Annual report of the Australian Gonococcal Surveillance Programme, 1999.

The primary aim of the Australian Gonococcal Surveillance Programme (AGSP) is to monitor the antibiotic susceptibility of Neisseria gonorrhoeae. In 1999 the AGSP examined 3,740 isolates of gonococci from all States and Territories. The rates and sites of infection and antibiotic susceptibility patterns varied considerably between regions, reflecting the considerable differences between non-urban and urban gonorrhoea in Australia. Resistance to the penicillin and quinolone groups of antibiotics was highest in urban centres. Although penicillins remained suitable for use in many parts of non-urban Australia, enhanced surveillance is required as levels of resistance increase. Endemic transmission of quinolone-resistant gonococci (QRNG) in homosexually active men increased substantially in New South Wales and Victoria where more then 90% of all QRNG were found. QRNG in other centres continued to be isolated mostly from overseas travellers and at a low frequency. All isolates remained sensitive to spectinomycin and ceftriaxone. A further increase in the number of gonococcal isolates from homosexually active men was recorded in New South Wales and Victoria. Strains examined in South Australia, New South Wales and Victoria were predominantly from male patients and rectal and pharyngeal isolates were common. In other centres the male to female ratio of cases was lower, and most isolates were from the genital tract in rates similar to those occurring in previous years. The impact of non-culture based detection methods will adversely affect the ability of the AGSP to monitor trends in gonococcal disease in future years.