Rise of Neisseria gonorrhoeae with mosaic penA-34, France, 2018-2023.

Surveillance of antimicrobial resistance in Neisseria gonorrhoeae was conducted in France from 2018 to 2023. The proportion of isolates with cefixime MIC ≥ 0.032 mg/L increased from 8.1% in 2018-2022 to 23.5% in 2023. This sharp rise was driven by the expansion of two clones, ST1580 and ST16676, carrying the mosaic penA-34.001 and penA-34.007 alleles, respectively. These findings highlight the essential role of genomic surveillance in monitoring the evolution of resistance determinants in N. gonorrhoeae.