Two cases of extensively drug-resistant (XDR) infection combining ceftriaxone-resistance and high-level azithromycin resistance, France, November 2022 and May 2023.

We report two extensively drug-resistant (XDR) (NG) isolates combining high-level resistance to azithromycin and resistance to ceftriaxone, obtained in France from two heterosexual patients, one of whom returned from Cambodia. Whole genome sequencing identified MLST ST16406, the mosaic -60.001 which caused ceftriaxone resistance in the internationally spreading FC428 clone, and the A2059G mutation in the 23S rRNA gene.

Two cases of multidrug-resistant related to travel in south-eastern Asia, France, June 2019.

We report two cases of multidrug-resistant urogenital infection with ceftriaxone resistance in a heterosexual couple in south-western France who were successfully treated with a single, high dose of intramuscular ceftriaxone (1 g). Whole genome sequencing of isolate F91 identified MLST13871, NG-MAST1086, NG-STAR233. Patient history revealed the isolate F91 was most likely acquired during a trip to Cambodia and belongs to the successful multidrug-resistant FC428 Asian clone.

Multidrug-resistant failing treatment with ceftriaxone and doxycycline in France, November 2017.

We report a multidrug-resistant urogenital and pharyngeal infection with ceftriaxone resistance and intermediate resistance to azithromycin in a heterosexual woman in her 20s in France. Treatment with ceftriaxone plus doxycycline failed for the pharyngeal localisation. Whole-genome sequencing of isolate F90 identified MLST, NG-MAST ST, NG-STAR, and relevant resistance determinants.