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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    Abstract

    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
    Volume23
    Issue number9
    DOIs
    Publication statusPublished - 1 Sep 2017

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    Northern Territory
    Neisseria gonorrhoeae
    Azithromycin
    Ceftriaxone
    Amoxicillin
    Penicillin Resistance
    Penicillinase
    Geographic Locations
    Polymerase Chain Reaction
    Gonorrhea
    Ciprofloxacin
    Nucleic Acids
    Guidelines
    Health

    Cite this

    Whiley, D. M., Trembizki, E., Buckley, C., Freeman, K., Baird, R. W., Beaman, M., ... Lahra, M. M. (2017). Molecular antimicrobial resistance surveillance for Neisseria gonorrhoeae, Northern Territory, Australia. Emerging Infectious Diseases, 23(9), 1478-1485. https://doi.org/10.3201/eid2309.170427
    Whiley, David M. ; Trembizki, Ella ; Buckley, Cameron ; Freeman, Kevin ; Baird, Robert W. ; Beaman, Miles ; Chen, Marcus ; Donovan, Basil ; Kundu, Ratan L. ; Fairley, Christopher K. ; Guy, Rebecca ; Hogan, Tiffany ; Kaldor, John M. ; Karimi, Mahdad ; Limnios, Athena ; Regan, David G. ; Ryder, Nathan ; Su, Jiunn Yih ; Ward, James ; Lahra, Monica M. / Molecular antimicrobial resistance surveillance for Neisseria gonorrhoeae, Northern Territory, Australia. In: Emerging Infectious Diseases. 2017 ; Vol. 23, No. 9. pp. 1478-1485.
    @article{409cafc9685c4696bf628c59f397ba13,
    title = "Molecular antimicrobial resistance surveillance for Neisseria gonorrhoeae, Northern Territory, Australia",
    abstract = "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.",
    author = "Whiley, {David M.} and Ella Trembizki and Cameron Buckley and Kevin Freeman and Baird, {Robert W.} and Miles Beaman and Marcus Chen and Basil Donovan and Kundu, {Ratan L.} and Fairley, {Christopher K.} and Rebecca Guy and Tiffany Hogan and Kaldor, {John M.} and Mahdad Karimi and Athena Limnios and Regan, {David G.} and Nathan Ryder and Su, {Jiunn Yih} and James Ward and Lahra, {Monica M.}",
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    Whiley, DM, Trembizki, E, Buckley, C, Freeman, K, Baird, RW, Beaman, M, Chen, M, Donovan, B, Kundu, RL, Fairley, CK, Guy, R, Hogan, T, Kaldor, JM, Karimi, M, Limnios, A, Regan, DG, Ryder, N, Su, JY, Ward, J & Lahra, MM 2017, 'Molecular antimicrobial resistance surveillance for Neisseria gonorrhoeae, Northern Territory, Australia', Emerging Infectious Diseases, vol. 23, no. 9, pp. 1478-1485. https://doi.org/10.3201/eid2309.170427

    Molecular antimicrobial resistance surveillance for Neisseria gonorrhoeae, Northern Territory, Australia. / Whiley, David M.; Trembizki, Ella; Buckley, Cameron; Freeman, Kevin; Baird, Robert W.; Beaman, Miles; Chen, Marcus; Donovan, Basil; Kundu, Ratan L.; Fairley, Christopher K.; Guy, Rebecca; Hogan, Tiffany; Kaldor, John M.; Karimi, Mahdad; Limnios, Athena; Regan, David G.; Ryder, Nathan; Su, Jiunn Yih; Ward, James; Lahra, Monica M.

    In: Emerging Infectious Diseases, Vol. 23, No. 9, 01.09.2017, p. 1478-1485.

    Research output: Contribution to journalArticleResearchpeer-review

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    AU - Trembizki, Ella

    AU - Buckley, Cameron

    AU - Freeman, Kevin

    AU - Baird, Robert W.

    AU - Beaman, Miles

    AU - Chen, Marcus

    AU - Donovan, Basil

    AU - Kundu, Ratan L.

    AU - Fairley, Christopher K.

    AU - Guy, Rebecca

    AU - Hogan, Tiffany

    AU - Kaldor, John M.

    AU - Karimi, Mahdad

    AU - Limnios, Athena

    AU - Regan, David G.

    AU - Ryder, Nathan

    AU - Su, Jiunn Yih

    AU - Ward, James

    AU - Lahra, Monica M.

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    N2 - 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.

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