Ceftriaxone-resistant Neisseria gonorrhoeae, Puerto Rico

The aetiological agent of gonorrhoea has developed resistance to first-line treatments, such as sulfanilamides, penicillins, tetracyclines, macrolides, and fluoroquinolones 1 The extended-spectrum cephalosporins are now the only antibiotics recommended for treatment of gonorrhoea in the USA and many countries. 2 3 Unfortunately, susceptibility to these antimicrobials has also decreased. 4-7 This trend has made the Centers for Disease Control (CDC) to recently classify N. gonorrhoeae as an urgent public health threat. 8 We report here the first N. gonorrhoeae isolate identified with high-level resistance to the extended-spectrum cephalosporin, ceftriaxone (inhibition zone diameter=9 mm) in Puerto Rico.