Evidence map›Paper›PMID 42550164›Full record

ArticleThe Journal of antimicrobial chemotherapy2026

Antimicrobial resistance in Neisseria gonorrhoeae isolates at the Bangrak STIs Center, Bangkok, Thailand and WGS of antimicrobial-resistant isolates, 2018-23.

Porntip Paopang, Pongsathorn Sangprasert, Daniel Golparian, Natnaree Girdthep, Nutchaya Jintana, Supawadee Sonnak, Padchara Sangsuk, Thewarkrith Bunpan, Magnus Unemo, Rossaphorn Kittiyaowamarn

Abstract read
In one paragraph

Article in The Journal of antimicrobial chemotherapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Porntip PaopangBangrak STIs Center, Division of AIDS and STIs, Department of Disease Control, Thailand Ministry of Public Health, Nonthaburi, Thailand.
Pongsathorn SangprasertBangrak STIs Center, Division of AIDS and STIs, Department of Disease Control, Thailand Ministry of Public Health, Nonthaburi, Thailand.
Daniel GolparianWHO Collaborating Centre for Gonorrhoea and Other STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Natnaree GirdthepBangrak STIs Center, Division of AIDS and STIs, Department of Disease Control, Thailand Ministry of Public Health, Nonthaburi, Thailand.ORCID 0000-0001-6888-2108
Nutchaya JintanaBangrak STIs Center, Division of AIDS and STIs, Department of Disease Control, Thailand Ministry of Public Health, Nonthaburi, Thailand.
Supawadee SonnakBangrak STIs Center, Division of AIDS and STIs, Department of Disease Control, Thailand Ministry of Public Health, Nonthaburi, Thailand.
Padchara SangsukDepartment of Medical Technology and Clinical Pathology, Vachira Phuket Hospital, Phuket, Thailand.
Thewarkrith BunpanDepartment of Medical Technology and Clinical Pathology, Vachira Phuket Hospital, Phuket, Thailand.
Magnus UnemoWHO Collaborating Centre for Gonorrhoea and Other STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID 0000-0003-1710-2081
Rossaphorn KittiyaowamarnBangrak STIs Center, Division of AIDS and STIs, Department of Disease Control, Thailand Ministry of Public Health, Nonthaburi, Thailand.ORCID 0000-0001-9382-7776

Funding

Bangrak STIs Center, Bangkok, ThailandÖrebro County Council Research Committee and Foundation for Medical Research at Örebro University Hospital, Örebro, Sweden
6 · The paper itself

Abstract

objectivesAntimicrobial resistance (AMR) in Neisseria gonorrhoeae is a global public health concern, particularly due to increasing resistance to the last remaining monotherapy, ceftriaxone, in several Asian countries. We examined the AMR of gonococcal isolates obtained at the Bangrak STIs Center, Bangkok, Thailand in 2018-23, and used WGS on isolates resistant to ceftriaxone, cefixime and/or azithromycin.

methodsGenital and extragenital swabs from males, females and transgender women were cultured. Etest (five antimicrobials) and EUCAST breakpoints (v16.0), or disc diffusion method (ciprofloxacin) were used to determine AMR. WGS was performed using Illumina NextSeq 550.

resultsIn 2018-23, 765 gonococcal isolates from 739 patients were cultured. Resistance to ceftriaxone, cefixime, azithromycin, tetracycline and ciprofloxacin was 0.5%, 0.8%, 1.7%, 83.7% and 95.7%, respectively. Ceftriaxone-resistant isolates, all resistant also to cefixime, were first detected in 2023 (n = 3, 1.2%). Additional cefixime-resistant isolates were found in 2022 (n = 2, 1.4%). Azithromycin-resistant isolates first emerged in 2020 (n = 1, 0.9%) and increased to nine (3.7%) isolates in 2023. All ceftriaxone-resistant isolates contained penA-60.001, but cefixime resistance was additionally caused by penA-34.019 and penA-10.001. All azithromycin-resistant isolates had 23S rRNA mutations and/or mosaic/semi-mosaic MtrD (subunit of the MtrCDE efflux pump).

conclusionsResistance to ceftriaxone, cefixime and azithromycin has emerged in gonococcal strains circulating in Bangkok, Thailand, and resistance appears to be increasing. Resistance to these last options for monotherapy or dual therapy emphasize the need for strengthened national culture-based and genomic surveillance to prevent the spread of MDR and XDR strains in Thailand and globally, and implementation of the novel oral treatments, i.e. zoliflodacin and gepotidacin.

Indexed as

Anti-Bacterial AgentsDrug Resistance, BacterialDrug Resistance, Multiple, BacterialGonorrheaNeisseria gonorrhoeaeAzithromycinCefiximeCeftriaxoneFemaleHumansMaleMicrobial Sensitivity TestsThailandThird Generation CephalosporinsWhole Genome SequencingAnti-Bacterial AgentsAzithromycinCefiximeCeftriaxoneThird Generation Cephalosporins

Identifiers

PMID42550164
PMCPMC13435612

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.