals a rise in super-strength cases in England.
There were 85,000 cases of gonorrhoea diagnosed in England last year, the highest level since records began in 1918. Left untreated, it can lead to serious health problems including pelvic inflammatory disease and infertility.
The vast majority of cases can be treated. But recently there has been an increase in people diagnosed with strands that are resistant to ceftriaxone, the “first line” antibiotic typically used to treat the infection.
Most of those affected were in their 20s, heterosexual, and acquired the infection abroad, though some had no travel history, according to the UK Health Security Agency (UKHSA). The public health agency confirmed there had been transmission of ceftriaxone-resistant gonorrhoea in England.
The UKHSA will publish a report on Thursday highlighting the concerning rise in antibiotic-resistant gonorrhoea infections in England, and urging people to protect themselves by using condoms.
Between June 2022 and May 2024, 15 ceftriaxone-resistant gonorrhoea cases were detected in England, according to UKHSA.
Five involved super-strength strands, which health officials said led to “extensively drug-resistant” gonorrhoea, meaning their infections were resistant to first and second-line treatments and other antibiotics.
Due to the serious nature of the drug-resistant infections, some of the 15 had to be hospitalised, and receive a cocktail of powerful drugs to prevent the gonorrhoea spreading to other parts of their body.
Before 2022, only nine cases of ceftriaxone-resistant gonorrhoea had ever been detected in England.
Dr Helen Fifer, a consultant microbiologist at the 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.”
For people having sex without condoms with new or casual partners, regular testing for STIs such as gonorrhoea is “essential” to maintain good sexual health, the UKHSA said.
Testing is free and can be accessed through local sexual health clinics, university and college medical centres or through self-sampling kits sent via the post.
Prof Matt Phillips, the president of the British Association for Sexual Health and HIV (BASHH), 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, had repeatedly called for a sexual health strategy for England, Phillips said. “This must be a priority if our expert sexual health workforce are to effectively meet these growing and changing needs in sexual health.”
The emergence of drug-resistant gonorrhoea comes amid wider concerns about rising levels of sexually transmitted infections (STIs) in England.
There were 401,800 new cases of STIs diagnosed in 2023 – a rise of 4.7% since 2022. Chlamydia cases accounted for almost half of these, with 194,970 diagnoses in 2023.
As well as 85,223 cases of gonorrhoea, there were 9,513 cases of infectious syphilis – the highest number since 1948.
While the majority of syphilis cases were diagnosed among gay and bisexual men, the UKHSA said there was a larger “proportional rise” in syphilis diagnoses among heterosexual men and women.
