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SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Pharmacology of Infectious Diseases
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1527128
Global Trends in Extended-Spectrum Cephalosporin Resistance in Neisseria gonorrhoeae: A Systematic Review and Meta-Analysis
Provisionally accepted- 1 Pasteur Institute of Iran (PII), Tehran, Tehran, Iran
- 2 Golestan Research Center of Psychiatry, Golestan University of Medical Sciences, Gorgan, Golestan, Iran
- 3 Kurdistan University of Medical Sciences, Sanandaj, Iran
The global emergence of antibiotic resistance in Neisseria gonorrhoeae (NG) infections poses a critical public health challenge. This study aimed to evaluate global resistance rates to extendedspectrum cephalosporins (ESCs) in N. gonorrhoeae, considering factors such as time, geography, antimicrobial susceptibility testing (AST), and resistance interpretation. A systematic review and meta-analysis of 183 studies from 64 countries revealed a weighted pooled resistance rate (WPR) of ≤ 2% for ESCs. Significant temporal variation in ESCs-resistant isolates (P ≤ 0.0001) underscores the dynamic nature of resistance development. Alarmingly, 17 out of 58 countries (29.3%) reported a concerning prevalence (>5%) of ESCs-resistant isolates. These findings emphasize the urgent need for effective antimicrobial stewardship, enhanced contact tracing, and comprehensive monitoring systems to combat antimicrobial resistance in gonococcal infections.
Keywords: Neisseria gonorrhoeae, antimicrobial resistance, third-generation extended-spectrum cephalosporin, systematic review and meta-analysis, PRISMA (preferred reporting items for systematic review and meta-analysis), Gonorrhea
Received: 12 Nov 2024; Accepted: 31 Mar 2025.
Copyright: © 2025 Sholeh, Beig, Beig and Azizian. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Khalil Azizian, Kurdistan University of Medical Sciences, Sanandaj, Iran
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