Maine CDC Health Advisory

February 7, 2023

Gonorrhea with Resistance or Reduced Susceptibility to Multiple Antibiotics Identified in Massachusetts

Massachusetts recently identified a novel strain of multidrug-non-susceptible Neisseria gonorrhoeae (N. gonorrhoeae) with resistance or reduced susceptibility to all drugs that are recommended for treatment in the U.S. The novel strain, identified in Massachusetts, showed reduced susceptibility to ceftriaxone, cefixime, and azithromycin and showed resistance to ciprofloxacin, penicillin, and tetracycline. This is the first isolate identified in the U.S. showing resistance or reduced susceptibility to all drugs that are recommended for treatment. This strain has the same sequence type recently identified in the United Kingdom and previously reported as circulating in Asia-Pacific countries. Identification of this novel strain is a reminder that N. gonorrhoeae is becoming less responsive to a limited arsenal of antibiotics.

While no cases of this novel strain have been reported in Maine as of today's date, gonorrhea continues to be a concern, with cases rising nationally and in Maine. Cases of gonorrhea in Maine increased 34% between 2021 (n=462) and 2022 (n=620). In 2022, rates of gonorrhea were highest for Black and African Americans, males, and persons aged 15-34 years; one-third of cases reported male-to-male sexual contact (2022 data as of February 2, 2023). The highest rate of gonorrhea in Maine was in Androscoggin County (122.5 cases per 100,000 population).

Advisory (PDF)