Neisseria gonorrhoeae is an etiologic agent of gonorrhoea, one of the most common sexually transmitted diseases caused by bacteria. For many years, infections caused by N. gonorrhoeae were considered to be relatively easy to treat; however, resistance has emerged successively to all therapeutic agents used in treatment of the disease, e.g., penicillin, ciprofloxacin or azithromycin. Currently, the global problem is the emergence and a threat of spread of N. gonorrhoeae strains resistant to extended-spectrum cephalosporins (ESC), such as injectable ceftriaxone and oral-used cefixime. Especially, dangerous are multi-resistant strains resistant simultaneously to ESC and azithromycin. Three strains with high-level resistance to azithromycin and resistant to ESC were first time isolated in 2018. Moreover, in 2018, the first ESBL was described in N. gonorrhoeae and that makes the threat of appearing the ESBL mechanism of resistance in N. gonorrhoeae more real, even though the strain was sensitive to ceftriaxone. Molecular typing revealed that variants resistant to ESC occurred also among strains belonging to epidemic clonal complex CC1 (genogroup G1407) distinguished in NG-MAST typing system. The G1407 genogroup, in particular the ST1407 sequence type, is currently dominant in most European countries. The presence of different mechanisms of drug resistance significantly affects clinical practice and force changes in treatment regimens and introduction of new drugs.

中文翻译：

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多抗淋病奈瑟菌：二十一世纪第二个十年的新威胁。

淋病奈瑟菌是淋病的病原体，淋病是细菌引起的最常见的性传播疾病之一。多年来，淋病奈瑟菌引起的感染被认为相对容易治疗。然而，对用于治疗该疾病的所有治疗剂例如青霉素，环丙沙星或阿奇霉素的抗药性相继出现。当前，全球问题是淋病奈瑟氏球菌的出现和传播威胁对广谱头孢菌素（ESC）具有抗药性的菌株，例如注射用头孢曲松钠和口服头孢克肟。尤其危险的是同时对ESC和阿奇霉素具有抗性的多重抗性菌株。2018年首次分离出三株对阿奇霉素具有高水平抗性和对ESC具有抗性的菌株。此外，2018年，淋病奈瑟氏球菌中首次发现了ESBL ，这可能会导致淋病奈瑟氏球菌出现ESBL抗性机制。更真实的，即使该菌株对头孢曲松敏感。分子分型显示在NG-MAST分型系统中区分的流行性克隆复合体CC1（基因组G1407）的菌株中也发生了对ESC的抗性变体。G1407基因组，特别是ST1407序列类型，目前在大多数欧洲国家中占主导地位。耐药机制的不同会显着影响临床实践，并会改变治疗方案和引入新药。