{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T05:54:33Z","timestamp":1781848473520,"version":"3.54.5"},"reference-count":12,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gonococcal resistance in England and Wales has been monitored since 2000 by the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP). Here we present the findings from the 2024 sentinel data and describe the recent trends in gonococcal susceptibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Consecutive\n                      <jats:italic toggle=\"yes\">N. gonorrhoeae<\/jats:italic>\n                      isolates from 22 clinics, collected during August-September 2024, were sent by participating laboratories to the UK Health Security Agency (UKHSA) STI Reference Laboratory (STIRL) for antimicrobial susceptibility testing. Data are linked to the national STI surveillance system and further supplemented by participating sexual health clinics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">N. gonorrhoeae<\/jats:italic>\n                      remains highly susceptible to the first-line treatment, ceftriaxone, with just 1.7% of isolates (25\/1,512) having reduced susceptibility (MIC &gt;0.03 mg\/L); 3.1% of isolates were resistant to the oral alternative treatment, cefixime (MIC &gt;0.125 mg\/L). Reduced susceptibility to azithromycin (ECOFF &gt;1 mg\/L) was 13.6%; however, most isolates (87.9%) had an azithromycin MIC of 2 mg\/L, immediately above the ECOFF. Most isolates (90.6%) were resistant to tetracycline (MIC &gt;0.5 mg\/L). A quarter of isolates (25.9%) were resistant to penicillin (MIC &gt;1 mg\/L), nearly double that the proportion in the previous year. Ciprofloxacin susceptibility was predicted from genomic data; resistance decreased from 58.7 in 2023 to 46.4%. Prescribing data demonstrated excellent adherence to the UK guideline for managing infection with\n                      <jats:italic toggle=\"yes\">N. gonorrhoeae<\/jats:italic>\n                      , with 97.0% of individuals receiving the recommended first-line of ceftriaxone 1g intramuscular monotherapy in 2024.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Cefixime resistance and azithromycin reduced susceptibility levels are concerning and may have implications for their use as second-line treatments in the future. Most isolates were resistant to tetracycline, supporting limited expectations for doxyPEP in reducing\n                      <jats:italic toggle=\"yes\">N. gonorrhoeae<\/jats:italic>\n                      incidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09564624261443879","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T21:19:07Z","timestamp":1776374347000},"page":"870-875","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Antimicrobial resistance in Neisseria gonorrhoeae in England and Wales; findings from the gonococcal resistance to antimicrobials surveillance programme (GRASP 2024)"],"prefix":"10.1177","volume":"37","author":[{"given":"Suzy","family":"Sun","sequence":"first","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1107-8177","authenticated-orcid":false,"given":"Prarthana","family":"Narayanan","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Jansen van Rensburg","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Vickers","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandhya","family":"Vivekanand","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penelope","family":"Cliff","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Pitt-Kendall","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"David","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella","family":"Breese","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Callan","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle J","family":"Cole","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamish","family":"Mohammed","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"},{"name":"Population Health Sciences, The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency"},{"name":"University College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katy","family":"Sinka","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Alexander","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7756-403X","authenticated-orcid":false,"given":"Helen","family":"Fifer","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"GRASP Collaborators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053273"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/09564624251345195"},{"key":"e_1_3_5_4_2","volume-title":"Supplementary information: prediction of ciprofloxacin resistance from whole-genome sequencing data","author":"UK Health Security Agency","year":"2025","unstructured":"UK Health Security Agency. Supplementary information: prediction of ciprofloxacin resistance from whole-genome sequencing data: UKHSA; 2025 [cited 2025 Nov 18]. Available from: https:\/\/www.gov.uk\/government\/publications\/gonococcal-resistance-to-antimicrobials-surveillance-programme-grasp-report"},{"key":"e_1_3_5_5_2","unstructured":"EUCAST. Clinical breakpoint tables. [Online]: EUCAST; [Accessed 2025]. Available from:https:\/\/www.eucast.org\/bacteria\/clinical-breakpoints-and-interpretation\/clinical-breakpoint-tables\/"},{"key":"e_1_3_5_6_2","unstructured":"UK Health Security Agency. GUMCAD STI surveillance system [Online]. 2025 [Accessed 2025]. Available from:https:\/\/www.gov.uk\/guidance\/gumcad-sti-surveillance-system"},{"key":"e_1_3_5_7_2","unstructured":"UK Health Security Agency. Gonococcal resistance to antimicrobials surveillance programme (GRASP) protocol. [Online]. [Accessed 2025]. Available from: https:\/\/www.gov.uk\/government\/publications\/gonococcal-resistance-to-antimicrobials-surveillance-programme-grasp-protocol"},{"key":"e_1_3_5_8_2","volume-title":"GRASP report: data to September 2025","author":"UK Health Security Agency","year":"2025","unstructured":"UK Health Security Agency. GRASP report: data to September 2025: UKHSA, 2025. [Accessed 2025]. Available from: https:\/\/www.gov.uk\/government\/publications\/gonococcal-resistance-to-antimicrobials-surveillance-programme-grasp-report"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7312a2"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlae053"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2022.27.50.2200899"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkae369"},{"key":"e_1_3_5_13_2","volume-title":"Quarterly report on diagnosis of syphilis, gonorrhoea and ceftriaxone-resistant gonorrhoea in England: provisional data","author":"UK Health Security Agency","year":"2026","unstructured":"UK Health Security Agency. Quarterly report on diagnosis of syphilis, gonorrhoea and ceftriaxone-resistant gonorrhoea in England: provisional data, 2026. https:\/\/www.gov.uk\/government\/publications\/sti-quarterly-surveillance-reports-provisional-data\/quarterly-report-on-diagnoses-of-syphilis-gonorrhoea-and-ceftriaxone-resistant-gonorrhoea-in-england-provisional-data-march-2026."}],"container-title":["International Journal of STD &amp; AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624261443879","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09564624261443879","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624261443879","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T05:46:23Z","timestamp":1781847983000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09564624261443879"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,16]]},"references-count":12,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/09564624261443879"],"URL":"https:\/\/doi.org\/10.1177\/09564624261443879","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,16]]}}}