Lahra Monica M, Enriquez Rodney P, George C R Robert
The National Neisseria Network, Australia; Neisseria Reference Laboratory and World Health Organisation Collaborating Centre for STD, 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.
The National Neisseria Network, Australia; Neisseria Reference Laboratory and World Health Organisation Collaborating Centre for STD, Sydney; New South Wales Health Pathology, Microbiology, The Prince of Wales Hospital, Randwick, NSW Australia.
Commun Dis Intell (2018). 2020 Feb 17;44. doi: 10.33321/cdi.2020.44.4.
The Australian Gonococcal Surveillance Programme (AGSP) has continuously monitored antimicrobial resistance in clinical isolates of from all states and territories since 1981. In 2018, there were 9,006 clinical isolates of gonococci from public and private sector sources tested for antimicrobial susceptibility by standardised methods. This was the highest annual total of isolates tested since the inception of the AGSP. The current treatment recommendation for gonorrhoea, for the majority of Australia, remains dual therapy with ceftriaxone and azithromycin. Decreased susceptibility to ceftriaxone (minimum inhibitory concentration (MIC) value ≥0.06 mg/L) was found nationally in 1.73% of isolates. The highest proportions were reported from Tasmania and non-remote Western Australia (7.3% and 2.1% respectively). In 2018 two extensively drug-resistant isolates were reported from Queensland patients. These two isolates, with ceftriaxone MIC values of 0.50 mg/L, high-level resistance to azithromycin (MIC ≥ 256 mg/L), and resistance to penicillin and ciprofloxacin were identified and reported to the World Health Organization as isolates of international significance. Resistance to azithromycin (MIC value ≥1.0 mg/L) was found nationally in 6.2% of isolates, lower than the 9.3% reported in 2017, but more than double the proportion reported in 2015 (2.6%). The highest proportions were reported from the Australian Capital Territory (8.7%), Victoria (8.3%), and New South Wales (6.5%). High-level resistance to azithromycin (MIC value ≥256 mg/L) was reported in nine isolates nationally in 2018: four from New South Wales, three from Victoria, and two from Queensland. The proportion of isolates resistant to penicillin in non-remote Australia ranged from 8.8% in non-remote Northern Territory to 44.1% in South Australia. In remote Northern Territory penicillin resistance rates remain low (1.9%), and higher in remote Western Australia (6.5%). The proportion of isolates resistant to ciprofloxacin in non-remote Australia ranged from 10.3% in non-remote Northern Territory to 48.3% in South Australia. Ciprofloxacin resistance rates remain comparatively low in remote Northern Territory (1.9%) and remote Western Australia (4.6%).
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临床分离株中的抗菌药物耐药性。2018年，共有9006株来自公共和私营部门的淋病奈瑟菌临床分离株通过标准化方法进行了抗菌药物敏感性检测。这是AGSP启动以来年度检测分离株总数最多的一年。在澳大利亚的大部分地区，目前淋病的治疗推荐仍然是头孢曲松和阿奇霉素联合治疗。在全国范围内，1.73%的分离株对头孢曲松的敏感性降低（最低抑菌浓度（MIC）值≥0.06mg/L）。报告比例最高的是塔斯马尼亚州和西澳大利亚州非偏远地区（分别为7.3%和2.1%）。2018年，昆士兰州的患者报告了两株广泛耐药分离株。这两株分离株的头孢曲松MIC值为0.50mg/L，对阿奇霉素高度耐药（MIC≥256mg/L），并对青霉素和环丙沙星耐药，已被鉴定并作为具有国际意义的分离株报告给世界卫生组织。在全国范围内，6.2%的分离株对阿奇霉素耐药（MIC值≥1.0mg/L），低于2017年报告的9.3%，但比2015年报告的比例（2.6%）高出一倍多。报告比例最高的是澳大利亚首都领地（8.7%）、维多利亚州（8.3%）和新南威尔士州（6.5%）。2018年，全国有9株分离株对阿奇霉素高度耐药（MIC值≥256mg/L）：4株来自新南威尔士州，3株来自维多利亚州，2株来自昆士兰州。在澳大利亚非偏远地区，对青霉素耐药的分离株比例在北领地非偏远地区为8.8%，在南澳大利亚州为44.1%。在北领地偏远地区，青霉素耐药率仍然较低（1.9%），而在西澳大利亚州偏远地区则较高（6.5%）。在澳大利亚非偏远地区，对环丙沙星耐药的分离株比例在北领地非偏远地区为10.3%，在南澳大利亚州为48.3%。在北领地偏远地区和西澳大利亚州偏远地区，环丙沙星耐药率仍然相对较低（分别为1.9%和4.6%）。
