Molecular antimicrobial resistance surveillance for Neisseria gonorrhoeae, Northern Territory, Australia

David M. Whiley, Ella Trembizki, Cameron Buckley, Kevin Freeman, Robert W. Baird, Miles Beaman, Marcus Chen, Basil Donovan, Ratan L. Kundu, Christopher K. Fairley, Rebecca Guy, Tiffany Hogan, John M. Kaldor, Mahdad Karimi, Athena Limnios, David G. Regan, Nathan Ryder, Jiunn Yih Su, James Ward, Monica M. Lahra

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    Neisseria gonorrhoeae antimicrobial resistance (AMR) is a globally recognized health threat; new strategies are needed to enhance AMR surveillance. The Northern Territory of Australia is unique in that 2 different first-line therapies, based primarily on geographic location, are used for gonorrhea treatment. We tested 1,629 N. gonorrhoeae nucleic acid amplification test–positive clinical samples, collected from regions where ceftriaxone plus azithromycin or amoxicillin plus azithromycin are recommended first-line treatments, by using 8 N. gonorrhoeae AMR PCR assays. We compared results with those from routine culture-based surveillance data. PCR data confirmed an absence of ceftriaxone resistance and a low level of azithromycin resistance (0.2%), and that penicillin resistance was <5% in amoxicillin plus azithromycin regions. Rates of ciprofloxacin resistance and penicillinase-producing N. gonorrhoeae were lower when molecular methods were used. Molecular methods to detect N. gonorrhoeae AMR can increase the evidence base for treatment guidelines, particularly in settings where culture-based surveillance is limited.

    Original languageEnglish
    Pages (from-to)1478-1485
    Number of pages8
    JournalEmerging Infectious Diseases
    Issue number9
    Publication statusPublished - 1 Sep 2017


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