Top 5 Takeaways

  1. Growing resistance: The prevalence of antibiotic-resistant strains of Neisseria gonorrhoeae, particularly to ceftriaxone, has significantly increased in China from 2017 to 2022, with resistance to ceftriaxone approximately tripling.
  2. Geographical variation: Resistance rates varied by geographic region, with some provinces reporting more than 10% resistance to ceftriaxone, indicating a significant public health challenge.
  3. Other antibiotics also affected: Gonorrhea strains showed high levels of resistance to other antibiotics, with resistance rates up to 97.6% for some, varying by antibiotic type.
  4. Public health implications: The rise in antibiotic-resistant gonorrhea underscores the need for effective diagnosis, treatment, and prevention strategies, including antibiotic stewardship to curb the spread of resistant strains.
  5. Surveillance and strategy: Identifying the causes of the spread of ceftriaxone-resistant N. gonorrhoeae in China is crucial for developing strategies to address this issue and protect public health.

Original Article Author and Citation

Corresponding Author

Shaochun Chen,

Suggested Citation

Zhu X, Xi Y, Gong X, Chen S. Ceftriaxone-Resistant Gonorrhea — China, 2022. MMWR Morb Mortal Wkly Rep 2024;73:255–259. DOI:


This MMWR article addresses the significant increase in antibiotic-resistant strains of Neisseria gonorrhoeae in China from 2017 to 2022, emphasizing the growing concern over ceftriaxone resistance. With gonorrhea being the fourth most reported notifiable infectious disease in China, the spread of resistant strains poses a substantial public health challenge.


The study utilized data from the China Gonococcal Resistance Surveillance Program (China-GRSP), which collected 2,804 gonococcal isolates from 13 sentinel sites in 2022, representing 2.9% of all reported gonorrhea cases. The prevalence of resistance to ceftriaxone and other antibiotics was assessed using the agar dilution method.


The findings highlight a troubling increase in resistance to ceftriaxone, a key antibiotic for gonorrhea treatment, with resistance rates tripling from 2017 to 2022. The report underscores the importance of effective public health strategies, including antibiotic stewardship, to mitigate the spread of resistant gonorrhea strains.


The study calls for immediate action to address the growing threat of antibiotic-resistant gonorrhea in China. This includes enhancing surveillance, improving diagnosis and treatment protocols, and international collaboration to prevent the spread of resistant strains.


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