High prevalence of tetracycline resistance in Neisseria gonorrhoeae across 22 European countries, 2024.

In 2024, based on the European Committee on Antimicrobial Susceptibility Testing breakpoint, we observed a tetracycline resistance prevalence of 62.3% (2,231/3,579) in Neisseria gonorrhoeae isolates from 22 European countries (range: 16.5-100%). Multivariable analysis of correlations between resistance and patients' epidemiological characteristics found tetracycline resistance associated with men who have sex with men (aOR: 1.38; 95% CI: 1.06-1.79). Our results are important when considering measures against transmission of sexually transmitted bacterial infections in Europe, such as in the context of doxycycline post-exposure prophylaxis (doxy-PEP).