We identified a case of extensively drug-resistant (ceftriaxone- and cefixime-resistant and high-level azithromycin-resistant) Neisseria gonorrhoeae in Canada. The strain harbors the penA 60.001 allele, which includes the A311V and 23S rRNA A2059G single-nucleotide polymorphisms associated with high-level azithromycin resistance. The infection was likely acquired during travel in Cambodia.
Keywords: Canada; Neisseria gonorrhoeae; antimicrobial resistance; antimicrobial susceptibility surveillance; bacteria; cefixime; cefixime-resistant; ceftriaxone; ceftriaxone-resistant; gonorrhea; mosaic penA allele; penA-60; sexually transmitted infections.