Extensively drug-resistant (XDR) Neisseria gonorrhoeae cured with ceftriaxone 2 g intravenous monotherapy in Croatia, March 2026

Eurosurveillance 2026 Open access

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Authors: Tajana Juzbašić, Tatjana Nemeth Blažić, Nilia Volarević, Ivana Bešlić, Daniela Glažar Ivče, Ivana Ferenčak, Dragan Jurić, Ljiljana Žmak, Dolores Peruč, Susanne Jacobsson, Daniel Golparian, Ivana Božičević
+2 more Iskra Alexandra Nola, Magnus Unemo
DOI: 10.2807/1560-7917.es.2026.31.21.2600422
Cited by: 1
References: 18

Abstract

In early 2026 in Croatia, a male heterosexual patient of Croatian origin was diagnosed with extensively drug-resistant (XDR) gonorrhoea after unprotected vaginal intercourse with a Croatian female. The Neisseria gonorrhoeae HR027 isolate (genomic lineage B, MLST sequence type (ST)9903) exhibited high-level azithromycin, ceftriaxone, cefixime, benzylpenicillin, ciprofloxacin and tetracycline resistance. It had the mosaic penA -60.001 allele, and A2045G mutations in 23S rRNA. A single dose of ceftriaxone 2 g administered intravenously cured the infection. HR027 showed zoliflodacin and gepotidacin wild-type minimum inhibitory concentrations.

Fields of Study & Subjects

Reproductive tract infections research Bacterial Infections and Vaccines Syphilis Diagnosis and Treatment

Publication details

Journal / source
Eurosurveillance
Publisher
European Centre for Disease Control and Prevention (ECDC)
Volume
31
Issue
21
Publication date
28 May 2026
Language
EN