Dramatic increase in a single genotype of TRNG ciprofloxacin-resistant Neisseria gonorrhoeae isolates in men who have sex with men

In 2003, episodes of gonorrhoea caused by ciprofloxacin-resistant strains increased to 15.3% from 11% in 2002. This was coincident with a marked increase in strains characterized as serogroup WI, ciprofloxacin-resistant bearing the tetracycline resistance plasmid. Molecular typing of these strains, using Neisseria gonorrhoeae multiantigen sequence typing (NG-MAST) revealed 71% (34/48) were of the same sequence type, ST338, accounting for 4.1% (34/824) of all strains in 2003. Epidemiological data demonstrated that transmission of ST338 was associated with men who have sex with men (MSM; 23/27), acquisition within the UK (22/26) and having two or more partners in the previous three-month period (18/27). The combined use of highly discriminatory typing and epidemiological surveillance helps to identify successful transmission networks.