Multi-drug resistant gonorrhea update

Advisory Alert

May 12, 2023

*Cette information est seulement disponible en anglais.

To: Local Health System Partners


Please note this is an updated Advisory Alert from our original alert sent on April 3, 2023 entitled ‘Multi-drug resistant gonorrhea identified’. Additional information was shared in the May 3, 2023 Public Health Ontario posting, ‘Detection of ceftriaxone non-susceptible Neisseria gonorrhoea in Ontario’. The post is attached to this Advisory Alert for reference.

Updates include:

Important information regarding ceftriaxone non-susceptible gonorrhea in Ontario

Recent international reports from Europe and USA have identified a multi-drug resistant strain of Neisseria gonorrhoeae. Through routine provincial disease surveillance activities, an Ontario patient with no known travel history was recently identified as having a gonorrhea infection with a similar resistance pattern. For instance, a reduced susceptibility to ceftriaxone and cefixime, as well as resistance to ciprofloxacin, penicillin, and tetracycline, which suggests circulation of this multi-drug resistant strain within Ontario. Currently, treatment with one dose of Ceftriaxone (250 mg IM) and Azithromycin (1 gm po) has been deemed effective as demonstrated by a negative test of cure.

In this context, and per the attached post, the Ministry of Health is recommending:

Current CGSTI guidance advises to re-screen persons with gonorrhea infection at 6 months post-treatment or else at the first follow-up appointment within 12 months, given risks of re-infection due to ongoing or repeat exposure.

Health care practitioners are asked to call the Sexual Health Clinic at 705.522.9200, ext. 482 (toll-free 1.866.522.9200) to report a case with multi-drug resistant gonorrhea infection, or for additional information.


Original Signed By

Dr. Penny Sutcliffe
Medical Officer of Health and Chief Executive Officer

NOTE: All Advisory Alerts are found on our website.

This item was last modified on April 4, 2024