{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T18:34:19Z","timestamp":1767897259083,"version":"3.49.0"},"reference-count":13,"publisher":"CSIRO Publishing","issue":"5","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":4368,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,10,14]]},"abstract":"<jats:p>Emerging antimicrobial resistance within Neisseria gonorrhoeae (NG) is a significant global public health threat. Detection and investigation of treatment failures is a crucial component of the World Health Organisation\u2019s response to this challenge. We report the cases of two homosexual men, both treated for pharyngeal NG with 500 mg intramuscular ceftriaxone, in whom a test of cure 1 week after treatment showed persisting infection. Both men denied further sexual activity. In the first case, treatment failure was confirmed, since the isolates before and after treatment were identical by auxotype, antibiogram, multilocus sequence type (MLST) and multi-antigen sequence type (NG-MAST). In the second case, the MLSTs before and after treatment were identical, but NG-MAST results were similar but not indistinguishable. These cases underline the importance of test-of-cure and molecular investigations in identifying treatment failure, but also highlight the complexity of distinguishing treatment failure from reinfection when relying on highly variable molecular targets that may be subject to drug pressure.<\/jats:p>","DOI":"10.1071\/sh13077","type":"journal-article","created":{"date-parts":[[2013,9,13]],"date-time":"2013-09-13T02:05:14Z","timestamp":1379037914000},"page":"460-462","source":"Crossref","is-referenced-by-count":48,"title":["One confirmed and one suspected case of pharyngeal gonorrhoea treatment failure following 500\u2009mg ceftriaxone in Sydney, Australia"],"prefix":"10.1071","volume":"10","author":[{"given":"Phillip J.","family":"Read","sequence":"first","affiliation":[{"name":"ASydney Sexual Health Centre, GPO Box 1614, Sydney, NSW 2001, Australia."},{"name":"BThe Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia."},{"name":"FCorresponding author. Email: phillip.read@sesiahs.health.nsw.gov.au"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. Athena","family":"Limnios","sequence":"additional","affiliation":[{"name":"CWorld Health Organisation Collaborating Centre for STDs, Prince of Wales Hospital, Sydney, NSW 2031, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"McNulty","sequence":"additional","affiliation":[{"name":"ASydney Sexual Health Centre, GPO Box 1614, Sydney, NSW 2001, Australia."},{"name":"DSchool of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Whiley","sequence":"additional","affiliation":[{"name":"EQueensland Paediatric Infectious Diseases Laboratory, Queensland Children\u2019s Medical Research Institute, The University of Queensland, Brisbane, Qld 4006, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica M.","family":"Lahra","sequence":"additional","affiliation":[{"name":"CWorld Health Organisation Collaborating Centre for STDs, Prince of Wales Hospital, Sydney, NSW 2031, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2013,9,13]]},"reference":[{"issue":"9","key":"2025102617082248700_R1","doi-asserted-by":"publisher","first-page":"2059","DOI":"10.1093\/jac\/dks188","article-title":"The ticking time bomb: escalating antibiotic resistance in Neisseria gonorrhoeae is a public health disaster in waiting.","volume":"67","author":"Whiley","year":"2012","journal-title":"J Antimicrob Chemother"},{"issue":"43","key":"2025102617082248700_R2","doi-asserted-by":"crossref","first-page":"19 998","DOI":"10.2807\/ese.16.43.19998-en","article-title":"First Neisseria gonorrhoeae strain with resistance to cefixime causing gonorrhoea treatment failure in Austria, 2011.","volume":"16","author":"Unemo","year":"2011","journal-title":"Euro Surveill"},{"issue":"31","key":"2025102617082248700_R3","first-page":"590","article-title":"Update to CDC\u2019s sexually transmitted diseases treatment guidelines, 2010: oral cephalosporins no longer a recommended treatment for gonococcal infections.","volume":"61","author":"Centres for Disease Control and Prevention","year":"2012","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025102617082248700_R4","doi-asserted-by":"publisher","first-page":"3538","DOI":"10.1128\/AAC.00325-11","article-title":"Is Neisseria gonorrhoeae initiating a future era of untreatable gonorrhea? Detailed characterization of the first strain with high-level resistance to ceftriaxone.","volume":"55","author":"Ohnishi","year":"2011","journal-title":"Antimicrob Agents Chemother"},{"key":"2025102617082248700_R5","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1128\/AAC.05760-11","article-title":"High-level cefixime- and ceftriaxone-resistant Neisseria gonorrhoeae in Europe (France): novel penA mosaic allele in a successful international clone causes treatment failure.","volume":"56","author":"Unemo","year":"2012","journal-title":"Antimicrob Agents Chemother"},{"key":"2025102617082248700_R6"},{"key":"2025102617082248700_R7","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/1741-7007-5-35","article-title":"Species status of Neisseria gonorrhoeae: evolutionary and epidemiological inferences from multilocus sequence typing.","volume":"5","author":"Bennett","year":"2007","journal-title":"BMC Biol"},{"issue":"8","key":"2025102617082248700_R8","doi-asserted-by":"publisher","first-page":"1497","DOI":"10.1086\/383047","article-title":"Rapid sequence-based identification of gonococcal transmission clusters in a large metropolitan area.","volume":"189","author":"Martin","year":"2004","journal-title":"J Infect Dis"},{"issue":"9","key":"2025102617082248700_R9","doi-asserted-by":"publisher","first-page":"3111","DOI":"10.1128\/AAC.00306-07","article-title":"Diversity of penA alterations and subtypes in Neisseria gonorrhoeae strains from Sydney, Australia, that are less susceptible to ceftriaxone.","volume":"51","author":"Whiley","year":"2007","journal-title":"Antimicrob Agents Chemother"},{"issue":"6","key":"2025102617082248700_R10","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1093\/jac\/dkt017","article-title":"Failure of 500 mg of ceftriaxone to eradicate pharyngeal gonorrhoea.","volume":"68","author":"Chen","year":"2013","journal-title":"Aust J Antimicrob Chemother"},{"key":"2025102617082248700_R11","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1099\/jmm.0.007641-0","article-title":"Two cases of failed ceftriaxone treatment in pharyngeal gonorrhoea verified by molecular microbiological methods.","volume":"58","author":"Tapsall","year":"2009","journal-title":"J Med Microbiol"},{"key":"2025102617082248700_R12","unstructured":"World Health Organization (WHO), Department of Reproductive Health and Research. Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae. Geneva: WHO; 2012. Available online at: http:\/\/whqlibdoc.who.int\/publications\/2012\/9789241503501_eng.pdf [verified January 2013]."},{"key":"2025102617082248700_R13","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1258\/ijsa.2011.011267","article-title":"UK national guideline for the management of gonorrhoea in adults, 2011.","volume":"22","author":"Bignell","year":"2011","journal-title":"Int J STD AIDS"}],"container-title":["Sexual Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/10\/5\/460\/1254714\/sh13077.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/10\/5\/460\/1254714\/sh13077.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:08:27Z","timestamp":1761512907000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/sh\/article\/10\/5\/460\/184886\/One-confirmed-and-one-suspected-case-of-pharyngeal"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,9,13]]},"references-count":13,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2013,10,14]]}},"URL":"https:\/\/doi.org\/10.1071\/sh13077","relation":{},"ISSN":["1448-5028","1449-8987"],"issn-type":[{"value":"1448-5028","type":"print"},{"value":"1449-8987","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,9,13]]}}}