Lahra Monica M, Enriquez Rodney, George C R Robert
Neisseria Reference Laboratory and World Health Organisation Collaborating Centre for STI and AMR, Sydney. New South Wales Health Pathology, Microbiology, 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). 2019 Apr 15;43. doi: 10.33321/cdi.2019.43.13.
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 2017, there were 7,835 clinical isolates of gonococci from public and private sector sources tested for in vitro antimicrobial susceptibility by standardised methods. Current treatment recommendations for gonorrhoea 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 1.06% of isolates, which is lower than that reported in the AGSP Annual Report 2016 (1.7%). The highest proportions were reported from Victoria and Western Australia (urban and rural) (2.1% and 1.4% respectively). Resistance to azithromycin (MIC value ≥1.0 mg/L) was found nationally in 9.3% of isolates, which is approximately double the proportion reported in 2016 (5.0%) and more than three times the proportion reported in 2015 (2.6%). The highest proportions were reported from Victoria (13.5%), South Australia (12.8%) and New South Wales (9.3%). High level resistance to azithromycin (MIC value ≥256 mg/L) was reported in 4 strains nationally in 2017, 2 from Victoria, one from New South Wales, and one from Queensland. The proportion of strains resistant to penicillin in non-remote Australia ranged from 10.3% in non-remote Northern Territory to 44.1% in Tasmania. In remote Northern Territory, penicillin resistance rates remain low (2.5%). In remote Western Australia, penicillin resistance rates continue to increase (6.7%) compared to the previous years, however, there were relatively low numbers of strains available for isolate based testing (n=12). 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 non-remote Australia ranged from 17.2% in non-remote Northern Territory to 61% in Tasmania. Ciprofloxacin resistance rates remain comparatively low in remote Northern Territory (1.3%) and remote Western Australia (5.0%).
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中的抗菌药物耐药性。2017年，对来自公共和私营部门的7835株淋球菌临床分离株采用标准化方法进行了体外抗菌药物敏感性检测。澳大利亚大部分地区目前针对淋病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，1.06%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），这一比例低于《2016年AGSP年度报告》中报告的比例（1.7%）。报告比例最高的是维多利亚州和西澳大利亚州（城市和农村）（分别为2.1%和1.4%）。在全国范围内，9.3%的分离株对阿奇霉素耐药（MIC值≥1.0mg/L），这一比例约为2016年报告比例（5.0%）的两倍，是2015年报告比例（2.6%）的三倍多。报告比例最高的是维多利亚州（13.5%）、南澳大利亚州（12.8%）和新南威尔士州（9.3%）。2017年在全国范围内有4株菌株对阿奇霉素呈现高水平耐药（MIC值≥256mg/L），2株来自维多利亚州，1株来自新南威尔士州，1株来自昆士兰州。在澳大利亚非偏远地区，对青霉素耐药的菌株比例从北领地非偏远地区的10.3%到塔斯马尼亚州的44.
