Lahra Monica M, Enriquez Rodney
Neisseria Reference Laboratory and World Health Organisation Collaborating Centre for STD, Sydney. Department of Microbiology, South Eastern Area Laboratory Services, The Prince of Wales Hospital, Randwick, NSW Australia.
School of Medical Sciences, Faculty of Medicine, The University of New South Wales, 2053 Australia.
Commun Dis Intell (2018). 2018;42. doi: 10.33321/cdi.2018.42.11. Epub 2018 Nov 16.
The Australian Gonococcal Surveillance Programme (AGSP) has continuously monitored antimicrobial resistance in clinical isolates of Neisseria gonorrhoeae from all states and territories since 1981. In 2016, there were 6,378 clinical isolates of gonococci from public and private sector sources tested for in vitro antimicrobial susceptibility by standardised methods. Current treatment recommendations for the majority of Australia is a dual therapeutic strategy of ceftriaxone and azithromycin. Decreased susceptibility to ceftriaxone (Minimum Inhibitory Concentration or MIC value 0.06-0.125 mg/L) was found nationally in 1.7% of isolates, similar to that reported in the AGSP Annual Report 2015 (1.8%). The highest proportions were reported from Queensland and Tasmania (3.7% and 3.6% respectively). Resistance to azithromycin (MIC value ≥1.0 mg/L) was found nationally in 5.0% of isolates, double the proportion reported in 2015. The highest proportions were reported from South Australia (19.5%), Tasmania (14.3%) and urban Western Australia (7.6%). High level resistance to azithromycin (MIC value ≥256 mg/L) was again reported in 5 strains. Nationally in 2016, 4 from Victoria and 1 in South Australia. There was no reported azithromycin resistance in remote Northern Territory. The proportion of strains resistant to penicillin in urban Australia ranged from 10.7% in the Australian Capital Territory to 41.8% in New South Wales. In rural and remote Northern Territory penicillin resistance rates remain low (3.0%). In remote Western Australia penicillin resistance rates have increased (5.3%) compared to the previous years, however, there were relatively low numbers of strains available for isolate based testing. To address this and to monitor resistance and inform treatment guidelines, widespread molecular testing for penicillin resistance in Western Australia is in place, and these data are included in the AGSP. The proportion of strains resistant to ciprofloxacin in urban Australia ranged from 16.1% in the Australian Capital Territory to 41% in South Australia. Ciprofloxacin resistance rates remain comparatively low in remote areas of the Northern Territory (3.0%) and remote areas of Western Australia (4.5%).
自1981年以来，澳大利亚淋球菌监测项目（AGSP）一直在持续监测来自所有州和领地的淋病奈瑟菌临床分离株的耐药情况。2016年，对来自公共和私营部门的6378株淋球菌临床分离株采用标准化方法进行了体外药敏试验。澳大利亚大多数地区目前的治疗建议是采用头孢曲松和阿奇霉素的双重治疗策略。在全国范围内，1.7%的分离株对头孢曲松的敏感性降低（最低抑菌浓度或MIC值为0.06 - 0.125mg/L），与《2015年AGSP年度报告》中的报告比例（1.8%）相似。昆士兰州和塔斯马尼亚州报告的比例最高（分别为3.7%和3.6%）。全国范围内，5.0%的分离株对阿奇霉素耐药（MIC值≥1.0mg/L），是2015年报告比例的两倍。南澳大利亚州（19.5%）、塔斯马尼亚州（14.3%）和西澳大利亚州城市地区（7.6%）报告的比例最高。再次报告有5株对阿奇霉素高度耐药（MIC值≥256mg/L）。2016年在全国范围内，维多利亚州有4株，南澳大利亚州有1株。北领地偏远地区未报告有阿奇霉素耐药情况。澳大利亚城市地区对青霉素耐药的菌株比例从澳大利亚首都领地的10.7%到新南威尔士州的41.8%不等。在北领地农村和偏远地区，青霉素耐药率仍然较低（3.0%）。与前几年相比，西澳大利亚州偏远地区的青霉素耐药率有所上升（5.3%），不过，可供基于分离株检测的菌株数量相对较少。为了解决这一问题并监测耐药情况以及为治疗指南提供信息，西澳大利亚州正在广泛开展青霉素耐药的分子检测，这些数据已纳入AGSP。澳大利亚城市地区对环丙沙星耐药的菌株比例从澳大利亚首都领地的16.1%到南澳大利亚州的41%不等。北领地偏远地区（3.0%）和西澳大利亚州偏远地区（4.5%）的环丙沙星耐药率仍然相对较低。
