Abstract
We report four confirmed autochthonously transmitted gonorrhoea cases in Germany in 2025, with Neisseria gonorrhoeae isolates exhibiting high-level azithromycin and cefixime resistance. Regarding ceftriaxone, isolates were susceptible for two cases and resistant for two, rendering the later extensively drug-resistant (XDR-NG). Cases, all heterosexual males, were in their late teens to mid-60s. Three isolates were MLST ST18091, with the mosaic penA-60.001 allele and the 23S rRNA A2045G mutation and were related to an XDR-NG detected in the United Kingdom in 2024.