Neisseria Reference Laboratory and World Health Organization Collaborating Centre for STI and AMR, Sydney. New South Wales Health Pathology, Microbiology, The Prince of Wales Hospital, Randwick, NSW, 2031, Australia.
School of Medical Sciences, Faculty of Medicine, The University of New South Wales, NSW, 2052, Australia.
Commun Dis Intell (2018). 2021 Apr 30;45. doi: 10.33321/cdi.2021.45.24.
The Australian Gonococcal Surveillance Programme (AGSP), established in 1981, has continuously monitored antimicrobial resistance in clinical isolates of Neisseria gonorrhoeae for more than 40 years. In 2020, a total of 7,219 clinical isolates of gonococci from patients in the public and private sectors, in all jurisdictions, were tested for in vitro antimicrobial susceptibility by standardised methods. Current treatment recommendations for gonorrhoea, for the majority of Australia, continues to be dual therapy with ceftriaxone and azithromycin. In 2020, decreased susceptibility (DS) to ceftriaxone (minimum inhibitory concentration [MIC] value ≥ 0.06 mg/L) was found nationally in 0.9% of isolates. There was one isolate, reported from Victoria in 2020, that was resistant to ceftriaxone (MIC value ≥ 0.25 mg/L). Resistance to azithromycin (MIC value ≥ 1.0 mg/L) was found nationally in 3.9% of N. gonorrhoeae isolates, continuing a downward trend observed and reported since 2017. Isolates with high-level resistance to azithromycin (MIC value ≥ 256 mg/L) are identified sporadically in Australia; in 2020, there was one such isolate reported in Queensland. In 2020, penicillin resistance was found in 27% of gonococcal isolates nationally, and ciprofloxacin resistance in 36%; however, there is considerable variation by jurisdiction. In some remote settings, penicillin resistance remains low, and this drug continues to be recommended as part of an empiric therapy strategy. In 2020, in remote Northern Territory, no penicillin resistance was reported, and in remote Western Australia 5/116 of gonococcal isolates (4.3%) were penicillin resistant. There was one ciprofloxacin-resistant isolate reported from remote Northern Territory, and ciprofloxacin resistance rates remain comparatively low in remote Western Australia (4/116; 3.4%).
澳大利亚淋球菌监测计划（AGSP）成立于 1981 年，对淋病奈瑟菌临床分离株的抗药性进行了 40 多年的持续监测。2020 年，对所有司法管辖区内的公立和私立部门的 7219 例淋病患者的临床分离株进行了体外抗微生物药物敏感性测试，采用标准化方法。目前，澳大利亚大部分地区的淋病治疗推荐仍然是头孢曲松和阿奇霉素的双重治疗。2020 年，全国淋病奈瑟菌分离株对头孢曲松的敏感性（最低抑菌浓度 [MIC] 值≥0.06mg/L）下降，占 0.9%。2020 年，维多利亚州报告了一例对头孢曲松耐药（MIC 值≥0.25mg/L）的分离株。全国淋病奈瑟菌分离株对阿奇霉素的耐药率（MIC 值≥1.0mg/L）为 3.9%，自 2017 年以来一直呈下降趋势。澳大利亚偶尔会发现对阿奇霉素高度耐药（MIC 值≥256mg/L）的分离株；2020 年，昆士兰州报告了一例此类分离株。2020 年，全国淋病奈瑟菌分离株青霉素耐药率为 27%，环丙沙星耐药率为 36%；然而，各司法管辖区之间存在很大差异。在一些偏远地区，青霉素耐药率仍然较低，这种药物仍然被推荐作为经验性治疗策略的一部分。2020 年，在偏远的北领地没有报告青霉素耐药，在偏远的西澳大利亚，116 例淋病奈瑟菌分离株中有 5 例（4.3%）对青霉素耐药。偏远的北领地报告了一例环丙沙星耐药的分离株，偏远的西澳大利亚的环丙沙星耐药率仍然相对较低（4/116；3.4%）。
