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

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Australian Gonococcal Surveillance Programme Annual Report, 2022.

Monica M Lahra1, Sebastiaan Van Hal2, Tiffany R Hogan3

  • 1Neisseria Reference Laboratory and World Health Organization Collaborating Centre for STI and AMR, Sydney. NSW 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. monica.lahra@health.nsw.gov.au.

Communicable Diseases Intelligence (2018)
|October 11, 2023
PubMed
Summary

The Australian Gonococcal Surveillance Programme reports increasing high-level azithromycin resistance in Neisseria gonorrhoeae. While ceftriaxone susceptibility remains high, widespread penicillin and ciprofloxacin resistance necessitates ongoing surveillance for effective gonorrhoea treatment.

Keywords:
antimicrobial resistancedisease surveillancegonococcal infectionNeisseria gonorrhoeae

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance Surveillance

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 isolates in Australia for 2022.
  • To assess trends in resistance to key antibiotics used in gonorrhoea treatment.

Main Methods:

  • Testing of 8,199 Neisseria gonorrhoeae isolates from public and private sectors across all Australian jurisdictions.
  • Standardised methods were employed to determine in vitro antimicrobial susceptibility.

Main Results:

  • 0.51% of isolates showed decreased susceptibility to ceftriaxone (MIC ≥ 0.125 mg/L).
  • Azithromycin resistance was 3.9%, with a record nine isolates exhibiting high-level resistance (MIC ≥ 256 mg/L).
  • Penicillin resistance was 38.8% and ciprofloxacin resistance was 63.3%, with significant jurisdictional variations, particularly lower rates in some remote settings.

Conclusions:

  • While ceftriaxone susceptibility remains generally high, the increasing number of high-level azithromycin resistance cases is concerning.
  • Widespread resistance to penicillin and ciprofloxacin continues, although lower rates persist in specific remote areas.
  • Ongoing surveillance is crucial to guide effective gonorrhoea treatment strategies in Australia.