Antibiotic-resistant gonorrhoea surge in England, UKHSA advocates for regular STI testing

Over 85,000 gonorrhoea diagnoses were reported in England last year, the highest number since records began in 1918

“Gonorrhoea is becoming increasingly resistant to antibiotics, risking the possibility of it becoming untreatable in the future,” Dr Helen Fifer, Consultant Microbiologist at UK Health Security Agency (UKHSA) has warned.

Dr Fifer highlighted that untreated gonorrhoea can lead to serious health issues, including pelvic inflammatory disease and infertility.

New data from the UKHSA revealed that between June 2022 and May 2024, 15 ceftriaxone-resistant gonorrhoea cases were detected in England.

Ceftriaxone is the ‘first line’ antibiotic used to treat gonorrhoea in the UK, and resistance to this drug can complicate treatment, especially for infections in the throat.

Among these cases, five were identified as extensively drug-resistant, meaning they were resistant to both first- and second-line treatment options and other antibiotics.

A total of 31 ceftriaxone-resistant cases have been recorded since the first case was detected in England in 2015.

All detected cases have been among heterosexual individuals, primarily in their 20s, with most infections acquired abroad.

While local transmission in England has been limited, the UKHSA has raised concerns about potential wider spread and increased treatment challenges, given the increasing number of cases in recent years.

UKHSA data also revealed that over 85,000 gonorrhoea cases were reported in England in 2023, the highest number since records began in 1918.

With these rising figures, the UKHSA has emphasised the importance of regular STI testing, especially for individuals who have had unprotected sex with new or casual partners.

Dr Fifer said: “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 (BASHH), expressed concern about the growing trend of antibiotic-resistant gonorrhea infections in England, highlighting the need for immediate action to address it.

He said: “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.”

Additionally, the rise in syphilis cases continues to be a significant concern. The latest UKHSA data showed that diagnoses of infectious syphilis increased to 9,513 in 2023, marking a 9.4 per cent rise from 2022 ((8,693).

This sexually transmitted bacterial infection can cause severe, irreversible, and potentially life-threatening damage to the brain, heart, or nerves if not treated.

While the highest rates were observed among gay, bisexual, and other men who have sex with men, the largest proportional increase between 2022 and 2023 was recorded in heterosexual individuals.

The UKHSA noted that while part of the increase in gonorrhoea and syphilis diagnoses may be attributed to expanded testing, there may also be more transmission of these STIs within the population.