Drug-resistant gonorrhea spreading locally across Europe, ECDC warns
Antibiotic-resistant gonorrhea is establishing local transmission chains in Europe, threatening to exhaust current treatment options as infections hit record highs.
Europe is experiencing a shift in antibiotic-resistant gonorrhea, with cases moving from isolated travel-related imports to established local transmission networks. The European Centre for Disease Prevention and Control (ECDC) reported significant increases in France, Germany, Sweden and the United Kingdom since 2025. Local transmission of drug-resistant gonorrhoea in Europe is a “warning sign we should not ignore,” said Csaba Ködmön, an ECDC microbiology expert.
Confirmed cases of the sexually transmitted infection reached 106,331 in 2024, the highest figure recorded since EU surveillance began in 2009. Over the last decade, notification rates have surged by 303%. The ECDC noted that expanded screening and better reporting contribute to these higher numbers, though actual transmission is also rising. Globally, an estimated 82 million new infections occur each year among people aged 15 to 49.
The public health and economic burden of untreated gonorrhoea is severe, potentially leading to pelvic inflammatory disease, infertility and ectopic pregnancy. Current treatments rely heavily on ceftriaxone, often combined with azithromycin, but the Neisseria gonorrhoeae bacterium is increasingly evading both drugs. “While the risk to the general population is currently low, growing resistance reduces the effectiveness of the therapies we rely on today,” Ködmön warned. A sustained spread of untreatable strains would place a heavier burden on European healthcare systems and demand costly new pharmaceutical interventions.
While Southeast Asian nations like Cambodia, Indonesia, Thailand and Vietnam remain the principal sources of ceftriaxone-resistant strains entering Europe, the continent is now sustaining its own outbreaks. Between 2023 and 2024, overall infection rates rose driven by a 7.9% increase among men, even as rates dropped 8.6% among women. Men aged 25 to 34 and women aged 20 to 24 recorded the highest rates, with men who have sex with men accounting for 62% of reported cases.
The ECDC assesses the risk to the general sexually active population as low, rising to moderate for those travelling to high-circulation areas or having condomless sex with new partners. However, health officials caution that the rising number of local detections likely represents an early phase of expansion. Without sustained control measures, the agency warned of further escalation across the continent.
