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Australian Gonococcal Surveillance Programme Annual Report, 2020.

Monica M Lahra1,2, Tiffany R Hogan1, Masoud Shoushtari1

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Communicable Diseases Intelligence (2018)
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PubMed
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The Australian Gonococcal Surveillance Programme tracked Neisseria gonorrhoeae antimicrobial resistance in 2020. While resistance to azithromycin is decreasing, ceftriaxone resistance remains low, though penicillin and ciprofloxacin resistance vary by region.

Keywords:
Neisseria gonorrhoeaeantimicrobial resistancedisease surveillancegonococcal infection

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Public Health

Background:

  • The Australian Gonococcal Surveillance Programme (AGSP) has monitored antimicrobial resistance in Neisseria gonorrhoeae for over 40 years.
  • Gonorrhoea treatment guidelines in Australia primarily recommend dual therapy with ceftriaxone and azithromycin.

Purpose of the Study:

  • To report on the in vitro antimicrobial susceptibility of Neisseria gonorrhoeae clinical isolates in Australia for 2020.
  • To assess current resistance trends for key antimicrobial agents used in gonorrhoea treatment.

Main Methods:

  • Standardised antimicrobial susceptibility testing was performed on 7,219 clinical isolates of Neisseria gonorrhoeae.
  • Data were collected from public and private sectors across all Australian jurisdictions.

Main Results:

  • Nationally, 0.9% of isolates showed decreased susceptibility to ceftriaxone (MIC ≥ 0.06 mg/L), with one isolate resistant (MIC ≥ 0.25 mg/L).
  • Azithromycin resistance was 3.9%, continuing a downward trend since 2017; high-level resistance was rare.
  • Penicillin resistance was 27% and ciprofloxacin resistance was 36% nationally, with significant jurisdictional variations. Remote areas showed lower resistance rates for these agents.

Conclusions:

  • Current gonorrhoea treatment regimens remain largely effective, with low rates of ceftriaxone resistance and decreasing azithromycin resistance.
  • Antimicrobial resistance patterns for Neisseria gonorrhoeae necessitate ongoing surveillance, particularly in remote settings where older drugs may still be viable treatment options.