More countries report rising levels of drug-resistant gonorrhoea, warns WHO
世卫组织警告称，越来越多的国家报告耐药淋病病例上升
The World Health Organization (WHO) warns that gonorrhoea, a sexually transmitted infection, is becoming increasingly resistant to antibiotics, according to new data from its Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP), which monitors the spread of drug-resistant gonorrhoea.
世界卫生组织（WHO）警告称，根据其增强淋病抗菌药物监测计划（EGASP）的新数据，淋病（一种性传播感染）正变得对抗生素越来越耐药，该计划监测耐药淋病的传播情况。
The report highlights the need to strengthen surveillance, improve diagnostic capacity and ensure equitable access to new treatments for sexually transmitted infections (STIs). The release of the new data coincides with World Antimicrobial Resistance (AMR) Awareness Week, reinforcing the importance of global action against drug-resistant infections. EGASP, launched by WHO in 2015, collects laboratory and clinical data from sentinel sites around the world to track AMR and inform treatment guidelines.
该报告强调需要加强监测、提高诊断能力，并确保对性传播感染（STI）新治疗方法的公平获取。新数据的发布恰逢世界抗菌素耐药（AMR）意识周，进一步强调了全球行动应对耐药感染的重要性。EGASP 由世界卫生组织于2015年启动，收集来自全球哨点的实验室和临床数据，以追踪耐药性并为治疗指南提供参考。
“This global effort is essential to tracking, preventing, and responding to drug-resistant gonorrhoea and to protecting public health worldwide,” said Dr Tereza Kasaeva, Director of the WHO Department for HIV, TB, Hepatitis & STIs. “WHO calls on all countries to address the rising levels of sexually transmitted infections (STIs) and integrate gonorrhoea surveillance into national STI programmes.”
世界卫生组织（WHO）艾滋病毒、结核病、肝炎及性传播感染司司长特雷扎・卡塞瓦（Tereza Kasaeva）博士表示：“这一全球行动对于追踪、预防和应对耐药性淋病，以及保护全球公共健康至关重要。世卫组织呼吁所有国家正视性传播感染（STIs）发病率上升的问题，并将淋病监测纳入国家性传播感染防控规划。”
Between 2022 and 2024, resistance to ceftriaxone and cefixime, the primary antibiotics used to treat gonorrhoea, rose sharply from 0.8% to 5% and from 1.7% to 11% respectively, with resistant strains detected in more countries. Resistance to azithromycin remained stable at 4%, while resistance to ciprofloxacin reached 95%. Cambodia and Viet Nam reported the highest resistance rates.
2022 年至 2024 年间，治疗淋病的核心抗生素头孢曲松与头孢克肟的耐药率出现大幅攀升，前者从 0.8% 升至 5%，后者从 1.7% 升至 11%，且已有更多国家检测出相关耐药菌株。阿奇霉素的耐药率维持在 4% 的稳定水平，而环丙沙星的耐药率更是高达 95%。柬埔寨和越南报告的耐药率为全球最高。
In 2024, 12 EGASP countries in five WHO regions provided data, an increase from just four countries in 2022. This is a positive development reflecting growing commitment to track and contain drug-resistant infections in countries and regions. The countries- Brazil, Cambodia, India, Indonesia, Malawi, the Philippines, Qatar, South Africa, Sweden, Thailand, Uganda and Viet Nam reported 3615 cases of gonorrhoea.
2024 年，世卫组织五大区域的 12 个淋球菌抗菌药物耐药性强化监测规划参与国提交了相关数据，相比 2022 年仅有 4 个国家参与提交，参与国数量实现增长。这是一项积极的进展，体现出各国及各地区在追踪和防控耐药性感染方面的投入正不断加大。上述 12 个国家分别为巴西、柬埔寨、印度、印度尼西亚、马拉维、菲律宾、卡塔尔、南非、瑞典、泰国、乌干达和越南，其报告的淋病病例共计 3615 例。
Over half of all cases of symptomatic gonorrhoea in men (52%) were reported from countries in the WHO Western Pacific Region, including the Philippines (28%), Viet Nam (12%), Cambodia (9%) and Indonesia (3%). Countries of the WHO African Region accounted for 28% of cases, followed by countries in the South-East Asia Region (13%, Thailand), the Eastern Mediterranean Region (4%, Qatar) and the Region of the Americas (2%, Brazil).
在男性有症状淋病病例中，超半数（52%）来自世卫组织西太平洋区域的国家，其中菲律宾占 28%、越南占 12%、柬埔寨占 9%、印度尼西亚占 3%。世卫组织非洲区域的病例占比达 28%，紧随其后的是东南亚区域（占 13%，主要来自泰国）、东地中海区域（占 4%，主要来自卡塔尔）以及美洲区域（占 2%，主要来自巴西）。
The median patient age was 27 years (range: 12–94). Among cases, 20% were men who have sex with men, and 42% reported multiple sexual partners within the past 30 days. Eight percent reported recent antibiotic use, and 19% had travelled recently.
患者年龄中位数为 27 岁（年龄范围 12 - 94 岁）。在这些病例中，20% 为男男性行为者；42% 的患者称过去 30 天内拥有多名性伴侣；8% 的患者近期使用过抗生素；19% 的患者近期有出行经历。
Strengthening and expanding global surveillance
强化并扩大全球监控体系
In 2024, WHO advanced genomic surveillance, with nearly 3000 samples sequenced from eight countries. Landmark studies on new treatments such as zoliflodacin and gepotidacin, as well as studies on tetracycline resistance, were conducted by WHO’s Collaborating Centre on AMR in STI in Sweden, in coordination with WHO. These are helping guide future gonorrhoea control and doxycycline-based prevention (DoxyPEP) strategies.
2024 年，世卫组织（WHO）推进了基因组监测工作，从 8 个国家采集近 3000 份样本进行测序。瑞典世卫组织性传播感染（STI）抗菌药物耐药性（AMR）合作中心与世卫组织协作，开展了针对唑利氟达星（zoliflodacin）、格替沙星（gepotidacin）等新疗法的里程碑式研究，以及四环素类药物耐药性相关研究。这些研究正为未来的淋病防控及多西环素暴露后预防（DoxyPEP）策略提供指导。
EGASP continued to expand its reach in 2024, with Brazil, Côte d’Ivoire and Qatar joining the programme, and India beginning implementation and data reporting starting in 2025 under its National AIDS and Sexually Transmitted Diseases Control Programme.
2024 年，全球艾滋病战略信息规划（EGASP）的覆盖范围持续扩大 —— 巴西、科特迪瓦和卡塔尔加入该项目，印度则将自 2025 年起在其国家艾滋病和性传播疾病控制规划框架下，启动项目实施与数据报告工作。
Despite notable progress, EGASP faces challenges, including limited funding, incomplete reporting, and gaps in data from women and extragenital sites. WHO calls for urgent investment, particularly in national surveillance systems, to sustain and expand global gonococcal AMR surveillance.
尽管已取得显著进展，全球艾滋病战略信息规划（EGASP）仍面临挑战，包括资金有限、报告不完整以及女性和生殖器外部位相关数据存在缺口。世卫组织（WHO）呼吁紧急加大投入，尤其是对国家监测系统的投入，以维持并扩大全球淋病抗菌药物耐药性（AMR）监测工作。
