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Meningococcal B Vaccine to Prevent <i>Neisseria gonorrhoeae</i> Infection.

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Australian Gonococcal Surveillance Programme Annual Report, 2019.

Monica M Lahra1, Masoud Shoushtari2, C R Robert George3

  • 1Neisseria Reference Laboratory and World Health Organization Collaborating Centre for STI and AMR, Sydney; New South Wales Health Pathology, Microbiology, The Prince of Wales Hospital, Randwick, NSW, 2031, Australia; School of Medical Sciences, Faculty of Medicine, The University of New South Wales, NSW, 2052, Australia.

Communicable Diseases Intelligence (2018)
|July 16, 2020
PubMed
Summary

Antimicrobial resistance in Neisseria gonorrhoeae remains a concern, with low but present rates of ceftriaxone and azithromycin resistance nationally. Penicillin resistance varies significantly by region, with some remote areas showing minimal resistance.

Keywords:
Neisseria gonorrhoeaeantimicrobial resistancedisease surveillancegonococcal infection

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • The Australian Gonococcal Surveillance Programme (AGSP) has monitored antimicrobial resistance in Neisseria gonorrhoeae since 1981.
  • Gonorrhoea treatment guidelines recommend dual therapy with ceftriaxone and azithromycin for most of Australia.

Observation:

  • In 2019, 9,668 clinical isolates were tested for antimicrobial susceptibility.
  • Nationally, 1.3% of isolates showed decreased susceptibility to ceftriaxone (MIC ≥ 0.06 mg/L).
  • Five isolates were ceftriaxone-resistant (MIC ≥ 0.25 mg/L), all resistant to penicillin and ciprofloxacin, but susceptible to azithromycin.

Findings:

  • Azithromycin resistance (MIC ≥ 1.0 mg/L) was observed in 4.6% of isolates, continuing a downward trend.
  • High-level azithromycin resistance (MIC ≥ 256 mg/L) was sporadically detected in eight isolates.
  • Penicillin resistance affected 22.1% of isolates nationally, with significant jurisdictional variation.
  • Remote areas, such as the Northern Territory, reported no penicillin resistance.

Implications:

  • Continued surveillance is crucial to track evolving resistance patterns in Neisseria gonorrhoeae.
  • The emergence of ceftriaxone-resistant strains necessitates careful monitoring and potential treatment guideline adjustments.
  • Regional variations in penicillin resistance suggest its continued utility as empiric therapy in specific remote settings.