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.
Bibliographical noteFunding Information:
This study was conducted as part of the Gonorrhoea Resistance Assessment by Nucleic Acid Detection study funded by the National Health and Medical Research Council (APP1025517), and the reference work of the National Neisseria Network, Australia, which is funded by the Australian Government Department of Health. Funding was also provided by the Australian Infectious Diseases Research Centre. D.W. is a recipient of a National Health and Medical Research Council fellowship.
D.W. reports research funding from SpeeDx Pty Ltd. M.C. is principal investigator on a gonorrhoea treatment trial funded by Cempra.
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