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Molecular Antimicrobial Resistance Surveillance for Neisseria gonorrhoeae, Northern Territory, Australia. 2017
David M Whiley, and
Ella Trembizki, and
Cameron Buckley, and
Kevin Freeman, and
Robert W Baird, and
Miles Beaman, and
Marcus Chen, and
Basil Donovan, and
Ratan L Kundu, and
Christopher K Fairley, and
Rebecca Guy, and
Tiffany Hogan, and
John M Kaldor, and
Mahdad Karimi, and
Athena Limnios, and
David G Regan, and
Nathan Ryder, and
Jiunn-Yih Su, and
James Ward, and
Monica M Lahra
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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